Administration and Leadership, Columns

Does EMS Need a Name Change?

Issue 5 and Volume 42.

There’s much discussion within, and among, several prominent EMS organizations and associations around the country, as well as the National EMS Advisory Council, that the EMS industry has grown into its own healthcare discipline, with several sub-domains, and it’s time we redefine ourselves as an industry and modify the nomenclature we use to describe ourselves.

Proponents of this idea believe that EMS and 9-1-1 response is just one aspect of what we do. We also provide community paramedicine services, preventive healthcare screenings, mass gathering care, non-emergent medical transportation and specialty care transport services, including interfacility medevac.

Our Own Discipline

So are we our own “discipline”?

A healthcare discipline is generally defined as “a branch or domain of knowledge, instruction, or learning of medicine.”

We have training programs around the country that specialize in our branch of medicine, which is treating the suddenly and acutely ill or injured outside of healthcare institutions.

These programs are accredited by independent organizations attesting to their competence and have their own textbooks that inform both the clinical care we provide and how we administer our systems.

We have our own trade magazines and peer-reviewed journals and conduct our own research. We have national conferences focused on our field, nationally recognized independent boards and commissions that assess and credential our services and practitioners, as well as numerous associations that represent various sub-domain constituencies.

We also have many academic institutions in America that offer accredited degrees, from associate’s level to master’s, often classifying them as part of “paramedicine,” within their schools of the allied healthcare professions. And, EMS physicians have been recognized as their own subspecialty by the American Board of Medical Specialties since 2010.

Other disciplines in our society, and in the fields of public health and public safety, have established well-known terminologies to identify themselves and their members. We routinely refer to various prosecutors’ offices, as well as police and sheriffs’ departments as “law enforcement” agencies and those who work within them as “law enforcement officers”. We call those who work in the “fire service,” “firefighters.” “Physicians” practice “medicine” and “nurses” perform “nursing”.

Rank and specialties exist in each of these disciplines and are referred to when discussions turn specific, but in normal, generic conversation, these broader terms are used.

When we think of the many names we use for the different things we do, and the various titles we go by in each state and jurisdiction, it’s no wonder that people, especially the media, are confused and stumble constantly over how to refer to us.

Even today, the terms “ambulance driver” and “emergency worker” aren’t uncommon. And we’re often added on as an afterthought as “other first responders” following “police” and “fire” when the media reports a story involving emeregency response.

Identity Crisis

So, it appears we have a bit of an identity crisis. Several EMS industry groups, such as International Paramedic (a collaborative of recognized thought leaders in EMS), the National EMS Management Association (NEMSMA) and the EMS 3.0 collaborative which is working to define the evolution of EMS alongside broader U.S. healthcare reform that’s underway, have all concluded it’s time we choose a name for our field and coin an industry-wide term that refers to all our practitioners.

Although work is still underway, it appears the consensus is that “paramedicine” is the name of our discipline, and “paramedic” is the generic title of the person, regardless of licensure or certification level and scope of practice, who provides care within the disciple.

However, some states prohibit a person other than the certified or licensed practitioner from using specific titles, including “paramedic.” Does this make a difference?

Speak Up

Advancing a generic term on the national level, like “paramedic” to refer to all practitioners in the field, doesn’t necessarily run afoul of state laws or regulations. Those rules govern individuals in their respective jurisdictions and how they refer to themselves, as well as organizations and how they advertise their services. And adopting such a term in our general discourse and national dialogue, and using paramedicine to describe our discipline, doesn’t break any law. But would it cause confusion?

I’d like to know what you think! Please go to www.jems.com/namechange and let me know. Your responses will help add to this national discussion, and I’ll report on them in a future column.