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In all the discussion, bickering and complaining about what EMS providers should be called (EMT, Paramedic, Ambulance Attendant, Steward etc etc) I got to thinking about the first part of my current title:



Walk into a room in most places on the planet, say you are a firefighter and I think it safe to say everyone knows what you do.  It has something to do with a big red truck and water and red stuff.  The specifics aren’t important and where you work isn’t important.  Or is it?

If I walk into that room as my 18 year old self I am a Firefighter following a 40 hour volunteer firefighter academy.  40 measly hours, yet I carry the same title as my counterparts in San Francisco, New York, Seattle, Los Angeles, Boston who have spent upwards of 18 weeks on the material.  They have more hands on training, more book time and a greater ability to do the job, but our titles are the same.  2 completely different skill sets and levels of education, same title.  No one who calls the Fire Department wonders how many IFSTA Certified, NFA FireFighter Level II’s are coming.  They care about how many firefighters are coming because what they need are people who can do the job.

At a car accident, no one has ever turned to a friend and said “Quick, call the EMT-99s this person is injured!”  No one holding a cyanotic child screams “Help! I need 2 Nationally Registered EMT-Basics trained to the new curriculum!”

They shout one of 2 things:

“Call the ambulance”

“Call the Paramedics”

The Paramedics

I say we run with it.

I am in favor of calling pre-hospital care providers Paramedics even though there is a large gap in the training, experience and capabilities of the many levels from sea to shining sea.  They don’t see the shiny patch on your shoulder is different than your EMT partner, nor do they notice you only inserted an OPA as an EMT instead of an ET.

They need help. We are it.  They call us what we are.

The  Paramedics.

Heck even most of us in the job are unsure exactly what a Paramedic should be, so what a great time to come together as one for once.

To those who will immediately back off and claim, falsely, that they earned a different title than the EMT when they completed their 2 year Paramedic program, come back when you’ve completed your Bachelor’s in EMS and tell me if you feel the same way.


My name is Justin Schorr and I am a Paramedic.  I have been a Paramedic in my patients’ eyes for almost 20 years, even though my little slip of paper says only 10.

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  1. in_the_city September 24, 2011 6:11 pm

    Maybe it’ll happen once we as an industry collectively pull our swelled heads out of our equally swelled backsides.

    God I hope I’m around for that day.

  2. Joe Paczkowski September 24, 2011 6:21 pm

    Completely agree. I opined on this a while back after someone posted one of those God awful “Someone called me an ambulance driver (sob)” chain posts on a forum I frequent. The fact is, no one outside of EMS cares. They want an appropriate amount of people who are able to adequately handle the situation at hand, and they’re going to assume that the people who show up in the ambulance wearing uniforms meet that description.  The bickering within EMS about titles is meaningless to everyone else, and the inability to portray a uniformed front is the exact reason why EMS providers get called every name under the sun.

    Until that time, the average voter will continue to call us “ambulance drivers,” and continue to think that very little occurs until the patient arrives at the hospital, where the “real professionals” take over.

  3. Hilinda September 24, 2011 6:24 pm

    I would like for everyone in the field to keep their skills up, whatever they are, and to actively pursue continuing education, so their ability to care for patients increases. If that happens, then I don’t care what anyone is called.

    You’re absolutely right that most people outside EMS have no idea what any of us do, or why, and they don’t care. They just want help.

    The quality of help has less to do with certification level, or title, than it does to the work ethic and level of caring of the individual providing it. I know Basics I trust absolutely, and a medic or two I wouldn’t want anywhere near me.

    Interesting idea, to have one title. Worth looking into what that might involve.

  4. Ryan Anderson September 24, 2011 6:35 pm

    Couldn’t agree more sir! I hold a BS-Emergency Medical Services Management. I am a Paramedic, dispite what future career path I may venture down, at heart I will always be a Paramedic. I take interest in the advancement of the profession. I also completely agree with Hillinda’s comment!

  5. Fern the Fire-Rescue newbie September 24, 2011 8:34 pm

    As an EMS Newbie (I’ve had my CFR for a little over a year now, and my basic for 2 months now), I’ve long held the same belief as you. Pick one name and stick with it. And with the new name, bring more quality education than the quantity current EMS Educators give. (Not trying to throw Greg Friese, Bill Toon, and the others who give quality education. Just the portion that stinks and rushes through things.)

