Paramedic Practitioner? Masters degree and future of EMS

MedicSansBrains

If it's the PC police then I'm not home.. got it?
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We've all heard of nurse practitioners. We probably don't know exactly what their scope is or depth of their training but we do know that they are a vital part, along with PA's, to amplifying access to healthcare in the US.

We also have heard or even participated in Community Paramedic programs. They help us reduce the incidents of frequent flyers and increase the access to healthcare of undeserved and immobile patients.

So when do we take the next step and create a Master of Science in Paramedicine? Where paramedics can pursue a graduate degree and be licensed to treat more autonomously and with a larger scope in the field?

I'd like to discuss how this or something like this will/should happen and what steps are being taken now. Education is the key to advancing our field, gaining more respect, more pay, and more of a career ladder.

It would be great to have a place to go other than nursing or med school to advance our medicine and unique skill sets and applications.
 

Tigger

Dodges Pucks
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While I think this is eventually a worthy goal, I think we should first concentrate on increasing the baseline education for paramedics. It is nothing short of amazing that EMS providers are afforded any sort of respect within the medical community given that many (most?) paramedics do not even a possess a two year degree in their field of study. How can we say we need masters level practitioners providing autonomous care when we struggle with the degree of autonomy that we already hold?

It is important to not get a head of ourselves. While I would like nothing more than to eventually be able to be in some sort of graduate EMS program (masters or not), I would rather see the majority of paramedics (who serve the very vast majority of our patients) have an education that allows them to become a true part of the healthcare team.
 
OP
MedicSansBrains

MedicSansBrains

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Agreed agreed. Are there stats on how many practicing medics are without a degree?
 
OP
MedicSansBrains

MedicSansBrains

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According to LEADS II ( https://www.nremt.org/nremt/downloads/LEADSFactSheetYear2.pdf ) 60% of paramedics have received an associates degree or higher. That's an increase of 9% over last year. It's getting there. *LEADS II is sample of 1,200 medics I believe. Not as many as I'd like.

What about requiring an AAS to receive your NREMT - Paramedic? A transition over 5 years?

While I understand that many people still work as volunteers, 20% according to NREMT, but that doesn't have to hold back us setting standards for National certification.

If you want to be a volunteer paramedic you can achieve your AAS within the 5 year transition period or you can practice and be certified as an AEMT. Please no one get offended. Not saying volunteers aren't necessary or respectable. I'm sure volunteers would like the profession to advance as well.

AEMT = "LVN", EMT-P = RN in rough terms. Therefore, EMT-P requires associates. Licensed Paramedic = BSN. Paramedic Practitioner = MSN. Awesomeeeeeeeeeeee

I'd appreciate some constructive thought from my new awesome community on how we would want to progress our profession especially with thought to education and standards. Maybe we can come up with some creative solutions and game plans.
 
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Tigger

Dodges Pucks
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I don't think an AAS requirement is far off. Getting rid of non-college affiliated paramedic programs was a big step. If the NR wants to start requiring that to be eligible test, they now have that ability.

As always though, I am not suggesting that increasing degree requirements will have a direct effect on patient care. There are of course plenty of paramedics who provide great care without any sort of degree and I am not attempting to discount that. However, I still think it is important as it will somewhat increase barrier to entry in this field, will hopefully provide students with learning methods to use while furthering their practice down the road, and perhaps most importantly, will do some good in terms of EMS getting a seat at the healthcare table.
 

Ewok Jerky

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Hi Remi, Do Physician Assistants work under the supervision of doctors or are they completely autonomous?
It depends on the jurisdiction. Where I work as a PA, I carry my own patient load. From new patient, work up, Dx, treatment, follow up, all the way to discharge. If I think I need need a surgeon I refer to either my supervising physician or another in the practice. Often I book the surgery and the only time my patient ever sees the surgeon is in the OR.

My colleague in the ED has the same relationship with the ED physicians.
 

Pond Life

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Cheers Ewok. Yup, in that case it sounds exactly like the UK practitioners that we have in some areas. We tend to have different scope of practice depending on where we work geographically and where we work within the health care pathway. The PPs and Cps have usually had a more limited scope of practices than ECPs but I think now its more about the organisation we work for than the name we adopt.
They (NHS) are now changing our names again :-( We have been Practitioner in Emergency Care, Paramedic Practitioners, Community Paramedics and Emergency Care Practitioners.
Now we are Specialist Paramedics and that is sub divided into either Urgent and Emergency Care or Critical Care.
My mates always said I was 'special', but never in a good way.. ;-)
 

Summit

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Every time this idea comes up, noone can satisfactorily explain why we have to make up an entirely new degree and level of practice and enact new laws instead of using PAs and NPs.

