The (non-existent) Professional Identity of a Paramedic

When I became a paramedic in 2008, I had a lot of hope for the future of my career. I felt as if I was walking into a wide open field of opportunity. In a lot of ways, I had this notion that paramedics received the same public attention as their law enforcement and fire department colleagues. It didn’t take long before I started to notice something. It wasn’t just the general public that didn’t have an idea what a paramedic was or did professionally, but my coworkers themselves struggled with the identity of what it is to be a paramedic.

If you are reading this as someone who is in the industry, this idea of lacking professional identity is not something foreign. At least this is true in the United States. The prehospital system in the US generally lacks a unified identity. Some departments function under a municipality (such as a Fire based EMS service), some for a private company and others for a hospital. To make it even more confusing, responsibilities can vary depending who has the contract for their service area. In other words, you could have a fire department and a private ambulance service responding to a single emergency call. Both of these agencies might have paramedics on their respective apparatus, with the same exact certification. However, when they arrive on scene together, they might have a pre-agreed hierarchical structure that leads the general public to believe that the fire department (in this example) has more capabilities, is better trained and owns the identity of “prehospital clinician.” The reality is this is simply a case of someone not getting the full story.

That example may or may not resonate with you (depending on what side of the scenario you are on), but it does point out a very important detail. The EMS system in the US is fractionated beyond recognition. The term “Paramedic” can mean so many different things and as far as the general public is concerned, an ambulance could be staffed by any number of professions. This begs the question, “how does this hurt the industry?” To answer that, we need to conduct a bit of self reflection. If you are a paramedic in the United States, what are some of the most desired changes to your role? Is it better pay? Perhaps you wish you had a more expanded scope of practice? Or maybe it is something as lofty as alternate career pathways and higher education that aligns with the profession. Whichever it is, the first obstacle we need to collectively tackle is identity. A singular identity for the paramedic profession would have only a positive impact. It would help non-clinical stakeholders better understand the value of a paramedic. It would help align all prehospital care providers and eliminate silos. It would do away with fictitious differentiation between providers with the same level of certification. It could even create alternate career pathways as paramedics define their place in the greater healthcare landscape.

The possibilities are endless and would certainly have an impact. This inevitably leads to the question of “how do we start working together to make this happen?” There really isn’t an easy answer to this question. The best that I can come up with at the time of writing this article is to encourage conversation at the local, state and federal level. Join a professional organization and advocate for defining the profession. If you are an educator, empower your students to take responsibility for their future by doing the same. Whatever the mechanism is, cohesive teamwork, regardless of agency, is key.