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Home > Topics > EMS Management
January 23, 2014
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EMS News in Focus
by Arthur Hsieh

When EMS systems go wild

Manipulating 911 responses to favor one ambulance provider puts reputations — and patients — at risk

By Arthur Hsieh

Ah, some of you dinosaurs remember the good ol’ days of ambulance wars: monitoring police scanners, driving like crazy to beat the competitor’s ambulance to an incident — ah yes, that was great fun, wasn’t it?

Would you like a side of sarcasm with that reminiscence?

EMS has matured a lot since the 1960s, evolving from a patchwork of ambulance and rescue services to EMS systems that are designed to provide the best possible coverage and response, given the money and other resources available. A system must continually reassess its performance as its operating environment changes. More importantly, providers and stakeholders within the system have to abide by its rules so it can function as a cohesive whole, or come up with good reasons to change a part of it, using administrative processes to do so.

Making arbitrary, on-the-fly decisions places the patient — and system — at risk. It can get especially messy if local politics interfere with the operation of the system. It raises questions about how the system is managed, how it’s paid for, and whether the safety of the community is in danger.

We don’t know what the actual complaint of the patient in this latest story about an ambulance company that halted a call long enough to move its ambulance to be the closest unit. Frankly, it could have been a low priority incident that should’ve not been in the 911 system in the first place, instead managed by the private provider. But that should be settled with an open, healthy discussion among system officials and administrators that separates business practices from public safety operations.

And just for the record — this kind of underhanded behavior doesn’t happen just in the private sector. Government-run and volunteer organizations are susceptible to the same pressures to make things go “their way.” In this age of decreasing resources and rising community expectations, this behavior is no longer in vogue, and it needs to go.

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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