A Lawyer Speaks Out On Diagnosis

Earlier in the week, I bruised a few widdle feewings on Facebook when I replied in the affirmative to an EMS forum post asking if paramedics diagnose. Quite a few people agreed with me, and a number stubbornly disagreed, and called me everything from "paragod" to "full of myself" to "doctor wannabe" and assured me that I was putting myself on shaky legal ground by diagnosing people, and that I'd definitely get my ass sued for doing it, and the Nomenclature Police would come take my paramedic patch away.

A few folks expressed outrage that I'd rebut these accusations, and that I responded in kind when people attacked me personally, rather than debate the validity of my assertion.

"Hey, it's OUR opinion!" went the refrain of one special flower. "How dare you attack us for expressing an opinion! It's our right to express our opinion, and you're a big bullying poopyhead for disagreeing!"

Well, as the saying goes, you are entitled to your own opinions, but you ain't entitled to your own facts.

After listening to a bunch of EMS guardhouse lawyers opine with tortuously twisted misinterpretation of legal doctrine, and people insisting they were taught that EMTs cannot diagnose, and that only doctors can, I conducted an informal poll here at EMS Today. I asked a couple of respected EMS physicians, "Do paramedics diagnose?"

Their answer was, "If they don't, how can they do their jobs?" They offered the same caveats that I did: a paramedic diagnosis is often rough due to our austere environment and lack of technological capability and advanced education… but it's still a diagnosis.

I asked a room full of EMS educators in the session I taught this morning, "Do you believe EMTs do not diagnose? How many of you teaach that EMTs treat symptoms only?"

Not a single hand went up.

And today in a podcast, I asked nationally respected EMS attorney Steve Wirth, of the law firm Page, Wolfberg and Wirth, a couple of questions:

  1. Do EMTs and medics diagnose?
  2. Are EMTs or medics at any legal risk for using the word "diagnosis," and has any EMT ever been sued for making a diagnosis?

Steve's answers?

  1. "Every patient, every call. How do you do your job without diagnosing? You may call it a field impression or a paramedic diagnosis, but the difference is just semantics."
  2. "Why would they be? It's not a protected word. And plenty of EMTs have been sued for making a misdiagnosis, but the word wasn't at issue – their care and decision-making was. They'd have been just as liable if they called it a 'field impression'."

This is a former paramedic, experienced attorney and consultant who makes his living providing counsel on EMS legal issues.

As I said before, if you think we don't diagnose, you are entitled to your opinion.

But you are not entitled to your own facts. And the fact is, we do diagnose, and we shouldn't be ashamed of saying so.


For further reading:

Demystifying Diagnosis

Yes, We Do Diagnose

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