Just Published: Commentary Response to Paramedics as Policy Arcitechts

Read the article here: https://journals.sagepub.com/doi/10.1177/27536386251346980 In his insightful commentary responding to Building Bridges and Moving Upstream: Paramedics as Policy Architects, Alan Morrison affirms the central argument advanced by Bolster and Batt: that paramedics possess critical, underutilised potential to shape health policy, not merely implement it. He concurs that the inclusion of a Policy and Strategy career pathway within the Canadian Paramedic Career Framework represents a significant milestone for the profession, signalling the need for paramedics to be integrated into health system decision-making structures. However, Morrison also invites the profession to adopt an even more expansive and ambitious perspective.

Drawing on a reflective conversation with a state health policy advisor, Morrison highlights how allied health professionals—and, increasingly, nurses—have successfully transcended their clinical roles to assume broader positions of influence in health system leadership. He contrasts this with the current orientation of paramedicine, which often frames policy engagement primarily as a mechanism for advancing the profession’s internal standing, rather than as a pathway to serve the wider health system and public good.

While supporting Bolster and Batt’s call for roles such as Chief Paramedic Officer, Morrison encourages the profession to move beyond a quest for status parity. Instead, he proposes a vision rooted in civic professionalism, a model in which clinicians extend their focus beyond their professional identities to actively contribute to health system reform, ethical leadership, and public service. In this view, policy careers should be seen not only as opportunities for professional advancement, but as vital avenues for stewarding equitable and effective health systems.

Importantly, Morrison’s response is not a critique, but an evolution of Bolster and Batt’s position. He recognises the critical importance of formalised education, mentorship, and institutional support for paramedics aspiring to policy roles. At the same time, he calls on the profession to cultivate a broader aspiration: one in which paramedics are not only included in policy dialogue, but are also positioned to lead health system transformation at the highest levels—as Directors-General, Secretaries of Health, and beyond.

Ultimately, Morrison’s commentary serves as a thoughtful provocation. While affirming the importance of creating space for paramedics in policy and strategy, he urges the profession not to stop at inclusion. Instead, he challenges paramedicine to reimagine its role entirely; shifting from a focus on internal legitimacy to one of external impact, public value, and systemic leadership.