Re: CAMTS

["Jurry Van Ark" <jurry@ridgenet.net>]

Paul, I hope you never learn the art of brevity for it would do this
listserver a disservice and would cost me a valuable source of education.

That said, I agree with your observations completely. Third party
accreditation's that are mandatory as part of doing business are definitely
treated differently than voluntary certs. This is even to the degree of
individual certs such as ACLS, BTLS and other third party certifications
widely accepted as standards in training. Some training centers are strictly
focused on AHA rules and guidelines, others promote their classes to have a
zero or near-zero probability of a failure-to-certify. This clearly is a
method to increase participation their courses over a competitor and reduce
the backlash of failing someone who does not have an acceptable level of
skills or knowledge to the standard established by the certification.

There is a huge disparity in training centers and how they teach these
nationally recognized certifications. Some are stringent while others
overlook mistakes and coach students on the material being tested.

Paul, I worked hard to learn the material for my first ACLS card as a
fledgling EMT. Today, I find little value of ACLS in what I see in the
current
practice of pay your fees and get a card, regardless of your skills or
knowledge. To me, ACLS is nothing more than having attended a class every
two years, even though some counties use it as a standard of training under
the guise of "raising the bar" for their paramedics.

When it comes to transport programs there are just as many problems, as you
have identified, with certifications and accreditation's. I have been
involved in various programs that served six different counties, with each
county having their own program accreditation process and requirements, with
some providers serving multiple counties. I have had personal experiences
where providers strongly focus on completing annual inspections and meeting
the accreditation standards only during the application / inspection
process, only to quickly shift gears to a business model where decisions are
based on revenue streams and cost of doing business and doing whatever it
takes to get into a previously unavailable stream or tapping into a
competitor's revenue stream.

Competition over revenue streams is a sad reality of this business. Revenue,
to a privately held corporation that provides ground / air transport
services, is a strong motivator to abuse employees, violate standards of
good business practices and requirements for accreditation until an
inspection period arrives or an incident triggers an inspection for cause.
While this is not the norm, it is prevalent in many highly competitive areas
of ground and air ambulance businesses. Taking the above mentioned accounts
in conjunction with the "dirty pool" tactics of using connections in the
media to slander a competitor, filing false litigious complaints and
spending large sums of money to maintain elected county officials that are
supportive of a specific provider yet antagonistic to another provider makes
it difficult for me to find value in this environment. My perspective may be
wrong, possibly, but I doubt that I just happen to live in the only area
where EMS is like a snakepit.

If I seem disillusioned, I feel that I am. I have looked around at other
areas, other counties and other providers, and these problems proliferate
the industry. It is my opinion, that private providers who truly want to
provide service over profit, treat their employees with respect, train their
employees consistently and want to exceed (not just meet) regulatory and
clinical standards are few in number. Unless a provider has the financing to
hire a consulting  or a full time risk manager or compliance officer, and
the intestinal fortitude to follow their recommendations, there seems to be
little incentive to do what is right, especially when it gets in the way of
profits.

All in my own opinion.

Jurry Van Ark




-----Original Message-----
From: Paul M. Wright, Jr. <pmwright@home.com>
To: flightmed@flightweb.com <flightmed@flightweb.com>
Date: Friday, January 26, 2001 11:34 PM
Subject: RE: CAMTS


>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
>
>
>
>
>
>
>
>
>
>
>
>>
>
>
>---------------------------------------------------------------------
>Flightmed:
>To unsubscribe, send e-mail to: flightmed-unsubscribe@flightweb.com
>For additional commands, e-mail: flightmed-help@flightweb.com



---------------------------------------------------------------------
Flightmed:
To unsubscribe, send e-mail to: flightmed-unsubscribe@flightweb.com
For additional commands, e-mail: flightmed-help@flightweb.com