Social and Professional Network
"Branding" - how should we be know to the public?
Here's a synopsis of a discussion I had with a friend the other day. I wonder what the rest of y'all out there think?
The XYZ EMS agency wants to put a higher priority on preventing people from getting sick as opposed to just taking care of those who already are.
Consequently, it's looking at changing the title, Emergency 'Medical' Services to Emergency 'Health' Services to coincide with that shift in its philosophy. It may sound a little confusing, but something similar has happened before.
We used to be called names such as Emergency Ambulance Services before being known as EMS. It seems as though many in the US Fire Service would like to have EMS changed to RESCUE as part of its assimilation process. Some view the term 'RESCUE' as much more appropriate for its entity/image and makes the cultural paradigm shift more palatable. Others say we are in the LIFE SAFETY business and that name should reflect our mission. Still others believe we are primarily a transport operation and our name should incorporate this fact by using the word AMBULANCE in the name.
TWO QUESTIONS:
1. If this was not 2009, but 35 - 40 years ago and you knew everything you know now, what would you want our profession to be named?
2. Should we now protect and hold onto our third-of-a-century BRAND ("EMS") and resist today's efforts to remold us into something more 'comfortable' and/or 'marketable, or should we try to re-cast our agency public image from scratch?
Fascinating contrast - in the UK and Australia, what we call "EMS" is called AMBULANCE, but they do first response, ambulance response, rescue, special ops, and community health. Here, we tend toward EMS, but over the years we have migrated toward doing nothing but transport. Why is that? And in those countries, the fire service wants nothing to do with ambulance work, and for the most part has successfully resisted efforts to bring it in. Is there a deeper meaning to it all?
Hopefully we can stimulate some interesting discussion of this topic.
Skip
The XYZ EMS agency wants to put a higher priority on preventing people from getting sick as opposed to just taking care of those who already are.
Consequently, it's looking at changing the title, Emergency 'Medical' Services to Emergency 'Health' Services to coincide with that shift in its philosophy. It may sound a little confusing, but something similar has happened before.
We used to be called names such as Emergency Ambulance Services before being known as EMS. It seems as though many in the US Fire Service would like to have EMS changed to RESCUE as part of its assimilation process. Some view the term 'RESCUE' as much more appropriate for its entity/image and makes the cultural paradigm shift more palatable. Others say we are in the LIFE SAFETY business and that name should reflect our mission. Still others believe we are primarily a transport operation and our name should incorporate this fact by using the word AMBULANCE in the name.
TWO QUESTIONS:
1. If this was not 2009, but 35 - 40 years ago and you knew everything you know now, what would you want our profession to be named?
2. Should we now protect and hold onto our third-of-a-century BRAND ("EMS") and resist today's efforts to remold us into something more 'comfortable' and/or 'marketable, or should we try to re-cast our agency public image from scratch?
Fascinating contrast - in the UK and Australia, what we call "EMS" is called AMBULANCE, but they do first response, ambulance response, rescue, special ops, and community health. Here, we tend toward EMS, but over the years we have migrated toward doing nothing but transport. Why is that? And in those countries, the fire service wants nothing to do with ambulance work, and for the most part has successfully resisted efforts to bring it in. Is there a deeper meaning to it all?
Hopefully we can stimulate some interesting discussion of this topic.
Skip
Replies to This Discussion
-
Permalink Reply by Duncan Hitchcock on -
I'll take a stab at this being an 'old guy' that started in this business 36 years ago.
When I started one worked for an "ambulance service" or a funeral home. As more of us became EMTs and eventually Paramedics the term EMS was adopted as a better discription of our goal and mission. I have been employeed for the last 31 years by a countywide system. Originally, it was a third service agency seperate from the fire department. In the mid-1980s fire and EMS merged. As with many such mergers, the EMS side sorta took the backseat in many decision making processes as to the future and growth of the entire agency. Finally, a light appeared in the eyes of the power brokers that the vast majority of what the fire trucks were doing were EMS related calls. The light moved to over their heads and budgetary decisions started to reflect the true maturation of a public service agency.
