The Dallas program shows how EMS can lead health care reform

By expanding our roles, not scope, community paramedicine programs represent a new way of thinking that can shape the future of health care

Six months ago we reported that the Dallas Fire-Rescue Department was initiating a community paramedic program to better service its population of frequent 911 callers. It’s no surprise the program is experiencing early success by saving the department (and taxpayers) valuable resources and money. Given that this is a pilot program, I am looking forward to seeing how it will evolve. 

There is a key element buried in this article: the partnership that the department is forging with area hospitals and medical systems that will provide the funding necessary to grow the program. This represents a new way of thinking for an industry long trapped by its own traditions and preconceived notions of what it was, not of what it is or could be. 

There have been quite a few workshops and conferences covering the community paramedic/mobile integrated health concepts over the past few years, including the recent ZOLL summit in May. EMS is at the tip of the spear when it comes to reforming health care in the United States.

What is happening to our segment of the industry is emblematic — we are expanding our roles, not our scope. We’ll see more of this evolution throughout health care.

A more subtle shift is in the area of public safety. Both fire and EMS services are experiencing change. Again, this should be no surprise — as society changes, so should the services it receives.

There are fewer buildings that burn, and more non-emergent patients to manage. There’s the increased threat to homeland security and a greater need for hazardous material mitigation. Public safety departments have to evolve quickly in order to protect their communities in a meaningful, effective way.

Kudos to Dallas and Fire Rescue for making the brave choice to evolve. Other large city departments, take notice —change can be done in a positive way.

About the author

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.

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