Saving America's 911 system

[Goose 188]

Found this article through another forum, i have never seen a better written, honest and spot on accurate account of what is wrong with EMS in this country. I know i will be printing highlighting and mailing this out to all of those politicians that represent me.

Most state constitutions mandate such "essential services" as law enforcement and fire suppression, but make no provision for EMS. One reason for this, says Dr. Bledsoe, is that their constitutions were written long before EMS even existed. And given stretched state budgets, they're unlikely to take it on now. In the absence of government support, salaries for EMS personnel are low. In Montana, an emergency medical technician (EMT) makes as little as $14,000 a year. Most full-fledged paramedics in Oklahoma make less than $33,000.

"Rendering EMS a nonessential service is one reason the salaries are so low," says Dr. Bledsoe. "It's set up as a kind of job for young people who can live on the salary it affords. But once they want a family of their own, they have to leave the field." And leave they do. According to a December 2007 national survey by EMS Magazine, just about every state is short on paramedics and EMTs — some critically so.

http://www.msnbc.msn.com/id/28368691//

I implore everyone that is bothered by the current state of EMS start sending this article to their elected representatives, i think enough is enough.

[xfirefighter484x 234]

Quite an interesting read, and well versed. Its not just a bunch of ramblings asking for money or support (like some auto makers and banks) ooooops, did I say that out loud??? This is one of those articles I hope leads to some action!!

[JBE 328]

Wow, very well written, and hits the mark in a lot of spots. I do hope it eventually leads to something brighter.

[ems-buff 81]

Finally someone get's it. It's about time EMS Professionals like myself, and others are getting some well needed help. i will be sending this out to all my friends as well as the elected representatives in my area.

[MerlinMedic 5]

Wow. What an article. Too bad the conclusion that only a total system collapse will force any changes is the correct differential diagnoisis.

[NWFDMedic 58]

With all due respect to some of the very intelligent EMS authorities noted in this article, it stinks. This is the second thread I've read on EMTBravo in a week where the topic is basically "why don't they do something better for us?". This article takes it a step further, basically saying the EMS is doomed and there's nothing that can be done about it.

I hate to say it folks, but changes in the EMS system aren't going to come from some national EMS czar or anything of that ilk. In fact, if you want something to get screwed up from the top, getting the Federal Government involved is a good way to start. Merging with fire may work in some locales but assuming that the person best suited to care for a sick or injured person is the same person that is going to run opposite the rats to go into a burning building is probably a less than valid assumption. The opposite probably also isn't true. I'm sure some departments do things well on a local level, but every time a large EMS system merges with fire, the medics are met with second class status, lower pay, and glass ceilings.

If you want to enact change in your EMS system, you should be starting from the bottom. Start to change yourself, then work to enact change within your community (or the community/s that you serve for commercial) and agency. If you work in a busy system, maybe you should tell yourself the truth and realize that working a 24 is not the best thing for your patient or for you and your family. Sure it might make life more difficult but I'd rather be inconvenienced with a bit more cumbersome schedule than putting myself at risk. Also, if you're one of those medics who just gets the minimum done to stay on-line, maybe you should consider that you're not doing the best for your patients, your coworkers, or your profession. I'm probably preaching to the choir here, but I like preaching.

Now, let's look at your agency. Does your agency actively participate in providing top notch patient care? Do they give you the proper tools to provide the same? Are they interested in being on the leading edge in care provided? Or, do they just do the minimum to stay on-line. If your agency is in the latter group, work to institute change from within. It's not always your boss who has to come up with the good idea. I know for a fact that our CPAP protocol was due in large part to a field staff medic with a mission and it's been shown to provide great results in the field.

Finally, once you have yourself and your agency on the right track, it's time to educate the community. They need to understand that an ambulance isn't a widget; there are indeed good and bad ambulances. There is a standard of care that should be expected AND there is a standard of response time that should be expected. Establish realistic expectations for your community and then back them up on paper in the way of contracts. If your community doesn't know what to expect for EMS service, remember ignorance is bliss.

Now, there are proactive medics, agencies, and communities out there, but they are the exception rather than the norm. As far as the agencies are concerned, I haven't once said anything about volunteer v. career or municipal v. commercial. These are the things the entire EMS system should be doing to influence change from the bottom up, instead of waiting for either (A) someone from above to do it for us or (B.) a total collapse of the system.

Edited April 12, 2009 by NWFDMedic