    Let’s bring the Basic training up to the PCP equivalent in Ontario. I’ve long been a fan of their model, and I hope the US starts to adopt it as well.

    Gah, this comment is getting too long. I’ll make a blog post to cover my views more thoroughly and post the link here.

  6. InsomniacMedic September 25, 2011 3:33 am

    There must be a pandemic of the same feelings around the world at the moment. I wrote about it last month (http://www.insomniacmedic.com/2011/07/its-time.html), as did Flobach all the way over in Australia (http://flobach.com/2011/07/29/whats-in-a-name/). HM, as is so often the case, I’m with you… 

    • Thehappymedic September 25, 2011 8:32 am

      I’ve written on it as well, but the Firefighter comparison was new in my mind this week.  Thanks for reading everyone!

  7. Bill Kanoff September 25, 2011 11:14 am

    I don’t disagree, but I am not sure that I totally agree either. Yes, firefighters are all called firefighters and cops are all called cops. But we also know that there are various ranks, certification levels and specialties within these services as well. EMTs and Paramedics, while working together to accomplish the same goal, have two different skill sets. Thanks to the movies, the public and the legal system are aware of the differences so if we call everyone a paramedic, what happens when a family tries to sue you for not performing paramedic level skills if you are just trained as an EMT, but called a paramedic? While not all EMTs are paramedics, all paramedics are EMTs. Perhaps we leave it at that?

    As for the traninig standards, I agree that they need to be raised. The basic EMT class should be lengthened and include more theory and knowledge. For you instructors out there, the DOT only outlines minimum standards. You can add and lengthen your programs as you see fit. It is up to you to raise the bar.

    • the Happy Medic September 25, 2011 11:32 am

      Not all Paramedic are EMTs.  We were EMTs, we are no longer.  we need to take a cue from PD and Fire on this one and adopt one title, but I think EMT just makes things murkier.  No one in the community calls us EMTs so we’re fighting a battle from the get go.  Lawyers claiming we didn’t act at the Paramedic level?  What about a beat cop that doesn’t act at the Sergeant level?  A firefighter who doesn’t act at the HazMat Specialist level?  I am a Critical Care Qualified Paramedic yet can not operate an antra-aortic balloon pump on my current ambulance.  Can I be sued for that? No, of course not.  Can an EMT level Paramedic be sued for only treating within their scope of practice? Of course not.  The training decides the level of care, not the title.  Let’s conform to the public’s view, then educate them on what we do.
      Thanks for reading and even more for commenting!

    • Joe Paczkowski September 25, 2011 11:47 am

      “what happens when a family tries to sue you for not performing paramedic level skills if you are just trained as an EMT”

      That’s like physicians being scared about lawsuits because physicians can’t act like Dr. House.

    • 9-ECHO-1 October 17, 2012 9:15 pm

      Some instructors can add to their minimum standard curriculums. In my home state, good luck with that. When I was teaching classes (EMT, EMT-I, and EMT-P) there was a state course outline. My dean of continuing education (the person who signed off on whether I could offer the class or not) would not approve anything that exceeded the ‘state guidelines’, since we could not be reimbursed beyond what the state required. It may have changed in the last few years, but I doubt it has changed much. The sad part is a lot of people who have sway over our EMS education view the ‘guidelines’ as a hard ceiling.

  8. anonon September 25, 2011 9:28 pm

    I’m an ambulance driver.
    There.Take the ego out of it.

    • InsomniacMedic September 26, 2011 2:30 am


      I’m not sure if you’re being deliberately provocative or not, but either way, it’s not a question of ego, it’s a question of identity. 

      Years ago, when EMS was a fledgling industry (and, oh, how much I hate that word), an ambulance driver was exactly that – a driver. 

      Paramedics (and EMTs for that matter) the world over now have knowledge and skills that were once the reserve of doctors only. We work hard for those skills, and deserve recognition for what we now do. Until we take pride in ourselves and what we do, we can never expect the public to understand, accept and respect us either. That understanding, that knowledge of who we are and what we do, has the potential over the years to come to stop people using an ambulance service as a taxi ride, and instead use us for our dedicated purpose: 

      Pre-hospital medical specialists. Or in short, whether EMT or otherwise, paramedics. 

