Legislative/Procedural Mechanisms for Changing Education Standards

[thegreypilgrim]

OK so the education horse has been bludgeoned to the point of particlization, and I think most of us are in agreement that serious changes need to be made in oder for EMS to be fully professionalized. I don't want th is thread to turn into another More Education vs. Whatever debate, however.

Now my question is what sort of pathways or steps would you have to take to actually get this done? Assume for a moment that all the nasty business of forging a new standard has largely been completed, and the remaining task consists of getting the old replaced with the new. What would have to happen? How would this work? Do you start at the federal level with NHTSA/DOT? Do you not bother with them and start at the level of your state legislature? Who, ideally, should be setting the education standards in the first place (NAEMT?)? What would be the process of getting universities to develop curricula/learning objectives for EMS programs at their respective institutions?

 

[MrBrown]

You are going to have to convince all the bottom feeding protocol sucking Parathinktheyare's and Fire unions that this is a good idea.

 

[mgr22]

I think small, pilot programs are good ways to try almost anything, but you have to be able to quantify results. For example, if I think I have a better way of teaching something, I'm going to have to measure some outcome that shows I'm right, or at least not wrong.

You're asking about moving toward professionalism. How would you measure progress? What criteria would indicate the endpoint? I think you'd have to resolve issues like those first.

 

[thegreypilgrim]

Brown & mgr22:

Those are both valid concerns of course, but for the purposes of this thread I want to basically assume that all that sort of stuff has been previously dealt with. The task I'm concerned with in this thread are the sort of "procedural" machinery that must be engaged with in order to change standards.

Do you start at the federal level or the state? Do you even want such standards encoded into statutes or do you want some professional organization like the NAEMT to develop a standard and all the states just defer to that? How do you get universities to essentially create a new degree program curriculum out of thin air?

 

[SanDiegoEmt7]

You are going to have to convince all the bottom feeding protocol sucking Parathinktheyare's and Fire unions that this is a good idea.

+1 It has to start with the hiring practices of fire departments and EMS companies. Fire services and rural ems services would lobby heavily against any such initiative seeing as they want to protect their interests, and requiring a bachelors to provide ALS services would make it very difficult for them.

There needs to be quite a bit of people already with the AAS/BS or in the process of acquiring it in the near future for a legislative mandate to occur. Legislators would have a hard time arguing for a law that would cause a major dip in employable paramedics in the 1-6 years after passing the law, unions and lobbyists would have a field day.

How do we get people to acquire BS degrees when no law mandates it, make it the minimum expected by employers. Right now the AS nursing degree still exists, but I don't know anyone going into it. They are all going in to the BSN programs, simply because respectable hospitals won't hire new RNs with an AS. These nurses receive the same pay as AS educated nurses of the past, but to them it doesn't matter because going to school for an extra 1.5 years is a better deal than looking for a good job for 3-5 years. I could see the same situation happening in EMS especially with all the paramedics I see waiting for fire jobs.

One last thought. On the education side there could be similar options to nursing schools. There could be dedicated Paramedicine degrees as well as 18 month post bachelor paramedicine programs for individuals with other bachelors degrees (with appropriate science prereqs already taken).

 

[SanDiegoEmt7]

I think small, pilot programs are good ways to try almost anything, but you have to be able to quantify results. For example, if I think I have a better way of teaching something, I'm going to have to measure some outcome that shows I'm right, or at least not wrong.

You're asking about moving toward professionalism. How would you measure progress? What criteria would indicate the endpoint? I think you'd have to resolve issues like those first.

How did the nursing and physician's assistant industries have to quantify results?

 

[Veneficus]

I think the simplest solution is to just reduce medicare/medicade reimbursements until it is no longer profitable to keep doing what we are.

At that point self educated providers could expand on what is done and ask for more reimbursement to do it.

You want to get FDs and privates in line, reduce the amount of payments until they have to choose between laying guys off or fielding an ALS unit.

 

[SanDiegoEmt7]

How do you get universities to essentially create a new degree program curriculum out of thin air?

Any university with health programs has the foundation to offer these types of degrees. Once demand is high for them (ie employers are asking for BS educated employees) more schools will start offering this type of program to attract future students.

 

[thegreypilgrim]

double post

 

[thegreypilgrim]

I think the simplest solution is to just reduce medicare/medicade reimbursements until it is no longer profitable to keep doing what we are.

At that point self educated providers could expand on what is done and ask for more reimbursement to do it.

You want to get FDs and privates in line, reduce the amount of payments until they have to choose between laying guys off or fielding an ALS unit.

Lolz, how very Bolshevist! Those not on board with the party line of the New World Order will be swept away when the revolution comes...I like it.

In all seriousness, though you're probably correct that something like this is necessary. EMS appears to be too far gone and overrun with fools to self-motivate change. It needs to be applied externally.

The rebuilding of EMS into Out-of-Hospital health, then, would begin with what though? Local projects? Sweeping reform?

 

[mgr22]

How did the nursing and physician's assistant industries have to quantify results?

I have no idea whether they did or didn't. I also don't know if they're professions. I think you'd get different definitions of "profession" from different people.

I answered a hypothetical question about making progress. I still think quantifiable criteria are better than, say, Kentucky windage.

What's your suggestion?

 

[Veneficus]

Lolz, how very Bolshevist! Those not on board with the party line of the New World Order will be swept away when the revolution comes...I like it.

I was thinking more Putinish actually.

In all seriousness, though you're probably correct that something like this is necessary. EMS appears to be too far gone and overrun with fools to self-motivate change. It needs to be applied externally.

That has been my thinking for quite some time. Since medical direction has failed to step up, I think the power of the purse seems to be all that is left.

 

[SanDiegoEmt7]

I have no idea whether they did or didn't. I also don't know if they're professions. I think you'd get different definitions of "profession" from different people.

I answered a hypothetical question about making progress. I still think quantifiable criteria are better than, say, Kentucky windage.

What's your suggestion?

It was a honest question, I wasn't in the healthcare business when they started making their push for education, so I'm not sure. But my guess would be that they didn't have to prove results to anyone, they did it simply on the basis of a bachelors educated person is more well rounded and garners more respect from colleagues.