The Empty Suits of EMS.

With absolute certainty the EMS empty suit proclaims that a college degree will fix all the issues EMS faces both today and in the future. Strangely, many of the proponents of a degree requirement do not even have a college degree themselves. They honestly believe it is a simple equation of supply versus demand. Degrees will cause there to be fewer paramedics and therefore increased demand for paramedics, which will fix everything. Complex problems rarely have simple answers.

Raising the barriers to entry and decreasing the number of paramedics won’t automatically equal higher pay for paramedics, it might just create more bastardized dumbed-down version of paramedic to skirt the regulations- think EMT-Intermediate,* Advanced EMT–Critical Care, Cardiac-EMT, Enhanced EMT, IEMT and all the other alphabet-soup flavors of ALS-lite that exist  for communities that can’t or won’t pay for paramedics to be on staff or volunteers that don’t want undertake that much education to help out their community. [1]

EMS empty suits love drafting position statements. What is better than telling someone your opinion? Writing it down and posting it (Yes, I am fully aware of the irony here of a blogger criticizing this). They opine that we must change our nomenclature to all be paramedics and stop identifying as Emergency Medical Technicians, issuing these position statements from an organization that still has Emergency Medical Technicians in the name. [2]

The EMS empty suit believes in the rigid doctrine of the protocol.  When confronted with the messiness of reality they begin to feel a sense of unease. If something is not in the protocol book or procedure manual, how can people be expected to know what to do? How can providers be expected to know how to act or think unless it is written down in a manual somewhere?

The EMS empty suit can tell you that we need to offer sub-specialties like community paramedicine, critical care, and tactical EMS without addressing the fact that we generally don’t provide regular EMS well. [3]

The empty suit refers to themselves as an EMS educator. With a deck of bad powerpoint slides, they work the conference circuit playing to the lowest common denominator. They sell themselves and their brand on social media. They meet you and tell you how they would love the opportunity to come to your service to provide you guys with some “CE’s.” If they do not know the answer they will dazzle you with bullshit. What delineates the EMS empty suit from someone who is just a shitty educator or bad public speaker? They cannot run a 911 call worth a shit. They are incapable of practicing the medicine that they teach.

The empty suit will tell everyone they meet how they are a critical care paramedic, or worse signs their name with the initials CCEMT-P, as if that is really a thing. Taking a test that one can pass by reading a few books does not make you a critical care paramedic. I hold an FP-C because I am a good test taker, not because I have been vetted in any way or because I proved my proficiency, I just memorized a bunch of stuff. This might just be chauffer knowledge. The ability to speak the jargon and knowing the technical terms does not mean someone understands the “why” or second-order consequences of their actions.

Empty suits love the virtue signaling act of raising awareness about an issue; believing that raising awareness about an issue is the same as doing something about an issue. It isn’t. Talking is not action.

The EMS empty suit confuses looking professional with being a professional. They focus their energy more on fine turning appearances more than things like our medicine, empathy, and compassion, making sure everyone is dressed according to the guidelines is more important than assuring we are aligned with goals. [4]

Empty suits love to thank you for all that you do. Of course, they have no idea what it is that you do.

The empty suit loves to lecture on leadership, oblivious to the fact that no one would  choose to work twelve hours with them on a shift. They take classes on leadership and go to retreats oblivious to the fact that they are insufferable.

The empty suit can tell you everything you need to do; what to wear, how to respond to calls, what the future of EMS holds, what certifications you need to get, what organizations you need to join and support financially, and what your agency is doing wrong and even how to think. They love to dress up like they are in the navy and give each other awards.

Rolf Dobelli hits it out of the park in “The Art of Thinking Clearly,” summing up the easiest way of identifying you are in the presence of an empty suit: True experts recognize the limits of what they know and what they do not know. If they find themselves outside their circle of competence, they keep quiet or simply say, “I don’t know.” This they utter unapologetically, even with a certain pride. From chauffeurs, we hear every line except this.

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Before anyone loses their mind.
1. Yes, I think a college degree is a good idea for EMS, I am just not certain that it is slam-dunk to higher wages and happier, more productive employees.
2. Lead by example. Change your name before you tell others to do likewise. I think separating EMS from the fire dept in the public eye is probably a bigger issue than our nomenclature.
3. Community paramedicine is great, but make sure your EMS is great before embarking on the latest fad.
4. We should look presentable but I would rather have a sloppily dressed medic that is a great listener and makes patients feel important and cared for than a sharped dressed asshole.

This article draws from the piece “The Intellectual yet Idiot” by Nassim Nicholas Taleb.