A Country EMS in The Big City

Last night I was fortunate enough to have been given the opportunity by Baltimore City FD to ride-along with one of their EMS crews as part of the EMS Today 2012 conference. My desire was to learn some of the many differences between their service and the more rural EMS service back home. While there clearly were definite differences, the thing that struck me more than anything else was actually how similar we all are, not how different.

I anticipated the promise that each tone held to expose me to some uniquely urban situation. And while the individuals I met were clearly unique, the choreography between us all was mostly a repeat. This is exactly how we are trained in EMS. We take whatever situation is given to us and we bring a defined order to the chaos. We seek sameness in purpose and outcome. The empathy I felt for the apparently homeless patient with the self-induced alteration in LOC and the young woman facing a possible miscarriage was no different here than anywhere. I simply wanted to help. The public attitude toward EMS leading to abuse of the system and the painful inefficiencies it causes was also no surprise. We face the same issues everywhere even if the proportions change.

It was witnessing the banter between calls that told me I wasn’t back home. The teams and even the sports were different, the union issues too. But then then there was the discussion of changes in protocols, the latest findings in medicine, the issues faced in home life. Maybe I am not so far from home after all.

At this conference I have already met medics from truly rural areas as far apart as Georgia and Alaska. I’ve met some who work for private agencies and others who come from city or county services. It is a commonality that brings us together and that allows us to discuss and learn from each other about our unique situations and approaches. The pre-conference session I attended yesterday has also helped me think about operational questions I had never considered before. Personally, I am definitely ready to start this conference today with a proper perspective.

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Comments
Jeffrey Hammerstein
Stop Dissing Response Times and Start Dissecting the Argument
I think that the position someone takes on this issue depends entirely on the circumstances of the particular EMS system they have in mind when they consider the question. If we're comparing a 7 minute response time to a 70 minute response time (or infinite as mentioned above), then of course it matters. That's a…
2015-07-03 11:44:45
Dave Shrader
Stop Dissing Response Times and Start Dissecting the Argument
I had meetings recently with a client in an underserved County. They have multiple tax supported volunteer organizations, and a City FD as EMS providers. The system is totally Balkanized with each agency doing it’s own thing. One agency failed to even respond to 66% of its calls last year. So, 66% of the time,…
2015-07-03 08:08:44
Matt Zavadsky
What Higher EMS Pay Requires
This article is spot on - the rapidly changing healthcare finance environment is a game changer for us - IF, and ONLY IF, we can prove that we bring value to the payer... Does our care make a difference in the patient's experience of care, outcome and cost of care... By assessing our patient satisfaction,…
2015-06-17 08:38:01
Steven Lichtenberg
What Higher EMS Pay Requires
The biggest issue in pay scales is one you hit on directly. Payment for service rendered is solely based on transports. Refusals/DNR/DOA etc are not reimbursed. Once Medicare determines that we are in fact medical professionals and not "ambulance drivers" and pays for care rendered we have a chance. Community paramedicine is one mechanism for…
2015-06-16 21:47:53
daleloberger
What Higher EMS Pay Requires
Thank you for making the comment, Kim. I suspect you may have missed my meaning in that statement though. The passionate folks in EMS are some of the hardest working people I know. My complaint is certainly not that "we" don't put enough into our jobs to deserve better pay, it is that we must…
2015-06-16 18:13:18

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