Great blog post:
The paramedic vs physician debate is probably as old as the respective professions and can be traced back to ancient Egypt.
Like many EMS folks, I’d say it is training, skills, experience and a supporting governance structure which is important, rather than the job title. However, much research still works on the physicians vs paramedics level.
When it comes to out-of-hospital cardiac arrest (OHCA), we now have what is considered ‘best available evidence’: A meta-analysis by Boettiger et al. The conclusions of this important work: ‘EMS-physician-guided CPR in out-of-hospital cardiac arrest is associated with improved survival outcomes’ (when compared to paramedic care).
Problem is, it is all observational studies. All observational studies are prone to confounding and bias, and when it comes to the value of EMS physicians, both factors almost always favor EMS physicians. Letting EMS physicians do research on the value of EMS physicians is about as objective as asking an Irish person to judge the best beer in the world…