I posed this question the other day on Twitter: “If you offered your local politicians a lesson in EMS, how receptive do you think they would be?” I got a variety of answers some more jaded then others, but it really got me thinking: what would I tell them, and what would I want them to take from what I have to offer?
When it comes to EMS, many people both in the community and in positions of power have an attitude of “how hard can it be?” They think if you put two people with a patch on their shoulder in an ambulance and put them on the street, they will pick someone up and get them to the hospital. That is true if you want mediocre service that provides nothing more than a “point A to point B” relocation for people. That, in my opinion, offers virtually nothing to the community. Prehospital response and care is supposed to be much more than that.
We have also accepted incorrectly that EMS is a time sensitive business. Faster is better. Fast care means effective care. Not true. Those of us IN the field understand that despite what some might think, lights and sirens do not always offer a safe response, and while they might get our ambulances there quickly there is little benefit to the patient in most cases. Sure, in some having someone there in minutes could be life-saving, but those instances do not occur as often as some might think, but more times than not, I feel that as an industry we have the right tools to guide us in triaging emergencies and when we use them the right way, we do a good job of determining which calls need a fast response and which do not. Contracts and public perceptions, however, have painted us into a corner and ambulances continue to scream from one end of communities to the other lights and sirens blaring.
As an EMS provider, I would rather see a highly trained EMT or paramedic standing at my door equipment in hand ready to assess me or one of my loved ones. I’d rather see an EMT take the time to make sure that all the lights are off and an elderly person’s house is locked up than flying down their streets lights blaring waking up all of their neighborhood and rushing them along undoubtedly increasing their anxiety level. Sometimes, all people need is an ear, a hand to hold, and the reassurance of a confident well trained medical professional. A good EMS professional sees and understands this. They realize that EMS is more about the people we care for than the lights and sirens.
Personally, if I could leave my local politicians with a few lessons about EMS I would start by asking them to change their perception of who we are and what we do. Think of that ambulance and its staff not as a means to get to treatment but as an extension of the emergency room itself. Think of that paramedic as a walking, talking “Swiss Army Knife.” At a second’s notice, they can switch from being a psych advocate to a respiratory therapist or an EKG tech. They don’t just “pick things up and put them down.” They care for people and are more highly trained and capable than most give them credit for.
Also, when evaluating who does EMS in your community, and more importantly how good they are at their jobs, look beyond their response times. Talk to the hospitals, and look at what is really important: patient outcomes. Don’t mandate what color trucks are, or how fast they need to get to emergencies. Leave that to the experts who have already done the legwork on that. Start looking at medical technology. Require care to be provided, schedule reviews, and ask that the service you select become another cog in the health care system. Make them a point of access to health care, not a means by which to access it.
I saw a local politician Tweet that she feels that many do not fully understand the importance of local politics and I could not agree with her more. Our local voter turnouts year after year are proof of that. Still though, I feel that local politicians could do more to get themselves more informed about what services are being provided to their community and if they don’t fully understand it, they should at least surround themselves with people who can provide a clear and concise answer for them. Above all else though make sure who you talk to has the right intentions. Remember: EMS is about caring for people not saving jobs.
To my colleagues in EMS, regardless of what level you are or how long you have been in the field, remember you are also someone’s constituent. Don’t be afraid to let them know who you are, and what you do. You would be surprised at who you might already know, and more importantly, who might already know you.
Make your intentions clear though. Sometimes messages can be muddied and intentions misconstrued because of who we have affiliations with. I face that challenge all the time. Sure, we all have our opinions on how EMS should be delivered, but we have to remember what our “end game” is: effective patient care.