In defense of EMS

It has been nearly nine months since I decided to pursue a career in Emergency Medical Services after my college graduation. In that time, I have frequently encountered the question, "You went to Dartmouth and you're here?" I simply reply, "Yes, I like EMS," and leave it at that. I'm growing increasingly irritated by the question, however, because it reflects both a misunderstanding of what paramedics do and the vaguely classist belief that EMS is a career field for the poorly educated.

Paramedicine is a career in a near-constant state of flux, and as a result many people are left with an outdated or simply misinformed perception of what EMS providers do. Although Johnny and Roy helped to introduce paramedicine into the public consciousness with "Emergency!" in the 1970s, more recent television programs like "Saved" (2006) and the gosh-awful "Trauma" (2009) have done more to muddy the picture than clarify things.

Thirty five years ago, patient care consisted simply of arriving on scene, throwing the patient in the back and speeding to the hospital so the patient could begin receiving treatment. These days of "Swoop and scoop" EMS are long gone, but the perception of paramedics as mere "ambulance drivers" has persisted. Today's paramedic ambulance unit, however, is essentially a mobile emergency department.

Paramedics have the knowledge and training to administer more than three dozen medications, to perform extensive airway management maneuvers, to interpet EKGs and manage cardiac dysrhythmias and to assist in childbirth in addition to providing treatment for a wide range of other medical and trauma (injury) emergencies. Whatever was once true, the 21st century paramedic is a highly trained, skilled practitioner of emergency medicine.

As for the false assumption that EMS is a job for the poorly educated, this largely stems from the low salaries many EMS providers earn. Paramedic certification does not require a college degree, so employers do not feel obligated to pay a high wage. Even for those EMS providers who do hold bachelor's degrees or beyond, salaries are primarily determined by the education you need to have, not the education a given individual necessarily does have.

Thus arises a vicious circle: Relatively speaking, EMS is a fairly low-paying job. Low-paying jobs tend not to appeal to Ivy Leaguers (or bachelor's degree holders of any stripe). As a result, few college graduates choose EMS as a career, and the dearth of college graduates in the industry enables agencies to continue justifying their low salaries. This industry-wide combination of low salaries and few bachelor's degree holders has bred the assumption that EMS as a career is somehow beneath the well-educated, that they ought to be working elsewhere while those with less education man the nation's ambulances.

I reject this view. A job may be low-paying, but that does not mean it is unimportant. EMS is a demanding and worthwhile career that will challenge even the most capable provider on a daily basis. What's more, it is taken for granted in today's society that if you call 911, someone will come to help you. So why the expectation that these heroes will be society's second string? Nothing could or should be further from the truth.