Kicking and screaming the old philosophy that we were a fire based EMS system evolved to the realization that we are an EMS based fire service. EMS is what we provide and what we do. Occassionally, we put out fires.
There have been countless discussion about the future of our business. Many have revolved around the idea of expanding our orientation into areas traditionally provided by health departments; i.e., immunizations, wellness screenings, clinics, etc. In Florida, language was added to the state statutes that allow for individual agency Medical Directors to train and authorize Paramedics to provide immunizations.
It is understandable from my perspective that in times of local and national emergency that all qualified medical professionals will be put to work for the greater good in whatever capacity is needed.
It is my opionion, that EMS should remain Emergency Medical Services.
The expansion of other community health care services should require the expansion of those health care services. We see the needs of our communities every day in the patients we encounter in the prehospital settings and in the over crowding of our EDs. The question becomes who and/or what agency should provide for their needs and fill these obvious voids. My humble opinion is that this is not the role of EMS.
-
Permalink Reply by Russell Stine on -
I can't answer for 30 or 40 years ago because I wasn't around and the times are different now. I'll agree with Duncan on a few points, however. 'EMS' should stay as the brand name. Not because we can't change, but an expansion to fill roles in community health that we don't already occupy would put us in greater peril of collapse than the health care industry now, and I believe that would simply be because the public has easier access to us and it's far easier to call an ambulance than to go to the doctor.
I think that transport to a urgent care or something similar should be within our ability, we would have to examine the risks and benefits or taking a pateint to a teritary care center and some exclusion crieria would have to be in place to allow that. I could see it easing the load on the ED's if we can take minor wounds and people that are 'out of meds' that don't have an emergent problem to an urgent care. I've called in many patients to ED's that are candidates for triage and get placed there, why not take them somewhere they can go for routine medical care and get their prescribed medications instead of them calling an ambulance when they run out?
I do like the idea of immunizations, we should be used to augment and not replace others. Maybe a limited expansion of protocols can allow those, but we should only give those to patients that we make contact with in our normal operating mode.
-
Permalink Reply by Tracey Baker on -
Though I did not read any feedback yet regarding this thread, I feel EMS should RETAIN this name for several reasons:
1. We are still in our infancy and to change now is not necessarily good when we are trying to BECOME!
2.Health services, in my opinion, refers to multiple other services: referrals to county agencies, preventative programs, a multi-system approach for effectiveness, etc..Though I do feel that EMS should partake in this endeavor; for a variety of reasons...it begs much funding, community participation, funding and again, a mulit-system transformation, which EMS may not yet be ready for system-wide.
Tracey
-
Permalink Reply by Duncan Hitchcock on
-
Was around and still around. Some of us old dudes not only started in the dark ages but have maintained an active and up-to-date involvement in the progress of our profession.
As Tracey stated above, we are but in the infancy of this new and growing profession. I will not bore you with the roller coaster path of the past 36 years of which I have had the pleasure and privilege to be a part of, work for and, hopefully, had some micro-impact on advancing.
I think all involved in health care will agree that the seams are ripping apart and the patients are being spilled out into the cracks and crevasses. What is left for them to grasp for is 911 and the local ED. The system, as a whole, needs a fasciotomy. Health care must become a right not a privilege.
The focus of EMS, in my humble opinion, should remain on prehospital emergency medical care. EMS will naturally be affected by a radical restructuring of the health care system. One impact could be a significant decrease in requests for service. Logic would dictate that if everyone has access to a health care system that meets their needs, only true emergencies would require a call to 911. But, I must admit, I'm a dreamer.
Now the question will always circle back to funding. Who is gonna pay for this major overhaul? And how long will it take? In my opinion....we all will pay and it will take seven to ten years. With each passing year the price will increase by 13-20% and take 3-5 more years to implement.
