The Professionalization of Ambulance Services.

Abstract

This dissertation focuses on the professionalization of ambulance work in the United States as a case study of professionalization in health care, and of the relation of formal education to professions. The methodology is historical and experiential, involving scholarly research, training, and personal work as a health care professional. A history of ambulance services is described, from its origins in nineteenth-century Europe to the present, in the United States, from a macro (national) level, to a micro level, with detailed analysis of Washtenaw County in Michigan, particularly from 1967 to 1984. The rise of the medical profession in the United States and of the American Medical Association is traced, with emphasis on its relation to the ambulance profession and differences between old and new professions. The history of medical education, its role with respect to professionalization, and the rise of the university and ideas of a professional career, are presented, with particular attention to The Univeristy of Michigan, in Washtenaw County. This is compared to the role of education with respect to the professionalization of ambulance work, its nature and setting (the community college). In conclusion, the implications of increased professionalization in our society, for individuals (in preparation, training, and licensure) and for society (in the nature and quality of services) are discussed. It is suggested that, although professionalization does involve limited material gains for individuals, these are at the price of specialization, separation from a total context, and the setting of worker against worker, specialty against specialty. Professionalization has implied certain improvements in services, but has also frustrated their efficient, widespread application, since public goals for which professions were supposedly established, are sacrificed for the private interests of the profession's members.