An EMS Wake-up Call

To all of the “ambulance drivers” out there, let me just say “wake up!” We have some amazing resources available to us to improve EMS in person and across the internet. Conferences like EMS Today provide a world of opportunity to learn new skills and improve our services. If travel is an issue, you can receive Continuing Education through services like LearnEMS from CentreLearn. All over social media there are discussions on both the ills and the future of EMS. LinkedIn has a group specific to EMS Leadership and Administration and Google Groups has a NEMSMA forum. Just this year a fantastic new blog, The EMS Leader, was started to promote thought-leadership in directing EMS. I’d even like to add my own Facebook page on High Performance EMS and Twitter feed at @hp_ems as examples of effective information dissemination and discussion. But with all of this available to us, I would like to paraphrase John Lennon in saying that “Your career is what happens to you while you’re busy making other plans.”

The reason I am so riled up this morning is because of a city council vote today in Jersey City that may end the 130 year legacy of a hospital run EMS in favor of a private, for-profit ambulance service offering the city money for the right to provide exclusive EMS services there. And we aren’t talking about just any hospital, Jersey City Medical Center is a nationally recognized teaching hospital run by LibertyHealth. With all the discussion of “Community Paramedicine” and EMS transforming into “Mobile Health Care” among ourselves, we see a municipality that appears to be looking exclusively at a financial bottom line (read Jersey City council hears arguments from two bidders for ambulance contract at tonight’s caucus or search for additional articles on the topic) instead of a broader picture of services and criteria based on community health and safety. Have we been so distracted by internal focused searches for evidence-based practices that we forgot to communicate our value to the public as health care professionals? Leadership in our profession is not solely the job of management. Sure, we need vision in our administrators and medical directors, but we are not exempt in taking responsibility for change. If you hope to see your career grow as a profession, we each must do our part to improve ourselves and expect more from our partners and throughout our services. What is happening in New Jersey should not be seen just as a political anomaly, it must inspire us to be more and let our communities know the value we can bring.


  • Jimmy A. says:

    I fail to see why a private service can not provide quality care. What am I missing here.

    • daleloberger says:

      I have no problem with private services per se. In fact, I believe that many of them are superior to the government run services they replaced. My concern for Jersey City is specific to the services in question. JCMC EMS is a nationally recognized, highly performing EMS service. The reason being considered for their replacement is strictly cost savings. Under the “High Performance EMS” title, I also support cost savings, but it should never be the sole measure of a health care provider.

      • Jimmy A. says:

        Then the natural follow up to that is- is the service taking over going to provide a high standard of care? Are they a known quantity? Because if they are, then the cost savings are justified.

  • Kevin says:

    You would probably see more “buy in” on this if EMS had a “Professional Career Salary” and not a fast food salary. Police, fire and nurses make a lot more than Paramedics. My wife is a Surgical RN Manager here at a major Hospital and she never has the inservice we have. And now with Community Paramedicine being talked about, there is going to be even more training and still horrible salaries. I’m tired of EMS folks advocating about doing more, get more continuing education and responsibilities but never bring up the insulting salaries across the nation.

    • daleloberger says:

      You are absolutely right, Kevin, that EMS services should offer pay commensurate with their duties and responsibilities. In the same way, an EMS service should be contracted not as the “low bidder” but based on attainment of measurable health care goals, performance, and efficiency. As long as politicians contract commodities, pay will remain low. Once we communicate – and provide – exceptional value things can change.

      • Robert says:

        Dale, I agree working with an EMS contractor or ambulance service pays relatively low. The fire service pays more because they have a great union and do great PR with the community. Fire-based Paramedics usually join the IAFF, not NAEMT or other EMS union. Collectively, if we would lose weight, stop smoking, and publicly promote a healthy lifestyle with some injury/illness prevention thrown in, PR ratings would increase along with pay. Why wouldn’t FF-Paramedics want to fund the union that helps them get more pay? Nurses get paid more because their profession takes their education seriously and requires a college degree to get registered… and they have a strong union. If EMS would jump on one of these bandwagons, it would help the providers get more commensurate pay for the work. It also doesn’t help we are federally represented by NHTSA vs. DHS. Instead we bitch, have low entry requirements, and don’t work collectively to improve our profession.

    • Skip Kirkwood says:

      If EMS providers would band together and get the educational requirements raised, there would be a smaller labor pool and salaries would rise. Salaries are what they are because people are willing to work for that money. And because we keep encouraging people who do it for free, and who CAN do it for free because entry level standards are too low.

