I understand the problems with this issue but must say that I don't know any Paramedics/Technicians that don't act in the best interest of the patient. If there is a 40 minute delay on scene it will generally be because this is the shortest time it took to assess and move the patient. Doctors don't realise that even someone who is "off their legs" may take 30 mins to load up and get down 5 flights of stairs. We do do a lot for the patient, but only if we think it's necessary. I don't stay and play unless it's absolutely necessary. Like most I'm pretty adept at canulating in the back of a moving bus. We all know that definitive care starts at the hospital. Thats it. We bring people to hospital so they van be cured/saved. Anything we do prior to that will be done because it is deemed necessary at the time.