Why Do Bad Ideas Stick Around?

I’ll confess. I like EMS blogger’s who rant about stuff. I know I don’t rant much here at The Spot. It’s not really my style and it doesn’t really fit with the mission of the blog. But sometimes we need folks to rant. Sometimes there’s just nothing quite as effective as someone who knows how to respectfully, intelligently rant.

Sometimes we need folks like Rouge Medic, Buckman and Ckemtp who are willing to call us all out. A passionate, well thought out rant can inspire change. It can motivate, encourage and provoke the kind of thoughtful introspection that we need.

We need someone to tell us when the emperor has no clothes. There are a lot of ideas floating around out there in EMS and many of them are just plain bad.  Let’s face it, we can come up with some whopper bad ideas now and then. Unfortunately, these ideas have a tendency to stick around for a long … long … painfully long time.

You want an example don’t you? OK … how about just one. The protocols I work under today require base station contact before a medic performs a cricothyrotomy. There … I said it. And now we’ll move on. I don’t want this to be a rant.

So why do bad ideas stay around so long in EMS? Here are a few of the reasons I see.

1.) The people who create the rules don’t work in the field.

2.) The people who try to act as change agents are labeled as trouble makers and problems.

3.) There are no mechanisms in place for honest, ongoing feedback about what’s working and what’s not.

4.) Policies are always easier to create than abolish.

5.) Training and building skill sets is more expensive than restriction and prohibition.

6.) If it worked last time it will probably work the next time. (This is also known as the normalization of deviance.)

All of these mechanisms make it difficult to be a change agent in EMS. I know.


Related Articles:

Five Rules For One Shift

Unconventional Thoughts on EMS

Are You The Opening Act, Or Are You The Rock Star?


  1. Sean Fontaine says:

    Here, here that is one DMPP that just flat out does not make sense, no patent airway or other viable option. Let’s just get on the biophone and talk for awhile, cause that makes sense. We do have good protocols in general, some people have far worse ones and some people have far better ones (Austin/Travis County EMS, for example).


  1. […] we covered a lot of ground. We started with the normalization of deviance and ended with a look at bad ideas (and why they tend to stick around.) In between we talked about SOAP reporting and being nice. We […]