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Detroit EMS eases away from brink

Contract with city shows EMS taking the lead toward a more stable work situation

Detroit’s financial woes have been well publicized and criticized over the past year. Its shrinking EMS workforce has been performing a yeoman’s task of providing emergency care under really poor and dangerous conditions for a long time, even before the city’s leaders shirked their responsibilities for maintaining public safety. While the details aren’t fully known yet, it sounds like the staff will start receiving much-needed raises and hopefully, improved working conditions.

Though extreme, Detroit’s issue is reverberating through the industry. Over the past couple of years we’ve seen both public and private EMS agencies struggling to keep the doors open and provide quality service. Shrinking revenues, changing operational environments and a deep, prolonged recession have contributed to less stable conditions, which affect EMS providers and their families.

On the bright side, innovations in EMS system design hold promise. Community paramedicine programs are being piloted throughout the country with real promise. It won’t replace the fundamental need for emergency response and transport, but community paramedicine may become an integrated part of what EMS providers do in the field.

Detroit EMS has a long way to go. Many of its problems were in place long before the financial crisis. But you can’t fix the bigger problems until there is enough structure in place to make change happen. Given the current state of affairs for the bankrupt city, it can only be a good thing that EMS is taking the lead in building a more stable work situation.

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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