My friend Mike Ward, who I met as “FossilMedic“, asked a question in a blog post back on September 10 wondering aloud “What will the fire service look like by September 11, 2021?” Well, a few of my fellow EMS bloggers took the challenge of answering that question. In his blog post on the subject, Greg Friese presented a mixed bag of specific predictions as he also extended the question to include EMS as well as Fire in the query. The gadget geek known as “UnwiredMedic“, or just Christopher Matthews to some, also quickly took up the challenge focusing on the advances in technology as he usually does in his post on “the closure of another anniversary“. Finally, Bob Sullivan focused on his trademark patient perspective in discussing provider skills and training that will be common in his view of “EMS on 9/11/2021“. I am quite late to the fray, but hope to join these friends in making my own prognostications from my own unique vantage point on improving the efficiency of EMS.
The way I see it, in another ten years we will be past most of the in-fighting we currently experience between firefighters and paramedics about who does what more effectively or efficiently. I hope that by the 20th anniversary of the terrorist attacks we will finally recognize that the public is both the focus and financier of our efforts outstripping our desires for shiny equipment or promoting blind union allegiance. We face the pressures today of a changing environment where a lack of volunteers is necessarily being replaced by paid staff increasing provider costs and an aging and increasingly unhealthy population is placing more demands on emergency resources. All while, the very foundation of the heath care system is continually being overhauled with changes to well-established financial reimbursement incentives. The fundamental change we will witness regarding the structure of provider agencies in coming years will not be a linear progression from today, but the enhanced variation of a “punctuated equilibrium” driven predominately by rising costs and demand that are clearly out of line with our commitment of resources.
The first ten years since 9/11/2001 saw unprecedented spending in public safety at every level raising debts nationally and locally. Now we face an economy that cannot sustain current spending patterns and will demand increased efficiency along with the increasing efficacy of evidence-based treatments. To get more from less, we must do better. I believe we will see the advances in technology and education that others have predicted because it will prove to improve service, but we will also see consolidation of agencies along with increased specialization. Medically focused professionals will handle the majority of medical calls. Savings will be realized by integrating these medical responses with advanced medical providers given incentives to improve long-term health outcomes.
A future we need and can live with. What do you see?