The lack of scientific evidence behind standard protocols will eventually come back to haunt us. Insurance companies and the Centers for Medicare and Medicaid Services (the federal agency that oversees government healthcare expenditures) will simply quit paying or pay only the rates that are justified by the evidence. This will ultimately be the death knell for the out-of-control air medical industry. As for ground providers, decreased reimbursement means low salaries. Low salaries result in an itinerate workforce. An itinerate workforce better describes a trade rather than a profession.
EMS, as we know it, is at a crossroads. Funding, whether it is governmental subsidy or user fees, is inadequate to support the system we are operating. Thus, salaries remain low. With low salaries there is a constant turnover of personnel and we never really achieve excellence as a result. Any service business (and EMS is a service business) that relies upon an itinerate workforce never achieves greatness. Think about the fast food industry. They have a constant turnover of personnel. When you go into a McDonalds or Wendy’s you generally don’t expect good service nor do you receive it. EMS, at present, is not all that much different.
