A lot of my friends in EMS complain about fire-based EMS. I’ve been among them, although I think the problem with many of the large urban fire-based EMS systems is that they’re large. Once a service becomes too big, it’s hard to manage effectively and even harder to prevent a “lowest common denominator” practice of medicine.
The one thing I’ll give the fire service is that, even when they bitch about being on the ambulance, they indoctrinate a love of the job. And that’s not something you always see in the non-fire-based EMS world. Where is the EMS version of Alan Brunacini teaching customer service or our version of Rick Lasky teaching “Pride and Ownership?” EMS will begin to improve when people who love being paramedics are running EMS systems.
And if you don’t love being a paramedic (or EMT), there are plenty of ways to deal with the burnout, whether it’s a change of employer, more education, or finding an alternative practice setting. (You know, there are non-ambulance settings where you can be an EMT or paramedic.) But until we fill EMS with people who WANT to be in EMS and who understand that clinical excellence and customer service/problem solving skills are both critical, we’re still going to be the ambulance drivers.
Love of EMS is certainly a factor, but it is only that; a factor. Leadership, energy, a solid business background, and a firm understanding of politics with the ability to work within the political system are also vitally important.
I agree with your statements. One other problem that I see is our lack of a clear placement in the scheme of things. We have public and private services, emergency (911), transfer and now community health services. The fire service (and I am in the fire service) typically has one niche, as does law enforcement. But we are seeing people emerge as leaders in our field. Bob Page is one such example of an EMS leader, and so is Wes Ogilvie. Many of us love EMS. Those who go those extra miles like Bob and Wes are our Alan Brunicinni’s.
Things are already improving-it’s just glacially slow. The advent of EMS as a sub-specialty and many agencies realizing the importance of some standardized practices, such as CQI, education, etc, things are changing for the better. Community Health Paramedicine and advances in STEMI, Stroke, and Trauma care are making a difference.
The problem isn’t that EMS doesn’t attract people who want to be there, the problem is it drives those people out in multiple ways.
I love being a Paramedic! 🙂