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The future of EMS...
So I have been a nationally registered EMT for several months now. I am not working yet for an ambulance service, but I plan to be VERY soon. The job I am currently in has nothing to do with medicine, so I have been out of the loop for a few months. I came back on JEMS and it seems like in that short time so much has happened in EMS. I was to become a paramedic and plan on being in EMS until I just cannot physically do it anymore. It seems that there are so many advances in medicine that I really wonder about the future of EMS. But here are a few questions/concerns of mine that I hope some of you can shed some light on…
What do you see with all of the advances in medicine these days with the training and responsibilities of EMT’s and paramedics? Do you see EMS getting more advanced training or more range of scope of practice with all of these medical advancements?
How do you think the economy is going to affect EMS in future? Do you think that the failing economy is going to hurt EMS in a sense of loss of revenue which leads to layoffs and cuts in EMS staffing? Or do you think that the demand for EMT’s and paramedics is going to grow in the coming years?
I do not mind having more advanced training. As far as I am concerned, if they want to start teaching paramedics how to do open heart surgery in the field then I will be the first in line for the training. My main concern is the future as far as jobs for EMS professionals.
Thanks for any advice or information. Stay safe out there.
Kevin
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Replies to This Discussion
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Permalink Reply by Alexander Woo on
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There are many issues on every level. Some very apparent; some not so much. As a provider, there is nothing you can do to prevent over-utilization of healthcare resources, mis-management of healthcare, remain in budget, pay vendors, reimbursements of care rendered, and many variable which make up healthcare delivery System. The U.S. healthcare system, spends over 17% GDP; just under $8000/capita... You can not control who are uninsured and under-insured; which is 40M/60M people in the U.S. So some times you will transport the uninsured. You can't control cost sharing and insurance companies claiming insurance premium has to go up due to research and development... Minimum wage will bring in $15,080; so there is no way they will be able to have private insurance. As for entitlement programs like Medicaid; it varies by state and some states see the minimum wage as too much income to qualify... If you have children and are working poor; they can qualify for SCHIP (State Children's Health Insurance Program)... However, with Medicaid and SCHIP; reimbursements are slow and low... So all the technology we have for medicine will be used and the returns would not make it cost effective. Especially with Third Party Payors like Private Insurance, MCR, MK, etc. using a PPS (Prosepctive Payor System), where a specific diagnosis or service rendered will get a bundled package for reimbursement, regardless for the amount of resources utilized... Also, a side note, Medicare spends over 40K on medical cost for a dying patient's last 5 days... There are so much, I can continue to ramble on...
I know I sound angry but I am angry at the system we have... So I do not see healthcare thriving; unless we stop it now. Many experts believe that if we cut administrative cost for healthcare; paper. All of the uninsured and underinsured will have adequate healthcare coverage. So, no one in America will be uninsured... Yet, many do not believe healthcare is a right; this is the problem we face. It isn't apparent on the surface but behind the patient care aspect; it is a problem dealt with everyday....
Come technology; there is an increase cost. If people continue to demand the state of the art intervention and because they have health insurance; adequate or not, they are not only one paying for it. We are all paying for it. This is a moral hazard. We push practitioners to the limit where they practice defensive medicine. Yet, doctors pay an excess of $14,000 in malpractice insurance... We have STEMI and Stroke Centers and other Specialty Care Centers; that's great for the patient but not great on the economy. You can bill the insurance all you want but due to DRG (Diagnostic Related Groups) which is related to PPS; decide how much will be bundled (already pre-determined) for specific diagnosis; they will only pay for specific amount of admission days. Anything over, the hospital absorbs the cost... This is why there is a battle between healthcare administration and the healthcare providers...
So, healthcare in general will continue to grow because we are technology driven but we will continue to pay for it. Stories of Social Security going bankrupt by 2014 is a fact if we continue to mound on the debt...
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