Community Paramedicine

Years ago, I attended a Citizen’s Police Academy program sponsored by my local police department.  It was designed to give the general public an insight into how the police department works and foster communications between the police and the public.  (And for what it’s worth, EMS is massively behind the times on our public outreach.  Fort Worth MedStar is the only non fire-based EMS system I’m aware of that operates a citizen’s academy for EMS.)

One of the best things that I got from this program was an explanation of community policing. The officers presenting this material explained that the police might have an idea of the community’s needs, but without actually engaging with the community and determining what the community wanted, there wasn’t community policing. The example was that the police might assume that the community wanted something done about an uptick in car burglaries, but the community might not even know about this and might well be more concerned with people speeding through a school zone. In other words, the police figured out that community policing doesn’t work without community engagement.

And now, let’s flip the conversation to EMS. EMS is talking a lot about “change” to meet call volume and demand.  We’re talking about alternative destinations for patients.  We’re talking about triage and different response models for “non-emergent” calls. But more than anything, we’re bandying about buzzwords and have convinced ourselves that the public is “abusing” the EMS system. We’ve almost become the police in the “bad old days” of policing where the cops were “us” and the public was “them.”

In other words, we’re doing what the police did before the community policing model developed.  We’re developing an EMS system based on what we think the public wants.  Perhaps we might even be developing an EMS system based upon what EMS wants. What we’re not doing is engaging the public to determine what they want, need, and expect from their EMS system.  Absolutely, we have a professional obligation as medical providers to first do no harm. That responsibility has some obligations.  As does the responsibility to be responsible stewards of the money provided to the EMS system.

But outside these obligations, how many EMS systems or political leaders engage the public to find out what they want or expect from their EMS system?  How many EMS systems educate the public what EMS is or does beyond “call 911 for an emergency?”  How many EMS systems teach that there haven’t been mere ambulance drivers for decades — or that EMT and paramedic aren’t necessarily interchangeable terms? And have we asked the public if they want mobile integrated health?  Or if they judge an EMS system by cardiac arrest survival rates and response time?  My strong guess is that many member of our public would be very happy with their EMS system if the medics showed up on time, were nice, gave them a safe ride to the hospital, and just maybe everyone’s medical records were synced together.

But if we don’t ask the public what they want from us and how we can help, we’re doomed to irrelevance and distrust, just like the police were — before they engaged the community.

Speak Your Mind

*