EMS volunteers in critical condition

Is it time to rethink system design?

The state-wide EMS system challenges in Iowa have been well publicized this past year. Any of us who volunteer to provide EMS to our communities know all too well the problems we face in maintaining continuous coverage. Sadly, this issue has been ongoing for decades — it’s been more of a dirty secret than a new issue.

Our national EMS system was conceptualized over 40 years ago, when life was simpler. Single income households were the norm, and volunteering large amounts of time and money was realistic. By and large, this environment disappeared a long time ago. I’m not passing judgment, but it has been time to rethink EMS provision for a long time. 

Why do volunteer systems continue to cling to the past? I suspect that it’s a combination of pride, provincialism and a perceived lack of available resources that maintains the status quo of a broken system. To be fair, other public services are also affected by similar factors — small towns that continue to have their own fire and police services, for example. Regionalizing such services can help reduce the administrative overhead and provide a greater level of resources.

But I digress. Rural communities deserve better service coverage than what this study appears to show. And it’s not fair to disparage the volunteer EMS provider. But maintaining the status quo should not be considered an option. 

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 Art.Hsieh@ems1.com and connect with him on Facebook or Twitter.

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