Before medical school, I had the joy and privilege of working as a prehospital provider.\u00a0 And during my years as an EMT, I was lucky to have a few adept female mentors on my volunteer service in rural Virginia. I looked to them for examples of how to move up the leadership ladder.\u00a0 Looking back, having only a fifth of our personnel be women was not outside the norm in EMS (Emergency Medical Services).\u00a0 In fact, today only 34% of EMTs and 21% of paramedics are women.<\/p>\n
As I advanced onto my career in medicine, I noticed female representation trailed, especially at the level of medical directorship.\u00a0 As of September 2017, only 18% of EMS fellowship directors were women, and only 15% of our national board, the National Association of EMS Physicians, are currently female.\u00a0 Of the ten largest cities in the US in 2017, only 6% of the medical directors are women.<\/p>\n
Despite the numbers, it quickly becomes apparent women have played vital roles in the advancement of prehospital care.\u00a0 Indeed, the entire concept of care in the field began with Clara Barton.\u00a0 During the Civil War, Barton, a nurse from the North, watched many soldiers dying before getting to the medical tents.\u00a0 In response, she coined the term, \u201cTreat them where they lie,\u201d becoming the first to encourage in-the-field care.<\/p>\n
Fast forward to 1966 when the paper, \u201cAccidental Death and Disability: The Neglected Disease of Modern Society\u201d was published.\u00a0 This study was a wake-up call; thousands of citizens were dying from car accidents, and these deaths were preventable.\u00a0 Throughout the country, multiple agencies blossomed to meet this need for prehospital care and trauma prevention.<\/p>\n
Leading the charge in Pittsburgh was one of the first female medical directors, Dr. Nancy Caroline.\u00a0 Through training her paramedics, Dr. Caroline developed the first comprehensive EMS textbook, called \u201cEmergency Care in the Streets.\u201d \u00a0From the oversight of Drs. Caroline and Peter Safar, the Pittsburgh\u2019s paramedic and resuscitation models spread as standards to use for the new programs beginning throughout the US.<\/p>\n
The next few years were an uphill battle for women serving in the prehospital realm. Initially, EMS and Fire Departments served out of the same stations, and to be a paramedic, you needed to be a firefighter as well.\u00a0 Fire departments did not want to hire women, and they were not shy about their bias. \u00a0Women were failed out of fire academy in spite of successful completion. \u00a0The aversion to hiring women was so strong, it often required a court decision to allow women to be hired.\u00a0 The first official record of a female paramedic in the U. S. is from 1972, Dianne Rechle of Palm Springs, California, six years after medic programs were begun in the US.<\/p>\n
As EMS was gaining footing in the prehospital arena, EMS physicians were working to establish themselves as a subspecialty.\u00a0 After beginning advocacy efforts in the 1990s, in 2010 EMS secured its own board certification.\u00a0 This herculean effort required a team endeavor and could not have been achieved without the labors of Drs. Debra Perina, Sandy Bogucki, and Jane Brice.<\/p>\n
Female medical directors in EMS are increasingly garnering national distinction.\u00a0 Recognized for their oversight under the great significance of mass casualty incidents, Drs. Jullette Saussy and Sophia Dyer have been commended for leading their EMS agencies during Hurricane Katrina and the Boston Marathon Bombing respectively.\u00a0 And currently, the list is growing of women that are medical directors of major metropolitan areas, including Dr. Marianne Gausche-Hill of Los Angeles County, Dr. Katie Tataris of Chicago, Dr. Kathleen Schrank of Miami, Dr. Elizabeth Char of Honolulu, Dr. Kristi Koenig of San Diego County, and many of those mentioned previously for other achievements.<\/p>\n
In a climate that has sometimes been known as \u201can Old Boy\u2019s Club,\u201d I wondered what methods have allowed certain women to thrive?\u00a0 I interviewed a few of today\u2019s leaders, and I shared their recommendations for success at FIX 2017, which you can watch here.<\/p>\n
How can we otherwise increase women\u2019s representation in EMS leadership? \u00a0First, we need to quantify how many women are in EMS.\u00a0 If we want to identify areas to improve upon, we should first know where we are beginning at.\u00a0 Currently, there is no national organization that gathers this data. \u00a0Second, we should aim to increase women providers in the field.\u00a0 As many EMS medical directors pursue the prehospital subspecialty after working in the ambulance themselves, it is not surprising, that with a lower percentage of prehospital providers being female, that leads to fewer female physicians being involved in EMS. \u00a0Finally, women that aspire to enter the EMS world should seek out mentors, male and female, for guidance.\u00a0 Those already established should develop their own mentor-mentee opportunities.<\/p>\n
Overall, advocacy efforts are increasing, evidence-based protocols are growing in number, and the interest in EMS is expanding.\u00a0 The future of EMS is bright!\u00a0 We can be the leaders we aspire to be, if we #CrashTheParty.<\/p>\n
Watch the full FIX17 talk below!<\/em><\/p>\n