A Letter From Your E.R. Doctor

bankstown hospital emergency room by red wolf via flickrEarlier this month, Dr. Rose Owens penned an open letter to EMT’s and paramedics across the country. She posted it in the Facebook forum “Paramedics on Facebook”. As a paramedic, Dr. Rose sees prehospital caregivers from the inside as well as from her position in the ER. This makes her observations so important. Her words are an interesting insight into our profession from an “outside” perspective. I post them here with her permission and blessing and I offer them without further commentary.

Dear POF Readers,

I was an EMT, then a Paramedic. Then I went to medical school and I’m your ER resident. I still carry my paramedic license because I was very proud to earn it, and I read this page and follow it because I am also an EMS educator.

You don’t know how carefully I watch and listen to my Paramedics and EMT’s–how much trust I put into your radio reports and skills. You don’t see me watch your skills to see what else I can learn, what else I can do to enhance the care you started. You don’t see me have a talk with the nursing staff, off to the side, over coffee later in the shift when I’ve seen them blow you off or disregard your information and skills. You don’t see me defend you to EMS directors, Chiefs, or your supervisor and you don’t see me go to bat for you when you may have screwed up. Those Christmas presents from the ER–that came out of my personal income because I remember being where you were and I like you. And I respect you.

You ARE my hands and eyes and ears outside of my safe domain of the emergency room. To the patient, you are an extension of my skills and knowledge. I have to trust you implicitly when I give orders to a patient I’ve never laid eyes on.

So I watch you. I watch the way you treat your partner, I watch how careful you are with equipment. I watch your body language, I hear the words that come out of your mouth. I observe the extra time you spend greeting people when you walk through the ER or down to the cafeteria. I honor you when you come to me and question my orders, or why I choose a certain protocol or did a certain skill. I respect you when you apologize if you feel you’ve screwed something up.

So when I see the EMS staff using foul language, kicking trash cans down the hallway, complaining about their salaries, and quipping dirty jokes in the run report room, I always take a step back. I realize the pressure you’re under and I think be glad you’re in a state with good pay, and I realize we all need to blow off steam. However, those things are best done appropriately, in your quarters, or worked off in a gym, or off shift.

Why? Because I can’t trust an angry medic, I can’t be comfortable with an EMT who throws tantrums. I won’t give you extra responsibility, I won’t go to bat for you with your superiors when you trash talk patients.

I read your comments, I listen to what ALL of you are saying, all over the country on this site. I want you to know that at least here in small town USA, your ER doctor, tired as she may be, exhausted as she may be has been where you are and understands.

But if you want to be treated totally professionally, you must act it all the time.


Doctor Rose

Still proud to be a paramedic.


  1. I’m in a different country, but apart from different (probably better) working conditions here, the ambulance Industry is pretty much the same everywhere…..

    While I sympathise with this letter (and mostly agree with it’s gist), I think to come over ‘holier than thou’ is a bit much – and yes, I know the author probably doesn’t intend it. I’ve seen & known many, many doctors & nurses, and other allied health staff, in Hospitals, in clinics & in other facilities, have tantrums, complain about patients & otherwise act unprofessionally. Hell, I’ve seen the medical practice of some doctors be utterly unprofessional, despite their many, many years more training & seniority.

    Frustration, stress & burn-out is not the sole domain of the EMS community. Compassion fatigue, discontent with management, anger at poor wages & conditions & a need to blow off steam NOW (not after work at the gym), is common accross the health sector – not just among Paramedics.

    Maybe all your colleagues are angels, who do not display that behaviour – but let me tell you, you’d be working in a pretty rare Hospital if that is the case.

    Maybe you’re proud to be a paramedic – but it looks like you’ve forgotten what it is to be one. Sorry.

    Rob in Australia.

  2. We are not pizza delivery people (no offense please). We are Firefighters, EMTs, Medics! We have the greatest job on earth (paid or volunteer) and are held to a higher standard. DON’T FORGET IT

  3. @ Rob in AU, a little sensitive are you brother? It’s a safe bet she is pointing this “open letter” to her own community. I would hope she wouldn’t be so myopic as to think that is a representation of all.
    I have a question for you. Aren’t we supposed to be the epitome of calm in the face of chaos? I agree we need to blow off steam, and repressing it is detremental, but we need to be responsible for our actions. We deal with enough drama with out creating more.
    Imagine your mom/g-ma or who ever is in the ER with a cardiac issue waiting for a room up stairs to be admitted and some jackwagon who needs to “blow off” steam “NOW” kicks a garbage can, yells or spews drama. You’d be pissed and I bet you’d say something about it.
    Maybe we’re lucky in my institution but, the break room is no rank land and a place to vent with out repercussion.
    Good luck, brother.

