While sitting in my office last week the phone rang. On the other end was a manager from a small private ambulance service asking me for my opinion. They where covering a music festival of between 4000 to 7000 people and they wanted to know if I thought that 8 personnel and 2 ambulances was enough. I replied according to every standard I know of it is appropriate. The conversation went on until we finally got around to why they where calling. They where at odds with the local fire district who thought they should have more resources and they where trying to convince them that what they allocated was appropriate. I told them it’s gonna be an uphill fight because government EMS agencies are infested with the “we have always done it this way crowd” and fail to realize that the days of indiscriminately throwing resources at a problem are over.
In this environment of shrinking budgets and downsizing, departments feel like they are in a fight for their very survival, the last thing they want to see is the private sector doing the same job with less. Mark my words in the near future a Fire Department official somewhere will be called to a hearing or indited for misuse of public resources for over staffing an event.
When I hung up the phone I started to think about why my beloved profession hasn’t advanced very far in my 23 years. Don’t get me wrong we have fancier equipment and safer ambulances but the core of how we do business and deliver services hasn’t changed in my time.
Other industries are growing, streamlining and becoming much more efficient, but not EMS. I think one of the reasons is we just don’t know how to make ourselves more efficient. The reason we don’t is because we as an industry don’t trust or embrace research. Too many in the profession equate research and talk of efficiency with job loss. This may be the case in some ways and is the inevitable byproduct of technological advancement but by embracing research it may make the transition less painful. Research is important to the future of EMS because the public has grown weary of the “we’ve always done it this way “attitude and are demanding proof that the money out lay for our services is justified. In the future EMS managers will have to justify every resources that is used.
EMS must begin to embrace research and enlist the assistance of institutions of higher learning. Compare EMS to companies in other industries such as FedEx and USPS. FedEx went to MIT and had them look and analysis their distribution system and propose changes to make them more efficient. Make a long story short FedEx is currently one of the most profitable and efficient company’s in the world and their employees enjoy a great deal of job security. The USPS which didn’t do any of that but just kept embracing the culture of “We have always done it this way” and if you follow the news you know the USPS is bankrupt, laying off 35,000 employees and closing some 700 post offices. Change is upon us will we be FedEx or USPS ?
EMS is in dire need of a growth spurt and I believe research is the first step. Research in EMS is one component of the system that has been sorely lacking. Returning to my earlier conversation the challenge in that situation is that there is no hard factual data concerning medical response for special events to prove or disprove what the fire department alleges. Too often staffing and equipment allocation as well as treatment modalities are implemented on the basis of anecdotal recollections rather than statistically sound, peer-reviewed research studies.
The Announcement !
Beginning this July SEMSNation is launching a research project to closely examine event medical responses. The data we collect will be used to develop the world’s largest database of it’s kind. We will invite the top researchers to use our database to conduct their research. This is an ambitious under taking and we will need the EMS community’s help. After every event you or your service are involved in please take a minute and fill out the survey.
Research is important to the future of EMS helping us to transition from a “we’ve always done it this way” field to a respected, evidence-based facet of the health care system.