This year I saw the trend of declining ethics in EMS continue. The media highlights every instance of public safety personnel involved in substance abuse, sexual misconduct and fraud/theft. Although 9/11 made us all heroes, we are making ourselves fools by our behavior. Each time one of these articles comes out, we lose credibility, and the community loses confidence in us.
I now teach the Roles and Responsibilities portion of our paramedic class here in New Mexico. And I have developed a presentation to get these students thinking about the ethical dilemmas they will face as paramedics and how they can rise to the challenge of keeping our profession with its head held high. What I don't know is whether we are just seeing an increase in reporting of these incidents, or whether the number of incidents is really on the rise.
The "generational thing" is also interesting to me, having been among our state's first paramedics and passionately involved in system development for many years. I've asked myself who the "movers and shakers" are now, and I have a hard time coming up with names. This is the "me generation" and paramedics have a very different point of view coming out of school than we did 25 years ago. They are on the clock, punch in and punch out. Few of them seem to have the passion that we did to make things better, to improve education and to make progress. We didn't have any great leaders because no one went before us we had to become leaders ourselves. No one can ever fill the shoes of people like Jim Page, who fought with bureaucracy to make a place for EMS among the most respected professions, when few had faith in us.
EMS however, continues to be the bastard child of emergency services overlooked in funding and still truly not recognized for what it is and what it does. While police and fire are clearly recognized as essential public safety components of our society, EMS is not. It's our own fault. I personally have a bias in favor of public sector services. I think that one of the main reasons we still don't have a place at the table when the big money is given out is because we have one foot in public safety and the other in the nasty business of health care for profit.
Unless and until we figure out who we are, no one else will either. Each time I see another paramedic service going down because of budget cuts, I think about how they wouldn't do that to the police or fire departments. As cities grow, and the percentage of penetrating trauma (which doesn't pay) rises above the percentage of blunt trauma (car accidents, which get paid for by insurance), we see many cities changing to public services. Trying to make a buck out of EMS is tough; though there are a few out there who have done it well. I've worked in both public and private sector EMS, and hands down, I preferred the public sector. It is a philosophical trait I shared with Jim Page.