Quality Corner: Talent Scouting Providers

As previously stated in my Ten Commandments of Quality EMS: EMS is not just a job, it is a profession. And it needs to be treated like the profession it is.

Gone are the days when any agency should just hire the next body with a pulse and minimal certifications that happens to walk through the door. EMS is the highest stakes practice of medicine there is—bar none. The degree of illness and the risk of death for the EMS patient is no less than those seen in the ER, but the challenge in dealing with them, if anything, is greater. The environment in which we operate is uncontrolled; we are generally limited in resources; and we operate without the safety net of medical specialty or clinical backup. Minimum, mediocre or average are simply not good enough for the kind of people needed to provide emergency medical care in this environment. We need to start thinking less like the standard business model of human resources for food service or retail America, and more like a talent scout for a professional sports team, actively seeking the best talent available.

EMS has been around long enough in most places to be well established and to have providers with credentials and reputations. Credentials are easily quantified by provider cards, certificates and a list of continuing education courses taken. And these credentials are important as far as verifying minimum competency. But, what’s every bit as important—and arguably even more so—is the provider's reputation.

Whether you realize it or not, all of us in EMS have acquired reputations during the courses of our careers. Without fanfare or notice, our reputations each began the first day we showed up for EMT class and continued as we headed out into the street. Since then our reputations have continued to evolve; call by call, agency to agency and year after year. After a while we each become a pretty well-known entity.

Anyone who has ever worked in human resources or management can tell you about the nightmare of dealing with difficult employees. Once you’ve lived through that experience, especially to the point of termination, you never want to go through it again. And while the chances of never having to deal with personnel problems are unlikely, there is certainly a lot we can do to keep those situations to an absolute minimum. In most cases it’s simply a matter of a little more diligence on the front end to save you a lot of aggravation and heartache on the back end.

Any agency truly concerned with and committed to high performance EMS should be actively recruiting those who have a reputation for being good EMS providers and good employees. Additionally, when you’re considering hiring, be diligent in performing background checks and contacting former employers as well as references. When you know a potential employee personally take full advantage of the benefit, though obviously not to the total exclusion of your standard hiring process. Reputations, while pretty accurate for the most part, may in the hands of a resourceful person be more the result of personality and effective self-promotion than an actual record of fact. It’s always best to acquire as much information as possible on a candidate before hiring, including facts of record as well as perceptions and impressions.

In most states, former or current employers may be limited on how much information they can reveal externally. But you should always ask and be attentive for any hints that may be offered as to potential problems. EMS, existing in the domain of public service as it does, also typically requires criminal background checks and child abuse background checks, as well as checks for any sanctions from the department of health against the provider that would be reportable to future employers. If the EMS provider is a medic, they will likely have a physician medical director who may also be contacted as part of the background check process to shed some light on their clinical performance.

Informal channels, where known to exist, should also be pursued. There’s nothing wrong with casually asking other providers who are known to have worked with the candidate about their opinion of the prospective employee: how they liked working with them, what they thought of their performance and even their personality. As a matter of practicality and fairness, personality conflicts do exist between even the best of people and that needs to be considered. One person speaking negatively about someone should not spell the end of the candidate's chances, but several people voicing similar complaints obviously need to be taken more seriously.

Once a new provider has been hired, make sure they know the agency’s expectations on standard of care. Ideally, the new hire should meet with both the quality coordinator and medical director early on as part of the orientation process. And at some point the new provider should be reminded that EMS is one of the noblest professions there is—one where our patients are literally trusting us with their lives—so we must take it seriously and always strive to be at our best.