As yet another trip around the sun ends, it’s time to pull out the top stories that shaped the industry and prognosticate about the events that are yet to occur in 2017. It’s a responsibility I don’t take lightly — I have had the privilege of commenting on EMS-related news on a weekly basis for the past six years. I make no apologies for my thoughts about our profession, be they complementary or critical of both general trends and individual conduct alike.
Of course, your opinion about mine will and should vary. That’s what great about our business — we can disagree, fight for our political beliefs and criticize the other side. Yet, I continue to believe that at the end of the day we will continue to respond without hesitation to calls for medical assistance and provide professional, compassionate care to our communities.
Health and safety
EMS provider health and safety was a constant commentary theme in 2016 and continues to head my 2017 list of “must-change” items. Sleep deprivation, poor dietary habits, lack of exercise and mental health stress combine to create a truly lethal environment for many of us.
I’m certain that none of us do this intentionally; but the need to work multiple jobs and long shifts in order to support a family compels folks to do some crazy things.
Low wages
Low wages are a major driver of poor health habits. Some of us had taken issue with the “Fight for 15" demonstrations in the fast food industry and with good reason — many EMS providers are being paid the same as or less than what is paid for historically unskilled entry level jobs. We need to advocate for higher wages that is commensurate with the required training and responsibility we have for our patients.
Low income reduces access to healthy food choices. Working long hours to compensate for low pay increases the chance of errors and decreases the chances for physical exercise and getting a solid sleep cycle. Spending long periods of time away from home worsens relationships and being able to spend time enjoying non-work related activities.
Payment for EMS service
Sadly, I don’t see EMS payment or funding changing much in 2017. Insurance reimbursement continues to be unrealistic and insufficient to maintain service levels expected by the community. There’s no clear path to sustainable compensation of the dozens of community paramedicine projects happening across the country.
The public is increasingly wary of tax increases and fee assessments to fund what they see as bloated public safety pensions. Given the shifting political winds and a swing toward financial conservatism, both private and public EMS systems will need to be more nimble than ever to provide emergency medical response.
Continuing consolidation
I foresee an ongoing consolidation of agencies, whether for-profit or government-based. Larger organizations will have to depend upon creating administrative efficiencies to run their operations. The need to collect data becomes even more critical, not only for cash flow and more effective operations, but also to find opportunities to better serve the health care needs of their communities.
Growth of non-emergency care
Indeed, the largest spark to innovation in EMS has been the increasing number of non-emergency care delivery models being piloted and proposed, like specially trained EMTs for combat vets, across the nation. Beyond the immediate benefits of providing health care that is far more effective than the traditional revolving door model of EMS transport to an emergency department, these projects are perhaps the tip of the spear for the future of integrated field care. It will require continued forward thinking of the profession and a willingness of public policy to fund this evolutionary step.
Need for professionalism
Yet all of this hopeful progress will be for naught if we are unable to respond effectively to everyday crisis. The volunteer shortage continues unabated. There are still large areas of the country where it’s not clear if EMS response meets industry norms. Individual providers and agencies alike continue to demonstrate a lack of professional commitment to excellence. As the saying goes, it’s tough to soar with eagles when you’re grounded with the turkeys.
We can do better than that, as demonstrated through leadership in the opioid overdose epidemic, or responding to the ever-increasing number of violent mass casualty incidents. The local papers are filled with stories about EMS providers performing little acts of kindness, one encounter at a time.
In reality, most of our wins are never reported. That’s because we shrug our shoulders and say that “it’s just part of the job.” Such is the trademark of a truly noble profession. Of that point, I do think that we agree.
