Socialized Medicine

When I accepted a paramedic position at Opryland seven years ago, my HR contact said she recommended me for the job not because of my experience, or references, or clean record, or willingness to dress like a grown-up; she liked me because I smiled a lot.

I was surprised to hear that. Smiling isn’t a natural act for me. When I smile it’s usually forced and often comes across as a grimace or sneer. There are worse problems to have, but it bothers me to think of the many budding acquaintances I may have inadvertently sabotaged because I couldn’t coordinate the muscles of my face. I was lucky Opryland interviewed me on a good day.

Smiling is a higher priority at Opryland than at other EMS venues because the primary business is relaxation, not medicine. Albert Schweitzer wouldn’t last at Opryland if he couldn’t direct hotel patrons to the swimming pool with a smile. EMS is just another aspect of customer service when your patients are also your guests.

At first I thought Opryland’s emphasis on pleasantries might infringe on medical matters. It’s hard to chat about recreation with fun-seekers when you’re sticking needles into them. By the end of my first year, though, I started to appreciate an EMS/entertainment hybrid—the social medic—whose amiability and maturity are at least as important as clinical competence.

You don’t have to be a paramedic to be a social medic at Opryland. “Medic” means any employee with EMS certification. Responders don’t wear patches; the emphasis is on service, not certification. All workers, including EMS personnel, are considered equally qualified to help guests enjoy their stay. When a patient feels good about an experience with an Opryland medic, it’s probably because the interaction complemented, rather than disrupted the guest’s vacation.

It’s not unusual for EMTs and paramedics who work outside of 9-1-1 systems to be considered minor leaguers by their street-centric peers. I know that because I felt that way, and so did most of my partners when I was in the field. Now that I’ve done both, I realize the social skills of practitioners at nontraditional EMS sites are often underrated. Consider, for example, these desirable characteristics of caregivers at entertainment venues:

Good communicator—You might be able to substitute professional detachment for rapport with emergent patients, but the majority of cases in a recreational environment require little more than pleasant conversation. Empathetic, congenial words, spoken effortlessly, foster a can-do image that facilitates problem solving.

Likes people—When folks pay to stay with you, they expect a respite from the petty indignities of life without room service. If you don’t enjoy the company of people, you’ll likely project ambivalence about your job that might remind guests why they needed a vacation.

Not a diva—I’m using that term figuratively to describe medics of both genders who opt for the dramatic when the therapeutic will do. We all know people like that. Working in entertainment doesn’t mean you’re star of the show.

Slow to anger—You’ve just Heimliched a diner’s last bite of brisket into orbit and are feeling pretty good about your standing in the universe when your patient’s spouse asks if they’re going to be charged for the meal. As imperative as it might seem to deliver a lecture on priorities, any reply other than a polite answer to the billing question would be inappropriate.

Good “bench” skills—There won’t be time to Google how to sling and swathe a shoulder injury when your impatient patient is late for a show. If your basic repertoire is rusty, consider spending more time in the company of manikins.

Part entertainer, part educator—Entertainment is about adding value to customers’ expectations. You don’t have to be P.T. Barnum to do that. Taking extra time with patients to explain findings and options almost guarantees you won’t be considered a weak link in your company’s service.

I don’t think there’s a single trait in the above list you wouldn’t want your street medics to have, too.

The social medic isn’t an aberration, but rather a progression of caregiving skills from clinical to comprehensive. With community paramedicine on the horizon, EMS providers will have to offer more than dispassionate emergent care. Personality, patience and a willingness to commit to something less than lifesaving are attributes almost every employer in our industry should be seeking the next time you look for a job.

Smiling wouldn’t hurt, either.

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.