If you could change one thing about EMS what would it be?

[Dustdevil]

...wages are more than desirable in a fire based system.

But then again, we're talking about EMS. Perhaps you thought you were at firehouse.com?

[WolfmanHarris]

What are you talking about This Fracture?, wages are more than desirable in a fire based system.

Fracture - in this case meaning broken up into multiple parts. For one EMS system to have excellent benefits and good pay, and another to not due to having a different model means that EMS is fractured. Now if we all enjoyed these benefits regardless of what model the service was provided in, than it would be inconsequential and more a matter of semantics.

For example, I come from a system where every service save three are third service municipal. The three that are not municipal are direct private contracts from the municipality to run their EMS system. Wages and benefits are comparable from service to service (Wages b/t $28-38/hr and benefits for all FT employees.) If I move to a different area of the province I don't expect to have to work as a FF, nor do I expect a pay cut or raise that isn't comparable to the increase or decrease in cost of living.

This is a non fractured system. Though talking with you is causing more and more deja vu. Tell me again how awesome LA Co is as a system again?

[HERBIE1]

I disagree. This is a generalization that looks past the fact that private EMS systems can be just as problematic as fire based EMS systems.

My change would be that we would all come to work with an appreciation for how great of a job EMS really is. (and stop the whinning)

Did it need to be something practical?

Of course every system has their own problems. The problem is, because the systems that provide prehospital care varies so much that many of the problems are NOT universal. In some areas, pay is the primary stressor, others deal with a lack of resources and/or funding. and others may have all of these issues and more. Point is, it would be nice to say that every person that provides prehospital care would be fairly compensated for their talents, but that is NOT the case. Fire based EMS vs 3rd service vs municipal contract provider- the quality of care provided is up to the practitioner.

I think most people in this business DO appreciate what a great profession this is or they would never endure the various hardships that come with the job. Of course, we always strive to make things better.

[EMS49393]

It's a tie between complacency and cheap talk.

A majority of the people are complacent with how things are and view change as evil.

Those that aren't complacent should get off their duffs and back up the talk.

"We need more education!" Go enroll in some classes at the local college.

"People are lazy!" Who is, and why aren't you working to flush them out?

"EMS is young." Bullcrap, it's had centuries to evolve. That's right, centuries. They had makeshift stretchers used to carry wounded off the battlefields 250 years ago. They were our first medics folks. Again in the Civil War they found ways to remove soldiers from the battlefield to makeshift hospitals. During the Korean war, they had actual military medics complete with a complement of drugs and dressings. EMS is not a new idea, but it's taking a hell of a long time to evolve.

Stop talking and start doing. Make sure those around you SEE you doing. A heated discussion on a website doesn't count. Talk is cheap, people need action. The lazy masses will eventually either get fired or give up. What a way to have a nice, healthy cleansing of useless meat.

You want to progress EMS? Get off your hind-end and lead by example, everyday.

[Pav56C]

Im sure some will take offense to this and if you do its pointed toward you but:

Get rid of the old time good old boys!

The organization I am affiliated with is run by old (70s) people who are very againist any sort of change.

You try to make the organization a more professional one so that it wont be laughed out through out the county and your ideas are dismissed with no thought or explanation.

I have given up caring about the place. I punch the cllock and do my time. Until they are gone any attempt at improvement is futile.

[Dustdevil]

That is unfortunately a factor out there. It always will be. Twenty years from now, the new kids will probably be wishing you would go ahead and retire so they could change thing, lol.

I suppose I am in a unique position, being retired and associating mainly with those who are active in promoting the growth of the profession. Most of those I hang with are guys who have been around since the 70s and 80s, yet they are at the forefront of pushing for change. Consequently I don't see that many old timers who are just slugs like you mention. Such is the danger of living in the so-called "ivory tower" that educators and academics like me inhabit.

A related problem that I have always noticed is that so many young n00bs try so hard to emulate the tired old burn-outs because they think it's cool to be like them. Consequently, the attitude is perpetuated by the new generation, and never dies. This is really one of the reasons that I often find myself saying the only way to fix EMS is to simply trash it completely and start over from scratch, re-educating everyone from the ground up. Almost a Pol Pot approach to rebuilding the profession.

Sure, it sounds drastic. But sometimes you gotta break a few eggs to make fruit salad.

[cosgrojo]

I would like to change many things about EMS... but if I had to narrow it down to just one I suppose it would be the attitude. Pervasive unprofessionalism both holds us back as providers, as well as monetary compensation. It has well been flushed out on these forums that education increases (nationalized or not) would be the best and fastest way to universal acceptance as professionals in the medical world.

It worked for Nurses, and it would work for us... but I do not feel that our current "roster" of providers is professionally (i.e. containing the proper amount of core values and personal development) competent. Raising the personal standards that each of us has as individuals would go a long way to justifying our place in the expanding world of medicine. Act a certain way... get treated that way. We could have all the education in the world... but if we act like monkeys, we will continue to be perceived and treated like monkeys.

Dust- Pol Pot, and eggy fruit salad... Hilarious. I agree by the way. I would whole heartedly vote for a complete dismantling of the system... but only if I got to be on the next planning committee.

[Mparham02]

End once and for all SSM, and remove all private ambulances services that operate for profit from all 911 work! 911 one needs to be funded by the tax payers and user fees. In my area there is a private ambulance services that consistantly sends ambulances out of the county for nonemergency call and leaves the citizens with less than necessary coverage.

[Dustdevil]

You're throwing out the baby with the bath water.

You could accomplish the same thing, without the negative effects, by simply separating the EMS and non-emergency transport industries once and for all. No crossover. Neither has any business doing the other.

As for profit, that's a non-issue. There is no profit in EMS, no matter who runs it. For-profit hospitals are the best hospitals in the nation, so obviously profit is obviously not a factor in decreasing the quality of an EMS service. If that were true, DCFD, LAFD, and Detroit EMS would be top quality.

[cosgrojo]

End once and for all SSM, and remove all private ambulances services that operate for profit from all 911 work! 911 one needs to be funded by the tax payers and user fees. In my area there is a private ambulance services that consistantly sends ambulances out of the county for nonemergency call and leaves the citizens with less than necessary coverage.

Either the subsidy being paid the Private service is not big enough to justify keeping ambulances at the optimum level... or you don't have a dedicated contract forcing them to stay. It costs a lot of money to run an ambulance service, and with Medicare constantly reducing compensation rates, many private companies are trying to spread themselves too thin to minimize losses.

I'm not agreeing with these practices... just reporting it.

You could accomplish the same thing, without the negative effects, by simply separating the EMS and non-emergency transport industries once and for all. No crossover. Neither has any business doing the other.

Just when I thought we were getting along... I believe I will start a new thread on this topic...