RE: CAMTS

["Paul M. Wright, Jr." <pmwright@home.com>]

Dave -

I appreciate the amplification.

And I agree with you that it's emphatically NOT the norm.  I also
need to firmly state that I think CAMTS has been tremendously
effective in many respects and that their efforts in standards
development and implementation have been crucial to the development
of the industry.  And I believe that some of the safety initiatives
that can be traced to CAMTS have, in fact, reduced both morbidity
and mortality in our industry.  My sole concern is my perception
that the credential is being tarnished by the few bad apples in the
barrel.

I believe that the vast majority of CAMTS accredited programs
got there the old-fashioned way - through hard work, straightforward
honesty and documents laboriously crafted by their own people to
accurately reflect the framework, values and procedures within
which a given program works.

My point, though, was that the system isn't perfect and is largely based
on voluntary compliance and self-reporting (the honor system, if you
will).  As Eileen correctly indicated, CAMTS cannot initiate an action
unless they receive a written complaint and maybe the more productive
discussion would be about how we can best help CAMTS protect the value
of the credential that many of us worked very hard to obtain and
maintain.  And, as I conceded in an earlier post, my expectations for
CAMTS to assume a regulatory posture were not realistic in view of
their mission and methodology.

The events I described are within my personal experience.  Thefts
of documents from accredited programs and subsequent submission of
portions of those documents have occurred at least three times that
I know of and in one case lead to civil litigation in which both
the plaintiff and the defendant programs were CAMTS accredited.
Evidence presented at the trial didn't make me particularly proud
to share the airspace and the credential with either one of them.

I also served as the Program Director of a program whose
trade name was appropriated by a rogue program to the point of
duplicating our name and our uniforms right down to the fonts
and colors we used.  And the purpose of their subterfuge was precisely
to convince potential customers that they were a CAMTS program and
in some cases they were successful.

And, even more sadly, I also have knowledge of currently accredited
programs whose operating practices are widely divergent from those
represented during their accreditation process.  Abandoning or
curtailing the training program to accommodate a high growth rate
or high employee turnover (or just to save money) is one of the more
common changes that a program might make that would represent a
substantial departure from the conditions present at the time of
accreditation.

In all of these circumstances, there has not been effective
remediation.  Often it has been because there was no one with the
knowledge, the legal standing and the will to initiate an action,
and I can't fault either CAMTS or the regulatory authorities in that
case.  Nor can I fault CAMTS if they make a referral to a regulatory
authority with jurisdiction and that authority declines to pursue
the case.   But I still have this sadness that I can't affirmatively
state that CAMTS accreditation means a program has achieved and
maintained the standard of excellence that I had long associated
with it.

To be honest, it is not uncommon for directors of incumbent
accredited programs to grouse about every newly-accredited program
in their market area.  Like any credential, at least part of the value
is in scarcity because it is then thought to confer a competitive
advantage and that advantage is diluted by every newly accredited
program.  I'm a recovering grouser myself.

But my fear is that when (if) CAMTS accreditation becomes a universal
requirement for operating authority, it will be even less of a badge of
honor for those committed to excellence (as it was in the beginning)
and more of just an item on a list of things to do when starting a
program.  And the incentive will be to just get through it, without
necessarily learning anything in the process.  Because it will no longer
be voluntary, I can see programs getting increasingly cantankerous and
resistant to adverse actions of any kind.  It's one thing to "withdraw"
a voluntary accreditation but quite another to do something that results in
loss of operating authority.  My comment about the CAMTS budget was based
on an estimate of the legal costs of the trial cited above that would put
it at about 4 times the annual CAMTS budget.  As I subsequently indicated,
that was based on my estimate of the probability that CAMTS would end
up as a civil litigant in one of these actions and I realized after
Eileen's post that I had overstated that probability.  But that could
change dramatically as CAMTS accreditation becomes more mandatory and
less voluntary.

>From comments made in this forum and elsewhere, it would seem that
Florida has had better success in regulating their air medical
operators than we have had here in Arizona.  Someone once described
our hyper-competitive operating environment as "Air Medical Armageddon"
but I have also heard horror stories from several other states as well.

Well, apparently I STILL haven't learned about brevity, but I have
appreciated the dialog.  I don't know what the answer is, but I do
think the questions are worth asking and the conversation is worth
having.



regards!

paul











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