EMT Fraud: Bad People or Flawed System?

Comment

Comment by John K. Murphy on June 27, 2010 at 11:53am

Mike

You asked this question on your blog - Why have EMS educators failed to evolve recertification requirements to the needs of providers?

The simple answer is the Medical Program Directors only allow EMT’s and Paramedics to follow existing guidelines, do not allow advances medical practices to occur in the field and the CME curriculum offered is repetitive and boring. In CME’s we focus on the stuff believed to be of value – intubations and IV’s for the Paramedic and Advanced EMT skill sets and the same old didactic material we learned 10 to 15 years ago for everyone. In those situations most Paramedics and EMT’s could pass the written evaluations asleep and the skill evaluations (IV’s and Intubations) are a waste of time.

What makes for a field savvy EMT or Paramedic is for the EMS profession to actually evaluate what our patient load looks like (more sick people than Cardiac Arrest and more home visits than Trauma) and to develop the curriculum and CME to reflect that need. The second is to have the numerous Medical Program Directors enable advanced medical care in their communities to meet the actual medical needs and not some preconceived notion that we need to squeeze the EMS system into an educational box – you can only do what you leaned in training and nothing more and we are going to repeat the same old stuff year after year.

Our profession spends years developing “NEW” curriculum through all sorts of committees mostly dominated by physicians and by the time it gets adopted, it’s old. New equipment, new drugs and new technology changes the dynamic. We are a dinosaur in the world of modern medicine and are way to slow to change.

What we need to avoid this CME scandal is a better system of educating our EMT’s and Paramedics to higher levels of care reflecting what we see in the field; STOP the number of Paramedics and EMT’s being trained (it’s a money maker for the numerous community colleges around the country and does nothing to advance our profession) and focus on the actual needs for the communities. Coupled with that is improvement of the CME programs to reflect the advance care and knowledge requirements of our providers and profession just like physicians and nurses receive in their CME’s. I have been to hundreds of medical CME’s for nurses and Physicians and very rarely do I see or hear the same thing from year to year. We need to replicate that type of CME in our profession.

We have created this monster ourselves with the boring and repetitive EMS CME. We can change this with some innovative and creative educational programs that actually advance our EMS profession. We have created the misdirected CME entrepreneurs who exchange CME’s for money and in many cases we have created the stagnation of EMS.

My suggestion is to reduce the actual numbers of EMS providers; license Paramedics to a standard that you would find in the Nurse Practitioner or Physicians Assistants disciplines and to enable all of EMS to deliver the care necessary to meet the medical needs of the community and keeping pace with education and technology.

What to do with the perpetrators of this scandal? Termination of employment and some jail time would be a good a good start and a deterrent.

Comment by Oscar Wiltse on June 26, 2010 at 10:26am

Mike -

As I'm sure you know - any live classes taken on duty in the fire/EMS station are fraught with difficulty. Everybody sits down to take ACLS recert or protocol review and then the alarm goes off and everybody leaves on calls. When they return in an hour or two - chances are the instructor just compresses the material into the remaining time available. And the Chief may get his name on the roster and still be in his office in another part of the building!

I bet the infractions that they found are just the tip of the iceberg!

Oscar Wiltse, Retired firefighter/paramedic - owiltse@comcast.net

Comment by Barry Aptt on June 25, 2010 at 9:24am

This seems to be an ongoing problem. I haven't heard of nurses falsifying their training for their CEU's, just EMS. I have seen it for years..people coming in, signing the roster and leaving, doing 45 minutes time for a 3 hour class and it goes on and on. I think both the system and the EMTS are at fault. In many ways, @ least in my state of Massachsetts, it's just a money grab to keep someone's nephew in a job. The OEMS office serves no purpose, the state is also brokn up into several regional EMS committees that operate almost autonomously, all the while following a "Statewide" treatment protocol.