  9. Matt W. September 26, 2011 6:15 am

    It is time. 

    The biggest battle is between ourselves. Yes there are legal
    considerations, yes there are training needs and yes there are some EMT-Basics
    who work more diligently and with more heart than some “Paramedics.”
    However, without one name, we will never be understood by anyone, even those
    who work in the EDs we deliver patients to. Without one name it will always be,
    “there was a big wreck on the interstate and police, fire and emergency
    workers are on the scene…” Without one name tax payers and insurance
    companies (CMS included) will only demand and ultimately pay for a shiny
    ambulance to arrive in a reasonable amount of time with personnel who are
    polite and efficient.


    I used to believe, mainly out of pride and ego, that I earned my
    Paramedic “status”having worked up every EMT level in existence to get there (EMT-B,
    EMT-D, EMT-I, EMT-P), and others should do the same. In the last year I have
    become a staunch advocate of a calling everyone Paramedics and feel that it is
    the number one thing we must do to become a profession. Here is what changed my
    mind. In Renfrew County, Ontario, Canada 15 years ago, if you asked any normal
    citizen on the street, “who works on an ambulance,” they would
    have given the confused answers of, “emergency worker, paramedic, emergency
    medical responder,”  and yes, “ambulance
    driver.”15 years ago Renfrew County leadership made everyone Paramedics. EMTs
    became Primary Care Paramedics, EMT-Is became Intermediate Care Paramedics, and
    Paramedics became Advanced Care Paramedics and so on.


    These are the keys to my embracing this:

    1) Today, if you go up to a citizen on the street and ask who
    works on an ambulance they’ll say “Paramedics”

    2) All “Paramedics” were expected to achieve additional
    education within the first year to retain their “Paramedic”, essentially
    raising the educational standards 

    3) There is still an Emergency Medical Responder level who does
    basic first aid, can drive the ambulance and be a provider, volunteer or
    otherwise, to serve in a support role

    4) and here is the kicker for me, citizens are starting to ask for
    and expect a Paramedic-level response to their homes.


    The citizens we serve need to understand who works on an
    ambulance. They need to be willing to pay for what they want. There will always
    be a need for a first responder level and we need to raise the educational
    standards for our profession, slowly but surely.


    International Paramedic took this issue head on in the Initiation
    Document http://bit.ly/iparamedic . We
    all must work together, move the ground and make change happen now. International Paramedic is helping states, counties, territories and regions move to this naming convention. You can be a part. This is not
    a new idea but one whose time has come. If you haven’t read the 1996
    “Agenda for the Future” please do.  http://www.nhtsa.gov/people/injury/ems/agenda/emsman.html.


    Thanks to Justin for his vision and ability to communicate, giving
    new life to this issue. -Matt W., Paramedic



  10. FireMedic October 4, 2011 2:34 pm

    When I was an EMT people always called me a paramedic. As soon as I became a medic, people started calling me an EMT. Maybe I was too adamant about people calling me and EMT when I was an EMT.

  11. PASSnoise October 10, 2011 9:54 am

     Well I’m an EMT/FF. I’m a volunteer and in my area I log close to 800 calls a year. I’m a BS paramedic student, I also am a certified VFF I, and II. Here the volunteers work hard, and side by side with our inner city paid counterparts. During the tornado outbreak on April 27th I found myself working with Alabama Heavy Rescue 1. During the days that followed I found myself working off of an ambulance.
     What’s the difference here? Standard of training. As an EMT I am just as capable of performing patient care as a paid firefighter, or a paid EMT with an ambulance service. As a firefighter, I’m a volunteer. The paid guys have more opportunity and time for training than I do. But, on both sides of the house I see a lack of standard of training. I know paid guys that serve their purpose stretching hose. I also know great firefighters that I would follow into hell any day of the week. What we need (and some states already have it in place) is a standardized continuing education program for volunteer firefighters to get us to the level of training of a paid FFII.
     On a regular day, I’m an automotive technician, by the way.

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