Reforming the paramedic profession? Two weeks with paramedics in Germany

While paramedics in Anglo-American emergency medical services enjoy relative autonomy, paramedic practice in the Franco-German model deployed in Germany depends heavily on emergency physician input. Increasing demand, especially from low-acuity incidents, causes challenges in these countries. To address this, German politicians plan to implement extensive emergency care reforms and consider an update of regulations around paramedic practice. A 2-week placement allowed for practice observation, discussions with stakeholders and a review of various resources to identify current issues in Germany. These include legal discrepancies, significant local differences in scope of practice, limited career opportunities and influence on clinical guidelines. Although the update and reforms are intended to resolve some of these problems, a groundbreaking evolution of the profession from its current restrictions is not expected. Possible development of the emergency physician role and associated specialities as a response to emergency care challenges is less debated.

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