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EMS systems must adapt or perish

But beware of the “more for less” mentality

Rural EMS has a unique set of circumstances that’s making it a challenge to provide. Lower population density, lower incomes, less insured, and longer transport times conspire to make it a tough operating environment.

Coupled with worsening inability for volunteers to leave their jobs to respond to an event, and you have all of the circumstances for a real loss of coverage for a community.

It’s great that the system is taking steps to grapple with the issue by replacing the existing structure with a private entity. Certainly having more units and more personnel on the road will help provide better coverage.

However, I caution the “We can do it better for cheaper” idea. It is fraught with flaws. It costs money to provide expert EMS, whether public, private, or volunteer. Indeed, the plan is to spend almost double the amount of money it spends now. I guess time will tell of whether the costs are absorbed over the next five years.

One thing is for certain though — EMS providers who have been working in the area for many years have a vested interest in staying there. Hopefully, the new service will be able to absorb their ranks. It would keep the system’s most vital resources connected to the community.

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor 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 textbook writer, author of “EMT Exam for Dummies,” has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.