  4. Not sensitive at all. Her letter was aimed at Paramedics, yet describes behaviour that I have witnessed by practically all professions within Health care, and indeed, outside it.

    So, why single us out? Why display a prejudice?

    EVERYONE needs to be responsible for their actions, not just paramedics. That might seem like common sense, but the letter implies otherwise. I refuse to be targeted because of my profession.

  5. Chris – you’re right, I’m not a Pizza Delivery man.

    BUT – should I be held to a higher standard that a Doctor? Or a Nurse? I think not.

    Because that’s what we’re talking about. The Standard should be the SAME, not one for us & one for them.

  6. Thanks for posting this. I read it when she posted it on PoF and thought that it sure would be refreshing to see other Docs talk about their Medics, EMTs, EMR’s the way she did.
    To think she is singling out Medics is off the mark. I agree with her in as much as we ALL need to maintain our professional manner. This woman is the kind of Dr. you WANT to have in the ER taking a report and giving you orders. She will talk with you, not bitch at you or talk down to you if you have a question. She IS saying that the consideration she shows towards EMS in general comes at a modest price: act professionally!
    Thank-you Dr. Rose for taking the time to help us do a better job.

  7. When I read this I don’t believe she is singling us out, but rather helping us. she sees our frusatrations and anguishes ..maybe you can say words of wisdom to help polishing the tarnish off to breath fresh life into us. The other indication that she is not singling us out is her is her closing salutation,(Sincerely, Doctor Rose Still proud to be a paramedic)

  8. Rob,

    I believe its a privilege to be singled out by a Doctor who wants us to improve. I believe it is a privilege to do the job that I am doing which requires me to be a leader. As a leader you have to lead from the front. By doing so we put ourselves in the hard situation that other people don’t want to face because its who we are. Leadership means being different; it means being above our own personal feelings of anger or disregard for our actions. It means that we don’t excuse ourselves because other health care professionals are doing it too. Personally I don’t care if someone has a poor attitude because I have to rise above that.


  9. My reading is that Dr. Owens went out of her way to be super-respectful and thoughtful in her observations and wishes. To me, the key word was trust.

  10. Thanks for sharing..

  11. Thank you for sharing! And thank you Dr Rose!

  12. Scott Wuerch says:

    So, Rob from Austrailia…are you saying that poor behavior is OKAY as long as I see others higher up the food chain display the same attributes that Dr. Rose is talking about? Or is this a “How dare you point out our behavior…your profession isn’t perfect either” deflection? She did NOT come off as holier-than-thou. In fact she was extra careful to explain herself and make sure that she did not come off that way. She clearly remembers what it is like to be where we are.

    She’s also right. To vent in front of patients/customers, to complain about salary, working conditions, equipment, etc is unprofessional in ANY occupation/profession (janitors to CEO’s). It’s not the place or the time…

    We’ve all had that drunk patient that just got on our last nerve and played a high G, the whiner who calls at 3:30 am to be transported for a headache that started 3 days ago, or the abuse case where we would love nothing more than to spend an hour with the abuser in a private room…however the point Dr Rose is making is that to state that or complain about it out where patients can hear/see/overhear it is UNPROFESSIONAL under any condition by any person. We are indeed held to a higher standard because of what we do.

  13. As a former lifeguard, paramedic, firefighter, and current (nearly retired!) physician (who often wishes he had never left the fire department), I can see why the author “single’s out” paramedics in her article. She wants them to act the professionals that they are. She wants them to realize what a gift they have, and how best to revel in it. She want sthem to find healthy ways to cope with life or professional stresses. When she goes to bat for her paramedic colleagues, she wants to have credibility that is lost if behavior overshadows competence. She feels a comraderie that she does not want to lose. She may, as do many of us, have similar or worse observations about other members of society, but like with family, it matters more when it involves a paramedic.
    Or not……but I hope I am right about this. Suspect I am.

  14. Anonymous says:

    To All:
    At least Dr. Rose is acknowledging that you all have the know how and still wants to learn from all of you. She is proud of who you are , to those of you who know who you are as far as being a professional. I’d really love to be a patient in an emergency room and all of a sudden see a Dr. kicking a trash can down the hallway and calling his staff a bunch of no nothings as much as I’d like being brought into that same hospital by some EMT/Paramedic that is having a bad day and decides to take it out on me or starts cussing like a sailor or worse yet belittling his/her own partner ! No one said it was going to be easy and I didn’t ask to get sick or injured. Please take care of me or who ever else it may be and leave the childishness and unprofessionalism at home. Believe it or not , there are people over and above you that actually care about you too !

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