ATale of Two Cities

Just today I have watched two very different stories about two very different Michigan cities. The first one in the news was Detriot and then later it was Grand Rapids. The common thread between the two is about getting control of the EMS system and improving its performance.

The situation in Detroit is truly sad and stems from a variety of problems spanning years. At this point the Governor is considering the appointment of an emergency manager while the system faces financial difficulties and now possible privatization. The comment that struck me in the video, however, was when the union president suggested that outsourcing would mean the city loses control of EMS. Is this really a system “in control”?

The story in Grand Rapids is very different. They began looking for control by trying to understand their existing system. What did they already know and how could that help them do a better job? They turned to study habits in their system and employ “System Status Management”. The sucess they found also earned them a local news story, but the tone was very different than the one above.

The question you need to answer is who is really in control of your system? That answer will determine whether the next news story about your service will be more like the one in Detroit or more like Grand Rapids. What is working for you?


  • Ray Mickol says:

    Great article. Unfortunately, as in other places, I am sure the EMS system in Detroit is run by politicians and career bureaucratic that haven’t a clue how to proper run a system. Until politicians can leave their hands off and trust the professionals to do the job they were hired to do we will always have excessive waste ans mismanagement.

  • Skip Kirkwood says:

    Here’s a simple fact. It costs money to provide quality EMS in a community. It is a rare community where “transport reimbursement” will pay for all the pieces of a quality, comprehensive EMS system. This is particularly true where many people are uninsured or under-insured (read “Medicaid”). The EMS system is not the only problem faced by Detroit, but it is symptomatic of the issues faced in what looks a lot like a distressed city.

    If the city wants quality EMS, they have to fund it. If they want to get out of the business, do so – but don’t let the service die a lingering death (because the citizens will, too). “Privatizing” is a temporary fix at best, because if the city can’t make it work, it is unlikely that a private company can make it work in the long term either. Savings from “private sector business practices” will either go towards company profit (a good thing in the private sector) or will come at the expense of patient care.

    Not an easy issue to address!

  • Dan Gerard says:

    I agree with Skip. Regardless of service provider/model, the system has to be adequately funded, with clear expectations spelled out (response time parameters, QA parameters, prevention activities, community education, etc.)

    My heart goes out to the residents of Detroit, the men and women in Detroit F.D. who are providing EMS.

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