EMS will remain EMS. There will be an increasing demand for wheel chair and stretcher transport services. Primary health care providers will visit ALFs, nursing homes and in-home cared for patients. The ARNP and the PA will care the majority of this burdon. Health care clinics will expand and increase in their locales to better serve the public. New roles and requirements will result in the evolution of past members of the health care team. But, EMS will remain EMS.
-
Permalink Reply by Tom Bouthillet on -
If EMS wants to start treating and releasing at the scene, then we're going to need a different kind of education. I'm okay with that! But as it stands right now we're not qualified to determine who does and does not need to go to the hospital. That's one of the major problems with curret state of paramedic education. It wasn't designed for "we just want you to check him out" calls. Yet, more and more, that's what we're being asked to do. If a refusal is supposed to be an informed refusal, then a paramedic should be qualified to explain the risk of refusing care. If the paramedic doesn't understand the risk the patient is taking refusing care, then how can the patient? Why haven't we adapted our education for what we're actually asked to do? I'd love to see expanded roles for paramedics, but we're going to have to raise the bar.
-
Permalink Reply by Skip Kirkwood on -
All the truth, Tom.
But consider - is that any more complex than some in-agency training, to address those matters the way the local medical community and your system medical director wants it done? It's getting done informally, every day, despite prohibitions against it. Instead of fighting the inevitable, we could snuggle up to it and make it ours, and make everyone (patients - medics - hospitals) more satisfied in the process.
Just like what we do when we want to introduce Level II HazMat, or tactical EMS, or a new protocol or device?
Maybe it IS more complicated, because you start having issues with value judgments about individuals of different socio-economic circumstances, etc.
Yes, we need to raise the bar - and happily so!
-
Permalink Reply by Tracey Baker on
-
As far as informed refusal..We have a pretty fail safe system here so I rarely worry about the ramifications on a personal level..I have, but rarely. I believe it is a Medical Director issue. Protocol should be very tight and very precise, as well as monitored.
Education can never be the wrong path. However, if we are to expand our roles maybe we should all be involved at a community level and SEEN-- not just ON SCENE! Many people complain and fail to take PERSONAL responsibility to get involved--so who is to blame if our roles do not expand? Furthermore, until ENTRANCE requirements change, at a BASIC level, how much education can one ask for when the foundation does not even exist?..........Tracey
-
Permalink Reply by Duncan Hitchcock on
-
The casting and recasting of our public image is an ongoing part of our existance as EMS. As an example, I offer "EMS Week." How many agencies operating out the the fire service model are committing resourses and time when compared with those expenditures for Fire Prevention Week? I am not suggesting that the activities, public educational forums and community outreach in the interest of fire safety should be decreased. The same energy and commitment should be made for EMS Week activities.
Where and how do we recruit our future co-workers? Is there a case to be made for active recruitment forums in our local high schools? Is a HS diploma or GED enough of a basic educational foundation to enter into this evolving profession? Will an AA or AS become the minimum criteria for becoming a Paramedic? Nursing survived this transition, why can't EMS?
Quality, well structured in-house training programs coordinated in conjunction with local community colleges can provide a means towards this end. I speak not of the minimalistic, 40 hours in a chair, crash courses that result in a 'you showed up' piece of paper (certificate of attendance) that barely meet the needs of an agency's promotional requirements. Instead, courses with soundly developed curriculums (or is it curriculi ?) taught by credentialed instructors. Courses developed with the involvement of Medical Directors, the medical community, college and agency administrators and our own co-workers.
We have moved well past the days of learning primarily the psychomotor skills of IVs, ETI and hooking up a monitor. We need to continue and excellerate the move towards the knowledge of how and why the body reacts the way it does, the how and why the individual responds the way they do. We need to continue to understand how and what we say and what we do affects the patient.
