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Top 10 ways agencies survive in the era of $6/gallon diesel

No. 2: A partnership with McDonald’s will net you unlimited biodiesel, but no, you still can’t use their bathrooms


Inflation is hitting us all hard these days, and we’re starting to feel the pinch in ways we never have before.

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Man, it’s getting tough out there. Yesterday, on the way home from shopping, I saw an EMS consultant sitting on the curb holding a cardboard sign that read, “Will design arbitrary and inefficient posting plans 4 food.”

Not one to ignore the plight of the down-and-out, I considered giving him some spare change, but in the end, I consulted the Magic 8 Ball my dispatcher uses to make posting assignments. It said, “Most Definitely Not,” so instead of money, I gave him a half-eaten Burrito Supreme … but told him he can only eat it cold, and on the random street corner I designate.

Inflation is hitting us all hard these days, and we’re starting to feel the pinch in ways we never have before. In that vein, here are the top 10 ways EMS agencies are cutting costs in the face of inflation and skyrocketing fuel costs.

1. Stop coddling employees. MRSA (Meets Required Standards Ambulance), a private company with 200 employees in Houston, recently announced plans to cut its employee appreciation budget in half. Via Zoom interview from his vacation home in Belize, company owner Greedy M. Ployer said, “Morale? We don’t have a morale problem! My morale is GREAT, and this move should save the company an easy $500 a year! In a down economy like this, everybody has to make sacrifices. I just laid off the pool boy, for goodness sakes.”

2. Innovative partnerships. One national ambulance company has announced business partnership with McDonald’s. In return for free ambulance transportation for all its employees, the fast-food giant has agreed to supply the ambulance company with all its used cooking oil to manufacture its own biodiesel. The move is projected to save the company nearly $10 million a year in fuel costs. Ambulance crews, however, will still have to pay full price in all McDonald’s restaurants. And no, you still can’t use their bathroom.

3. Alternative fuels. A number of ambulance coach manufacturers have committed to retrofitting existing ambulances with natural gas conversion kits for all Ford and GMC engines, along with a collector system fitted to the cab seats. As anyone who has ever worked with a partner who subsisted on the 3:00 a.m. gas station burrito diet can attest, this is an idea long overdue.

4. Advertising and sponsorships. Picture this: instead of your company’s logo and a Star of Life on the side, plaster your ambulance with decals from major sponsors. Above the stretcher, we’ll post a sign from the Law Offices of Dewey, Cheatham and Steele that says, “If you can read this, you may be entitled to a substantial cash settlement.” Instead of a post-call debrief, we’ll have a press conference:

Reporter: “That was a pretty strong run there, Dale. You got a ROSC and only had a 17-minute scene-to-balloon time on that one. To what do you attribute your success?”

Paramedic: “Well, I had cardiology talkin’ to me on the radio the whole time and we had a real good pit crew doin’ CPR and I shocked her a few times and give her a little shot of Epi on the straightaway. Stretcher got a little light on the back end as we pushed her to the truck but I got ’er back under control and we caught all the green lights on the way to the ED. I’d say it was a pretty good day for the Number 9 Hardee’s Pennzoil Bound Tree Blue Cross ambulance here today, and we’re lookin’ for a good performance at Decubitus Acres Nursing Home next week … ”

5. Maximizing transport capability. Let’s face it, EMS bike teams are a luxury we can scarcely afford with today’s fuel costs. We still need a small, agile response vehicle that can navigate through crowds at fairs and festivals, though. Introducing the EMS rickshaw from Wheeled Coach! Now your bike team has full transport capability, with no fuel expended!

6. Ambulance ride-sharing: When you work for a private ambulance company that does the renal roundup every day of the week, outfit a couple of your ambulances with a rack system for multiple litters. Schedule dialysis pickups along a designated route, and stack ’em in there like cordwood. (That’s a joke, for you shady ops managers who have been doing this illegal practice for years.)

7. Make patients pay out-of-pocket for luxury non-essentials. Make them pay extra for things like air-conditioning and shocks. A simple credit card reader and a thermostat interlock system would place the financial burden of climate control squarely on the patient. Customer service and comfort are overrated anyway; we’re in the business of saving lives, not coddling people!

8. Reduce idling time. No more wasting costly fuel at scenes or posting locations. From now on, if the vehicle isn’t in motion, the engine is off. What’s that? You’re sweating to death trying to stabilize the heat stroke patient? Well, all the more incentive to get that rig a movin’, son! Get some air flowin’ through those windows! Stop dawdling on scene and at the hospital, and that oughta improve our UHU and time on task, to boot!

9. Hold staff meetings at the ED. No sense paying people to listen to operational concerns every quarter or every month. You’d have a captive audience if you just sent the ops manager to the ED overflow area at each hospital. All your crews are stuck there anyway, and you won’t have to pay them extra!

10. Invest in new ambulance designs. With Tesla’s self-driving technology in their electric vehicles, we could eliminate fossil fuel dependency altogether, and cut staffing costs in half! Just let the vehicle drive you to the ED!


Read next:

10 ways to survive on an EMS paycheck in the age of 9% inflation

“At the rate inflation is going, I’m going to have my financial planner invest in Top Ramen stock” columnist Kelly Grayson, is a paramedic ER tech in Louisiana. He has spent the past 14 years as a field paramedic, critical care transport paramedic, field supervisor and educator. Kelly is the author of the book Life, Death and Everything In Between, and the popular blog A Day in the Life of An Ambulance Driver.