What do you think are the 10 most critical problems facing EMS today? Please number them and keep it brief. I'll start out with a few of my own, not necessarily in order of priority.
1. Low Reimbursement rates & financial overload on EMS
2. Severe manpower shortage (Recruitment & Retention)
3. Overregulation & overloading EMS
4. Lack of awareness by our politicians and governments
5. Low EMS staff pay and benefits (or lack thereof)
6. Vol. EMS being pushed aside - No incentives
7. EMS technology outpacing our ability to provide consistant care
8. Patient Care isn't what it used to be
9. Current EMT-B training
10. Infighting within our respective EMS organizations

Be safe out there and remember that EMS is NOT just a business.

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We only get 10 and you want use to keep it short!!! Ok just joking, here are a few of mine.

1. Inadequate training of EMT-B’s, to include hands on and clinical time.
2. Not being recognized as a profession
3. Poor compensation
4. Volunteer EMS/FD not working together, to better response, care, and available resources or duplicating resources
6. PA Statewide protocols !!!!!!!
7. Not taking EMS seriously, not recognizing or refusing to recognize problems with self development.
8. Very poor CQI program for this region (volunteer that is).
9. Appearance
10. Respect

Just my 2 cents

Jeremy Welshans
Thanks Jeremy. This will help our RR&R Committee. Please encourage others to list their 10. I agree, the list should not be limited but I'm thinking that if we can find the 10 most common that we might be able to affect some change. Have a great weekend and thanks for your post.
1. reimburstment rates
2. lack of standardized training throughout the state
3. Lack of government representation and understanding
4. Low pay and poor benefits
5. Failure of educational institutions to ensure competencies before graduation
6. Poor representation by individuals IE: Dress, appearance, attitude, competencies
7. Lack of indivdual municipalities to take responsibility for EMS in their region as they do for Fire and Police departments.
8. Little chances for advancement
9. EMS not being acknowledged as a profession and providers who do not support this
10. Failure of the state to allow us the proper medications needed to perform our job (Etomidate +)
Thanks Ken. Encourage others to list their 10 so we don't miss anything.
Have to add 2 more to my list.
1. Slower or non-existant response times by licensed BLS services to Emergencies
2. Bloodborne pathogen "Exposure Followup" by hospitals for EMS personnel
1. lack of respect between definitive care personnel and pre-hospital providers.
2. lack of and prolonged time to advance in ranking status (paramedics vs firefighters)
3. The actual need to convert emt-b's to emt-i's especially within the city of philadelphia.
4. recruitment & retention
5. lack of goverment and state funding for paid and volunteer ems dept's.
6. psychologicals evaluations periodically
7. national paramedic mock exams need to more applicable to the actual exam being taken.
8. ems resources and research.
9. all paramedics should be on the same training levels regardless of state.
10. confrontation within the ems community.
1. Low Pay/No Benifits
2. Not enough ongoing training
3. Better communication
4. Attitudes
5. Morale
6. Personal Appearence of Personell
7. Need EMT-I's
8. did I mention consistant training

thats all I got. I work in a great place! But see other companies..... :)
very thought provoking. Just seems that 'throwing a line in' should be more of a basic type skill?? But I guess what is the use of that if there is no meds to push! hehe
So good point!

Jeremy Gassert said:
Gayle, In regards to # 7. I have lived and worked in 2 states with intermediate's, TX and NM. I appreciate the skills that intermediates bring to the table but a lot of folks wish they would do away with this level. NM doesn't utilize intermediates for much more than IV skills, TX is a physician extender state so most "I's" intubate and perform ACLS. If you note in or around 2013 the Intermediate-99 certs can take a "bridge course" to earn the Paramedic Patch. Perhaps this is one more step to eliminate Intermediate.

In my experience if you live in a rural community with hours long transport times to level II or level I facilty with no flight service available, intermediates are an economical solution. But if you have at least hospital based paramedics rendevousing (as we did in Tioga and Potter county when i lived there) they aren't needed. The other aspect that needs to be considered is what would their scope be? Paramedics will get upset if you encroach on "our" scope, and no one will want to be one if they are closer to basic scope of practice.

I haven't been in PA in 8 years (military) so please accept my criticism with a grain of salt. If there is an outcry for intermediates, i suggest we look at it like a new piece of equipment, if we "buy" it will it change how we treat our patients enough to soundly justify it beyond a reasonable doubt?


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