-
Permalink Reply by Tom Bouthillet on
-
Our local receiving hospital always provides lunch for the local EMS providers during EMS week. Our battalion chiefs rotate units so that everyone can get their "free lunch" and small gift, which is usually some type of travel coffee mug or a pair of trauma sheers. I always thought we should turn the tables, and buy lunch for the nurses and doctors at the hospital during EMS week. After all, they're part of the EMS system, too. I think it would be a good way to remind them that we're in this together. It's a shame that in this day and age, the relationship between the ED and EMS is still dysfunctional in so many areas. We're living in a time when a high level of cooperation is more important than ever before. I've seen thousands of dollars invested in technology to transmit prehospital 12 lead ECGs to the ED, only to have the ECG showing STEMI completely ignored (or at least not acted upon) until the patient reaches the ED. We need to do public outreach, yes. But we also need to reach out inside the EMS system and fix the things that are broken. It starts by getting our own houses in order.
-
Permalink Reply by Jasen Adam on -
Russell Stine said:BR>
I think that transport to a urgent care or something similar should be within our ability, we would have to examine the risks and benefits or taking a pateint to a teritary care center and some exclusion crieria would have to be in place to allow that. I could see it easing the load on the ED's if we can take minor wounds and people that are 'out of meds' that don't have an emergent problem to an urgent care.
Russell I agree with you here, however, I see where this won't work. Urgent care centers and Dr. offices require that the patient pay a co-pay at the time that services are recieved, this is why they don't go there in the first place. I know someone is out there saying then the problem with overburdening this system is fixed then. Wrong. What is going to happen is we will start responding for chest pain (in reality fever, runny nose, diaper rash, infected finger or fill in your own non emergent nature) just so they will get taken to the ER, where there is no co pay needed.
We have a saying where I work and that is "public aid won't pay for a taxi but it will pay for an ambulance".
-
Permalink Reply by Skip Kirkwood on
-
That would be part of the medic's decision-making process. If you're insured, there is a co-pay at the ER too. If you are uninsured, you're right - certain facilities don't have to take you. But other facilities (like public health clinics) are operated just for the care of those who can't get care on the private side. Each community has to learn about its own capabilities and build programs and protocols to match what the community has to offer. How about detox, and the mental health crisis facility?
And an EMS service could save itself a lot of wear and tear by figuring out who the patients are who just need a ride, with no medical care, and helping them get that ride - whether through taxi vouchers, a paratransit service, or some other alternative that doesn't involve 2 paramedics, a firetruck, the 911 center, and a $130,000 ambulance with $75,000 worth of sophisticated biomedical equipment. But FIRST, we have to get medics trained to make those decisions, and make sure we have medics who will do what is best for the PATIENT, not what is best for themselves.
Check out our new program - we'll be reporting on how it works after a few months: http://firenews.net/index.php/news/news_article/20090104_news_wake_...
Skip
Jasen said:Russell Stine said:BR>
I think that transport to a urgent care or something similar should be within our ability, we would have to examine the risks and benefits or taking a pateint to a teritary care center and some exclusion crieria would have to be in place to allow that. I could see it easing the load on the ED's if we can take minor wounds and people that are 'out of meds' that don't have an emergent problem to an urgent care.
Russell I agree with you here, however, I see where this won't work. Urgent care centers and Dr. offices require that the patient pay a co-pay at the time that services are recieved, this is why they don't go there in the first place. I know someone is out there saying then the problem with overburdening this system is fixed then. Wrong. What is going to happen is we will start responding for chest pain (in reality fever, runny nose, diaper rash, infected finger or fill in your own non emergent nature) just so they will get taken to the ER, where there is no co pay needed.
We have a saying where I work and that is "public aid won't pay for a taxi but it will pay for an ambulance".
-
Permalink Reply by Tom Bouthillet on
-
Nice car, Skip!
Follow JEMS
Share This Page Now
Add Friends
JEMS Connect is the social and professional network for emergency medical services, EMS, paramedics, EMT, rescue squad, BLS, ALS and more.
© 2010 JEMS / Elsevier Public Safety Our Sites: JEMS.com - EMS Today Conference & Expo 2009 - FireRescue Partners Firefighter Nation
Commercial Use Limitations: Use of any content features (blogs, forums, messaging, etc) for direct self-promotion, spamming, etc. will result in account termination. Profiles are for individuals only at this time. Profile icons may not include company logos.
