AMU Fire & EMS Original Public Safety

Why We and Our Government Must Work Harder to Fix EMS

By Allison G. S. Knox
Edge Contributor

In the U.S., we often think about our society’s problems and how to solve them. To this end, we elect individuals to local and state governments, as well as to the federal government, in the hope that those people will fix societal problems.

However, the American government system is relatively inefficient and complicated. While the division of the legislative, judicial, and executive branches of the federal government keeps the powers of each branch in check, it has also created numerous obstacles for ordinary citizens to quickly make positive changes and affect dire situations. Often, we wait for problems to become catastrophes before we institute change.

For instance, there are numerous issues with our emergency medical services (EMS) system – including personnel recruitment and retention and inadequate budgets – that need solutions right now. EMS is a critical part of the U.S. healthcare system, which has already struggled with its own problems for the last couple of decades.

Related link: Changing and Improving EMS Agencies Starts at Local Levels

Recruitment and Retention of EMS Personnel Is Critical

One EMS issue that needs immediate resolution is workplace shortages. EMS departments have operated with workplace shortages for decades. If these workplace shortages in EMS continue and EMS agencies are forced to close because of inadequate staffing, the EMS system may collapse throughout the United States.

In addition, according to a 2021 survey conducted by the National Association of Emergency Medical Technicians (NAEMT), turnover among paramedics and emergency medical technicians ranges from 20-30% annually. NAEMT notes that “Most communities are facing crisis-level shortages of EMS personnel, and many communities have seen EMS agencies close altogether, removing this critical community lifeline.”

Related link: Why It Would Be Beneficial to Consolidate EMS Agencies

Better EMS Funding Is Also Essential

A second issue that must be fixed quickly is funding. Many EMS agencies are already inadequately funded, and many EMTs and paramedics subsequently receive low wages in exchange for their work responding to 911 emergencies.

Fixing EMS Problems Will Require the Whole Community Approach

The U.S. government is reactive and uses a thorough process for creating new policies. In many respects, that design is helpful because it ensures that numerous areas of a new policy are sound before a bill is passed and implemented.

Where the EMS system is concerned, though, EMS is at the center of seriously complicated wicked problems. Unfortunately, these problems can be complicated by additional legislation that attempts to put a bandage on a terribly broken healthcare system.

Without the government creating policies to improve EMS problems, the EMS system is on a trajectory to fail. EMS serves as the backbone of the healthcare system and if it fails, many people will be unable to obtain equal access to quality prehospital care or transportation to healthcare facilities.

Unfortunately, EMS system issues have no simple solution and require a whole community approach to solve them. Such an approach requires extensive collaboration at all levels of government and in multiple areas of society. EMS leaders also need to carefully contemplate which local government leaders to bring into conversations for their respective EMS agencies.

This crisis involving the U.S. EMS system should not be treated lightly. Americans and government agencies should not be waiting for the EMS system to fail before creating new policies to fix EMS system problems.

Allison G. S. Knox teaches in the fire science and emergency management departments at American Military University and American Public University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison serves as an Intermittent Emergency Management Specialist with the Department of Health and Human Services, as At-Large Director of the National Association of Emergency Medical Technicians and as Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences. She is also chair of Pi Gamma Mu’s Leadership Development Program. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds multiple graduate degrees.

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