“Success is to be measured not so much by the position that one has reached in life… as by the obstacles which he has overcome while trying to succeed.”
- Booker T. Washington
With multiple premiers of The Chronicles of EMS and a wave of enthusiasm from the EMS Today conference in Baltimore, the future of EMS looks bright, blindingly-bright. I’m incredibly optimistic about where this crazy experiment in EMS is headed, but I also see some big hurdles in our path.
Put on your shades and let’s talk about what I feel are the five biggest challenges to EMS reform.
1.) We’ve been talking a lot about unity and standardization, but individual EMS systems are unique in every way. How do you influence standardization and still allow for the tremendous leeway required for EMS agencies to be optimized for the communities that they serve? Can EMS agencies be different in geography, financial resources, administrative structure, culture, call volume, compensation and certification/education level and still find enough unity to advance the profession together?
2.) Today’s EMS systems are run by local agencies. A collective of public, private and third party agencies, guided by medical directors who maintain autonomous control over the care given in their system. People in positions of power and influence are reluctant to sacrifice control to larger concerns. How do you convince local power brokers to relinquish control over standards that they currently establish and oversee as they see fit?
3.) How do you encourage unity without creating conformity and stifling creativity and innovation?
4.) Mother Teresa once said that she would never attend an anti-war rally, but if you ever organized a peace rally, she’d be there. Will we gain more by rallying against the things that are wrong with EMS or supporting and expanding on the things that are right?
5) Emergency room physicians and hospital administrators have a tremendous amount of influence over how EMS is conducted. They also profit from the current inefficiencies in the U.S. EMS system. How should we encourage hospitals and physicians to support the idea of alternate transport destinations when they are the ones who profit from patients being delivered to the E.R. Why would U.S. ER Physicians support paramedics making doctor’s appointments, transporting to urgent care facilities and leaving patients at home when it takes revenue from their pockets?
There are good answers to all these questions. Before EMS 2.0 can blossom these questions will need to be answered.
What are your answers? (Note: If I get a large enough response from the blogging community, I’ll create a follow up post to link them all together.)
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