Struggling for an identity
While unfortunate that the Field EMS Bill died in the lame duck Congress, it was not unexpected. It's lack of priority for our nation's congressional leaders reflects the overall lack of understanding of what EMS professionals already know — emergency medical care and transportation of the sick and injured is as much of a fundamental public safety issue as law enforcement, and fire suppression.
Since 1973, when the EMS Act failed to create a comprehensive infrastructure to operationalize, manage and improve EMS nationally, we have been struggling to find our identity as a public safety provider, health care provider, or public health provider — and in reality, we're a bit of all three, and master of none.
It's no secret that EMS systems vary widely in purpose, philosophy, and deployment structure. Sitting in my crew's quarters, I began to think about just how variable it is. Here's my quick list on how we vary:
- Paid versus volunteer versus combination
- Tax supported, medical reimbursement, subscription, donations, combination
- Hospital service, county Service, fire Service, commercial, volunteer, police service, nonprofit, public utility, private-public partnerships
I'll bet that readers can come up with even more ways we vary, coast to coast, state to state, region to region, even from one town to the next.
Why is this important to note? With each variable it becomes more and more difficult to understand exactly what we do, and how we do it. With no consistency in data, we have no consistency in quality management.
Without that, how do we demonstrate our effectiveness? I mean, each one of us makes a difference, but how do we do it as a profession? How do we achieve a consistent set of standards that we set for ourselves, for education, training, pay, or level of care?
Efforts like this white paper, and the Field EMS Bill, aren't THE answer to our issues. However, they start the process that has the potential to set up the infrastructure that allows us to move forward as a unified profession during the next 30 years, in ways that it hasn't been able to in the last 30 years. Now, that would be government I would believe in.