With the current shortage of EMS manpower in rural areas of our country with many vol. EMS depts. having to pay for staffing or worse, going out of business; who is going to take care of the citizens when volunteer/rural EMS is all gone? Regionalization seemed to be the answer but what happens when downsized regionalized EMS depts. experience the same problems? How much sense does it make to try to professsionalize BLS services by adding more and more state and federal requirements/regulations and unfunded mandates at the expense of our patients?
I applaud the efforts of those educators, administrators and others leading the parade to better educate and credential our EMS personnel but I fail to see the benefit of pushing vol./rural EMS out of business in the mean time before a better system can be developed and implemented in a seamless manner. It appears to me that the efforts to improve EMS with higher standards, degrees etc. is contributing to our current crisis in the rural areas. Nobody wants to admit to it but the current "trend" towards higher qualified and credentialed EMS personnel is a large part of our current problem.
EMS is supposed to be about serving the people in time of Emergency. How are we supposed to accomplish this when we are constantly losing EMS personel and depts. Our numbers are dwindling while the demand for our services are increasing. God forbid we even think about Homeland Security or natural disasters. Our "local" armies of vol. and rural EMS & Fire Depts. are becoming extinct. Who is going to take care of the people in our rural areas in time of Emergency when the vol/rural services are all gone?
I respectfully request that our state and Natl. EMS organizations, Councils, NAEMT, AEMS and others take a serious look at this problem and address it. There are many rural areas that are in a state of crisis right now and nothing positive seems to be happening to solve this problem. Is anyone in a position of power or influence in EMS even aware of whats happening outside of the cities?
One final thought. Was it better 15-20 yrs ago to have enough manpower and EMS Depts. to handle the calls in an expedient manner or is it better today that we have fewer EMS Depts., fewer personnel and longer response times? If EMS is all about providing the best patient care, we need to reevaluate our current system and make some common sense improvements. If anyone doubts the validity of the above, contact me and I will be happy to take you on a road trip through rural Pa.
This Discussion is being posted on the AEMS group site as well as the Pa. EMS Providers group site in hopes of stimulating awareness, concern, discussion and hopefully some positive action to improve EMS for our rural communities.

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Replies to This Discussion

I got my start with a volunteer ambulance service that not only covered an urban area but also a large rural area as well. About 10 years ago, they decided that in order to better service the area they should go paid.
Since their decision response times have increased but unfortunately patient care has seriously declined. I don't know if it's because of the attitudes of the people that they are hiring or if they're just don't have good hiring abilities. Whatever the reason, the attitudes and patient care skills of the volunteers far outweigh those who are being paid.
I'm no longer with that service and haven't been for a very long time, but I'm certainly glad that I was able to be with a volunteer organization that carried such a wonderful reputation and not be associated with what they have become.


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