By Drew Johnson
EMS1 Editor
One way or another, the future of EMS in the United States will look very different from the present.
That was the message given by John Sinclair, Fire Chief and Emergency Manager of Kittitas Valley, Wash., Fire and Rescue at a session on the future of healthcare and the role of EMS at Fire-Rescue Med in Las Vegas on Friday.
Chief Sinclair, who is also the chair of the Fire-Rescue Med planning committee, said the time to drastically rethink the role of EMS in healthcare has come.
“We have to realize that EMS has a larger role in healthcare, and that not all the calls we are going on are emergencies,” he said. “Think about your system: are you bending under the weight of too many patients? Is your system already broken?”
In his talk, Chief Sinclair echoed many of the ideas put forth by Chief Dennis Murphy in his session Thursday about the role of mobile healthcare in EMS. Both argue that various pressures will inevitably force EMS systems to deal with the problem of too many emergency calls.
Chief Sinclair argued that as the baby boomer generation hits old age, the number of non-emergency calls agencies face will continue to rise. These patients, as well as younger people suffering from obesity-related diseases, will further burden overstretched EMS systems.
One solution to this, he said, is broadening the role of EMS in the healthcare system. He argued that medics should be able to treat non-emergency patients while still getting compensated by Medicare and Medicaid.
“We have to look at whether ‘treat and release’ has a part in our system,” Chief Sinclair said. “Because the fact is that now, if you don’t transport a patient to the emergency room, you don’t get paid.”
Firefighters and medics should be using their substantial political resources to influence government spending on EMS, Chief Sinclair said. He pointed to the fact that though EMS only receives a tiny fraction money from Medicare, it is a driver of other healthcare spending, much of that in the form of unnecessary emergency room visits.
That’s a disparity that must be addressed, especially with a growing segment of the population needing low-acuity care.
“The future may be a paramedic in a Chevy Volt or Smartcar, who goes out to take a look at the patient and treat them or call 911 as necessary,” he said.
Whether or not that vision becomes a reality, EMS needs to take a hard look at whether people are using the system or abusing the system, he added, because, as it is now, EMS will begin to lose its ability to function.