The problem is with the current system's incentives and thus the motivation to have that role, not a lack of PA/NP or some unicorn midlevel with paramedic in the title.

That said, I totally think that an AS should be the minimum for Paramedics.
 

Chewy20

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Hmmm 2.5 years to get your medic,or half the time to get your medic. Yeah I will go for the shorter one until it actually means something to hold a degree in this field. All a two year degree gives you some general core classes. You can say "well it will never happen if people keep taking the certificate route." Thats BS, departments and companies have to start the trend and not hire people until they have a degree. Which will never happen, they like their profits too much.

Until its REQUIRED for us to get a degree (hopefully 4 with pay to show for it), the field will be the joke it already is.

To the OP. Like others have said, lets try baby steps before we talk about masters programs.
 

Tigger

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There a lot of ADNs looking for good jobs that probably also said "half the time, sign me up!"

And then the industry changed and they're stuck. I know BSN RNs that work in SNFs that are waiting for decent jobs to open up. Eventually that might well become the case for EMS.

This came up on the facebooks today: http://www.wral.com/news/local/video/14892531/

DCEMS is a premier service that is competitive to get on with and I expect this trend to continue, though I don't see it happening as quickly as nursing, which has its collective act together.
 

Ewok Jerky

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The problem with higher education and advanced practitioners is that the more you know, the more you want to be paid.

My friend in PA school was very gung ho all along about maintaining his P cert and still taking shifts after school. I kept telling him A)you won't have time B)even if you do have time why take a $40/hr paycut to be treated like crap and not have any of the diagnostic/treatment options available. 9 months later he works FT in primary care and hasn't taken a shift on the bus in 6 months.
 

triemal04

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I don't like repeating myself...or maybe I do...;) Either way I guess it's time to mention this again:

Just as an aside, for those of you talking about "paramedic practitioners," I hope you understand how laughable that is, and how much it shows the lack of awareness about EMS, medicine, and the healthcare system in this country.

First off, do you actually understand what a PA is? What a PA can do? If you do, why bother trying to reinvent the wheel?
Do you understand how difficult it would be to create a provider at that level that was actually accepted by the healthcare community AND the insurance companies AND the federal gov't (holds the medicare purse strings)?
Do you understand how pathetic it is to talk about creating a much higher level of provider when the current providers are so ****ed up, uneducated, unstandardized and *******ized across the country? Maybe...I don'tknow...fix, REALLY FIX the current problems first.

Carry on with the original topic, but keep this in mind.
 

SandpitMedic

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There a lot of ADNs looking for good jobs that probably also said "half the time, sign me up!"

And then the industry changed and they're stuck. I know BSN RNs that work in SNFs that are waiting for decent jobs to open up. Eventually that might well become the case for EMS.
This, like Paramedic vacancies, vary greatly depending on where you are located.
Out "West" anyone who can put RN after their name can be making 6 figures or damn close to it, and have sign on bonuses, relocation allowances, etc etc.

Supply... and demand.

I'm headed the PA route, personally... As to, not reinvent the wheel ;)
 

ExpatMedic0

MS, NRP
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the mid level provider level for paramedics already exist regionally with varying results of success in the UK and Australia. It may or may not happen one day in the U.S. but it will comes down to the demand for it when selling the concept to stakeholders and policy makers along with making it work with the healthcare reimbursement system. Paramedics in the U.S. working in emergency response, critical care transport, and community paramedicine, are all grossly underpaid and inadequately educated for entry level practice. With that being said many paramedics are teetering on the edge of earning their degrees and I agree with you a transition system should exist to make it a minimum national standard at some point.
 

zzyzx

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I like the OP's enthusiasm for wanting more education and expanding the role of paramedics. As others have said, we should first take baby steps. A good start would be to require all medic schools to require the prerequisites of anatomy, physiology, microbiology, and basic psyche.
 

Tigger

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This, like Paramedic vacancies, vary greatly depending on where you are located.
Out "West" anyone who can put RN after their name can be making 6 figures or damn close to it, and have sign on bonuses, relocation allowances, etc etc.

Supply... and demand.

I'm headed the PA route, personally... As to, not reinvent the wheel ;)
Not in this part of the "west." Certainly there are regional variations, but things are changing.
 
OP
MedicSansBrains

MedicSansBrains

If it's the PC police then I'm not home.. got it?
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Ok. So everyone agrees a "Paramedic Practitioner" is a stupid idea.

Also, everyone agrees getting an Associates Degree is a good idea.

What do y'all think about Bachelors? @ExpatMedic0 I see that you have one of those.
 

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