Things that make no sense in EMS

1) EMTs and paramedics are constantly told “We don’t want you to know how billing works because we don’t want you to let finances influence a decision to transport a patient.”  Makes sense.  But then we’re told, “If you don’t document this chart correctly, we can’t bill for it.”  So, are we supposed to have an understanding of billing or not?   Personally, I wouldn’t mind a better understanding of billing and reimbursement.

2) When a volunteer service fails, we hear the advocates for paid EMS argue that a community gets the EMS that it pays for.  Exactly.  Please remember that same maxim when a private operator argues that they can provide EMS service to a community for free or a very small subsidy.  These operators will continue to make money by scrimping on pay, minimal equipment, minimum staffing, lowest common denominator protocols, and posting crews at street corners.   And with these working conditions and/or wages, the community will get the kind of EMTs and paramedics they’ve paid for.

3) Final thought from someone who volunteers.  We hear about the death of volunteer EMS.  Sadly, I’m afraid that day may be closer at hand.  But I also think that there’s a place for volunteers still, even if just to supplement staffing and coverage.   All it would take is some organizational commitment and flexibility.  My question is whether we’re really losing volunteers or whether we’re losing organizations that accept volunteers.  Around my neck of the woods, it’s the organizations that don’t want volunteers….


  1. I’m a volunteer EMT, employed full time as an Air Force IT guy. I truly love emergency services, whether I’m hanging out with police, fire, EMS, or emergency department staff. I have no desire to do EMS full-time; I don’t want to hate it, and I can make more money using my IT skills.

    I only want to ride as a third hand. As far as I know, every paramedic I’ve worked with has had a high opinion of my EMT skills and is grateful for my help.

    Unfortunately, the two local major municipal fire departments (primary 911 EMS providers here) wouldn’t give me the time of day because I’m not a student. I do ride occasionally with a local county EMS agency, but it has a very low call volume and I’m not officially supposed to touch the patients, despite being NREMT certified and state licensed.

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