A little elaboration on "horrible protocols" ? I never understood this idea. I thought protocols were more or less constant throughout the country, thats why we have our national scope, so different states and counties can vary or modify as they please. But anyways, on horrible protocols. Is it because you can do less? Less drugs, interventions, etc? Or is it horrible because of too much?
I'd figure in a compacted response area, you do way less because of the geography, but I dont think that has anything to do with protocols.