      We are in a mess of our own making, and we don’t have the courage to get out of it.

  • John says:

    Were was everyone when the township of Edison and JFK shut down the voulentert. Squads who had that stats similar to jcmc. The 6 min response times the cardiac resuscitation torn oversz no where. That’s were, that’s the nature of the beast in the industry of EMS. Deal with it.

  • I am not an EMS professional. I’m a mom in Jersey City who has learned a lot about EMS, ambulances, response times, MARVLIS, BLS vs ALS ambulance, etc. in recent days because of what or Mayor is proposing – a change from JCMC to a much small private EMS provider majority-owned by CarePoint Health.

    Since learning about this issue and researching it for my blog, I am STUNNED by the amount of expertise, quality, and passion I see at JCMC, and that I assume exists at other high performing EMS centers.
    For me, this is 100% about quality. As a taxpayer, I care about keeping taxes low. But JCMC is offering the services at zero cost AND they currently have some of the best response times in the nation, they have MARVLIS which is unique in the tri-state area (not even NYC has it, apparently), and the feature article in JEMS from Feb/2012 is about as clear a picture of quality that can be painted.

    Yet our city council wants to go with a private provider that currently handles 20% of the volume that JCMC provides, PLUS the provider is located in a different city (Bayonne). I just don’t get it.

    In my opinion, Jersey City residents would be more concerned by what is going on (with potential loss of JCMC as BLS EMS provider) if there was more awareness about EMS. I think there is a general level of appreciation for first responders, but the factors that separate the good from the great are worth educating the public about.

  • mrfaisel34 says:

    I’m sorry, but all this naysayer’s spiel and portensions of doom, should another EMS service takeover the city contract, is nothing but FEAR OF CHANGE. After 130 years, Jersey City residents are in desperate need of change! Awarding another EMS service the EMS contract does not preclude them from expanding the business. In fact, this is what any wise EMS administrator would do, once awarded the contract. JCMC EMS needs competition. The new EMS service will prove to Jersey City they are better. Right now, JCMC EMS does not have the desire to prove it can be the best. It is stupid so simply accept the status quo as the best situation for JC. Lest we forget: price gouging, diverting of patients to JCMC and missed emergency calls are some of the many complaints from Jersey City residents. My friend is the victim of ongoing gang-stalking which JCMC EMS drivers willingly participates in collaboration with OEM/HLS director W. Greg Kierce. This has gone on for four years. City taxpayer money should NEVER be awarded to an organization that knowingly disrespects Jersey City tax payers.
    JCMC EMS has forgotten that Jersey City residents are the “LIVES THAT MATTER,” not theirs.

  • Skip Kirkwood says:

    To the folks moaning about the salaries – learn about the law of supply and demand, and the P-Q curve. Here’s the magic – as long as it is easy to make cheap EMTs, salaries will stink. As long as we allow and encourage people to do the job for free, salaries will stink. If we raise entry requirements, choke off the supply of cheap labor, salaries will rise. It’s as simple as that.

  • Skip Kirkwood says:

    And by the way, salaries are not terrible everywhere. If you choose to stay in a low-pay or no-pay market, that is a personal choice.

  • Anthony Correia says:

    Is this article about expanding EMS services or about JCMC? Not for or against JCMC losing the contract. I have to be a neutral party on that situation. This type of process to select EMS services has been going on for a quite a bit of time and increasing in NJ. It may be an anomaly in Jersey City, but not in the rest of the US, including NJ. EMS has few recognized performance stands for quality of care. In fact the 8 minute response time is the most used, yet has little impact on outcome and has been shown to be a poor barometer of quality performance. All your government leaders care about is getting their constituents to the hospitals where the “pros” can take care of them. EMS agencies in general, other than the fire service are not organizations where careers flourish. Providers work 2 and 3 jobs to make ends meet. As Skip alluded to there are too many providers out there to make them of values and from my perspective no real science on the value of well trained, experienced providers making a significant impact on mortality and morbidity. If that was the case, this discussion would not be going on. As said many other places, until EMS becomes a value added service measured by the quality and experience of the employees that are encouraged to make their service a long term career choice, not much is going to change. While I am a huge proponent of Community based EMS, ( It doesn’t have to be paramedics), We aren’t going to move that concept forward in many communities until we find value in EMS in general.

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