The fight for control of EMS systems

It's vital the powers that be put the politics aside and work toward optimal configuration for the patient

Editor’s Note:

Editor's note: With two local legislators proposing a state law that would force a Fla. county to use firefighters to take patients to the hospital, Art Hsieh takes a look at the bigger picture.

Shades of deja vu: This article highlights yet another reason why EMS can't fight its way out of a wet paper bag.

This time the local jurisdictions fighting for control of their EMS system are using the blunt edge of politics to outmaneuver common sense and reasoned debate.

There are the typical assertions that are being thrown as fact and dogma. "It's cheaper if we do it this way." "It's faster if we do it that way."

Please. Haven't we been down these paths before? Both of these assertions will require intensive study to really get to a fundamental understanding of the facts.

Let me emphasize, however, that the "facts" may not be the ultimate "truth". There are so many variables beyond the figures that are difficult to quantify.

For example, does time really make a difference for 99 percent of EMS calls? Do non-transport paramedic providers really make a difference in outcomes?

For that matter, do transport paramedics make a difference? Can the system evolve into a more proactive one that provides a greater range of services, beyond ambulance transport?

I'm hoping that the legislator's proposed bill will do what's intended — in as much as bringing everyone to the table, along with a real financial analysis and a true operational analysis.

I have no doubts about it — money is tight and resources are thin. And with federal reimbursement of ambulance transport failing to keep up with the operational cost, the smart people who run the system really need to put the politics aside and work toward optimal configuration for the patient.

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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