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In Praise of (Some) Bureaucrats

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The National Association of State EMS Officials (NASEMSO) meeting is always one of my favorites. For one thing, it’s held in interesting places that typically don’t host national conferences—think Madison, Wis., or Little Rock, Ark. This past September, it was held in Boise, Idaho. (Pronounced boy-SEE, not boy-ZEE, as Dia Gainor, former Idaho state EMS director and current executive director of NASEMSO, likes to remind me.)

For another thing, it’s embracing to see how the state and federal bureaucracies are tackling many of the toughest questions facing the profession: workforce planning, future reimbursement models, disaster preparedness, education, safety, drug shortages—you name it. That’s right, the bureaucracies are fighting for you!

In not just this election cycle, but for many years the term “government bureaucracy,” as well as the bureaucrats who work there, have come to be almost synonymous with evil, and I think it’s wrong to be so dismissive. If you recall your Management 101 history of organizational development, it was economic guru Max Weber who in the early 1900s originally promoted the idea of the bureaucracy—an organization with a specific mission, standardized written rules and procedures, and a defined hierarchy staffed by people with technical expertise compensated based on demonstrated skills, experience and education. This was a stark counterpoint to the nepotism, inefficiencies, incompetence and outright thievery that was the norm at the time.

OK, so that ideal hasn’t exactly worked out. Obviously there are many government bureaucracies that can be incredibly frustrating to deal with, enforcing rules and procedures that are designed to be fair to all but that can seem idiotic when applied to the individual (at least to this individual). However, the conversation needs to be about how to make our bureaucracies better and more agile—to use a term phrased by Jay Fitch in his BP Leadership Series—and not to simply demonize the entire government workforce.

The NASEMSO conference is full of bureaucrats at the state and federal level, and guess what: The vast majority are very smart, dedicated people who work extremely hard at making things better for everyone in EMS, even if the bureaucracies they work within can be cumbersome, and even if you don’t necessarily agree with the policies they were hired to fulfill.

One session updated the major projects being done on a federal level. The panel included Drew Dawson, director of NHTSA’s Office of EMS; Elizabeth Edgerton representing EMS for Children; Rick Patrick and Mike Stern from the Department of Homeland Security and FEMA; and Gregg Margolis from the Office of the Assistant Secretary for Preparedness and Response. These five organizations belong to the Federal Interagency Committee on EMS (FICEMS), which also includes the Federal Communications Commission (which deals with many 911 and emergency communications issues) and the Department of Defense. FICEMS meets regularly to coordinate their efforts, and you can download minutes of their meetings at here.

I don’t have room here to go into detail on their reports (we’ll be covering those in future issues), but you should get familiar with their efforts—and the more involved you get, I think the more impressed you’ll become with these public servants.

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