I've been reading this post and comments with interest. It seems to me that the Dr side of the argument has some logic but that logic is overshadowed by an arogant attitude towards other HCPs. HCPs are all in the same business - helping patients. Would it not be more sensible for Dr Crippen et al to stop complaining about the paramedics and technicians lack of knowledge and spend more time assisting them to increase their knowledge. I have not met a paramedic or tech who has not been keen to increase / develop knowledge, yes there are protocols to follow but these protocols, I am sure, can be developed to take in new practice IF the right people put forward balanced and logical reasons for that to happen along with sensible solutions. Pre hospital emergency care is a specialist area much narrower and with less training, but just as relevant as the wider GP medical knowledge. GP's need to recognise that and work with the system not against it. As pointed out, it is the patients interests that need to be met. I have known of many nurses and A&E staff going out on shift with the ambulance service but I do not think that this is something that GP's tend to do. May be an attachment to the ambulance service should be part of their training to try to help break down the obvious barriers? And just one more point, the use of the term "less qualified" sounds particularly derogatory. The ambulance crew may have less medical qualifications but surely experience and exposure to emergency pre hospital medicine counts for quite alot. I think these GPs maybe need to think "different, specialist" medical knowledge rather than "less qualifed". Unfortunately in the real world, from a laymans point of view, the reputation of GP's is lessening - personnally I am inclined to go with the so called "less qualified" ambulance service if I have an emergency!