Challenges for rural EMS

Editor’s Note:

Editor's note: Officials are worrying about how to recruit and retain volunteers for EMS in rural West Texas. Editorial Advisor Art Hsieh says that he doesn't think financial incentives are the final answer.

Rural EMS is a beast onto its own. The number of calls is few and far between, and insurance reimbursement for those runs is never enough to cover the cost.

I don't know what the real statistics are, but I'll hazard a guess that proportionally there is a higher incidence of high energy trauma cases and medical acuity of patients who live in these areas.

There are few numbers of available Emergency Departments and trauma centers that service these areas, naturally, and it's well known that it is difficult to recruit and retain physicians, nurses and other professionals to live and work in rural parts of the country.

Reagan County appears to be trying in earnest to keep its volunteer-based EMS response system going. They have offered some money to its providers to respond to calls.

It seems though that financial incentives are not the final answer — it's the ability to recruit and retain volunteers in an economy that have people looking for work, or working a string of low-paying jobs to simply make ends meet.

It's a scenario that is repeated daily throughout the country, not just in rural regions but in suburban areas as well.

This situation is unlikely to improve, even when the economy does. We have come to expect a certain level of training for our Prehospital care providers, and the complexity and sophistication of even basic systems have risen to beyond the ability of volunteer administrators.

At the same time, we are not prepared to fully fund EMS services. The passion of the existing volunteer structure, coupled with cash-strapped municipalities makes it an incredible challenge to overcome. Add to that the notion that no two systems have the same exact needs, and it'll be some time before there will be a good solution to this issue.

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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