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Home > Topics > EMS Management
November 07, 2013
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EMS News in Focus
by Arthur Hsieh

EMS volunteers in critical condition

Is it time to rethink system design?

By Arthur Hsieh

The state-wide EMS system challenges in Iowa have been well publicized this past year. Any of us who volunteer to provide EMS to our communities know all too well the problems we face in maintaining continuous coverage. Sadly, this issue has been ongoing for decades — it’s been more of a dirty secret than a new issue.

Our national EMS system was conceptualized over 40 years ago, when life was simpler. Single income households were the norm, and volunteering large amounts of time and money was realistic. By and large, this environment disappeared a long time ago. I’m not passing judgment, but it has been time to rethink EMS provision for a long time. 

Why do volunteer systems continue to cling to the past? I suspect that it’s a combination of pride, provincialism and a perceived lack of available resources that maintains the status quo of a broken system. To be fair, other public services are also affected by similar factors — small towns that continue to have their own fire and police services, for example. Regionalizing such services can help reduce the administrative overhead and provide a greater level of resources.

But I digress. Rural communities deserve better service coverage than what this study appears to show. And it’s not fair to disparage the volunteer EMS provider. But maintaining the status quo should not be considered an option. 

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. In the profession since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at Art.Hsieh@ems1.com.
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