Volunteer EMS needs to become non-existent.

[bahnrokt]

Careful with the term "hobbyist". You could make a strong argument that anyone taking the time to post on an EMS forum is a hobbyist. At the minimum we are all "EMS Enthusiasts".

Personally I think all of the paid EMTs on here have a little bit of envy when they see the Vollies driving around with sweet light bars and strobe lights on their POVs.

 

[NomadicMedic]

I agree! Nobody should be allowed to volunteer to help somebody in a medical emergency.
Only professionals who are trained, and paid have the knowledge and skills to take care of a pt.

Hmmm. I smell sarcasm.

 

[bigbaldguy]

There is one other difference between vollies and paid that I think it is fair to point out. Most true vollies do the job because it's something they enjoy. When they stop enjoying it they stop doing it. If they feel burned out they take a break and can come back to it. If they have drama in their lives they also tend to stop volunteering. People who do it for a living don't have this luxury. Burn out is much higher among paid staff simply because they have to do it day in and day out.

Is an inexperienced EMT worse than a severely burned out one? How about one who's going through a divorce and hasn't seen their kid in 3 months?

 

[Anomalous]

NREMT standards are the same for paid and volunteer providers...

Dang. I wanted to sign up for a Volunteer Medic Class.

 

[joshrunkle35]

I do know that 86% of fire in the US is volunteer. EMS is probably similar. Think about the budget constraints if a lot of those really rural counties went paid. They might run two volunteer trucks, but if they went paid, they may only be able to barely equip one truck. If surrounding areas do the same, there wouldn't be much in the way of mutual aid for the big calls.

At the end of the day it's about patient care. While you want individuals to have higher standards, if everywhere went paid, there may be places where there isn't even a barely competent person to show up. I'd take a barely competent person over no one any day.

 

[rescue1]

86% of fire might be volunteer, but that 14% protects 65% of the population. I would guess EMS is even more...probably more like 70%+ of the population. The last two places I lived, fire was volunteer while EMS was paid or mostly paid, so I think paid EMS coverage is more common then paid fire.

However, your points are still valid for rural areas.

 

[Bullets]

86% of fire might be volunteer, but that 14% protects 65% of the population. I would guess EMS is even more...probably more like 70%+ of the population. The last two places I lived, fire was volunteer while EMS was paid or mostly paid, so I think paid EMS coverage is more common then paid fire.

However, your points are still valid for rural areas.

I think that is a result of cost as well, cheaper to pay 2 emts than 4 firemen

 

[DrParasite]

I think that is a result of cost as well, cheaper to pay 2 emts than 4 firemen

and yet, more places are willing to pay 2 firefighters to come off the engine and staff the ambulance than pay for a separate paid EMS system

 

[hogwiley]

Id love it if my volunteer agency was replaced with a private agency and we got paid for what we do, but the reality is theres no money. Thats basically why volunteer agencys exist in the first place, theres no money in EMS.

With communitys across the country in debt, the situation isnt going to change any time soon either. This is why education standards are so low, not just for EMTs but for Paramedics as well. EMS is just not the type of thing people do for a career, it doesnt pay well enough and the jobs just arent there.

Also, I dont really agree with the notion volunteer EMS are a bunch of poorly trained amateur bumpkins. They went through the same training paid EMTs did and passed the same exams, and are often medical professionals in their day job. We have 8 volunteer EMTs with my agency. Two are RNs, one is an LPN, the other a hospital PCT, and one is a radiology tech. The other two are school teachers. Some of us have more medical training and experience than the EMTs with the local paid service, and even some of the Paramedics.

 

[EpiEMS]

and yet, more places are willing to pay 2 firefighters to come off the engine and staff the ambulance than pay for a separate paid EMS system

Eh, it's really just to justify their bloated budgets. Fire-based EMS is an unfortunate consequence of the fact that you can't touch fire budgets, even though the number of fires is way down (see: http://www.nfpa.org/itemDetail.asp?categoryID=953&itemID=52970&URL=Research/Fire%20statistics/The%20U.S.%20fire%20problem) -- not as a result of more firefighters, but as a result of better fire protection systems and better design. And since firefighters respond to more medical calls than fire calls, well, hell, say the bureaucrats, let's give fire the responsibility of handling EMS. A major mistake, I say.


I've posted this before, but it bears repeating:

This too:

The most effective way to handle medical calls is NOT a firetruck. It's a BLS ambulance and possibly an ALS fly-car. ALS ambulances are a valid, if cost-prohibitive, option.

 

[Swimfinn]

the town i live in used to be all volunteer (this was back when my mom and dad were on it). now, 17 years later, it is a paid volunteer. so i guess you get paid to do inhouse call, regardless if there is a call, and then you get paid if you go out on calls? thats my understanding of how the system works. and we have some real proffessional, down to earth, know what the :censored::censored::censored::censored: they are doing people. and just like every department out there (volunteer or paid) we have our share of :censored::censored::censored::censored:nuts as well. stupid people are out there. paid/volunteer really isnt gonna weed that out.


also i beleive paid or not you are a healthcare proffessional and therefore should be respected as a proffessional

 

[DrParasite]

Id love it if my volunteer agency was replaced with a private agency and we got paid for what we do, but the reality is theres no money. Thats basically why volunteer agencys exist in the first place, theres no money in EMS.

do you have a paid police department? how about a paid DPW? do you have paid garbage men? do you have paid people who fix the traffic and street lights? if so, than you can have paid EMS!!!

the reality is, there is no money for EMS because no one has ever allocated funding for EMS. And since EMS has gone decades with minimal funding allocated to it, municipalities now say there is no funding, because the funding has been allocated elsewhere. How would you pay people? cut every other town department's budget by 10%, and give it to EMS. yes, it's a crunch for everyone else, but EMS needs to be funded, and that will give you the money that isn't there presently.

The other reality is there is no money to be MADE in EMS, if you do the job right, and if you are working in an urban or not rich area. that means properly staffing, not cutting corners, and only doing 911s. Many private companies have tried, most have failed, and those that succeed are able to offset their losses by a transport division that makes the profits that the 911 service uses to survive. the only way to make money as a 911-only service is to be supplemented by tax dollars, just like the two biggest black holes in public safety, the police and fire departments. And the only way to do that, is for the government to both run and fund the EMS system.

 

[EpiEMS]

And the only way to do that, is for the government to both run and fund the EMS system.

That's not necessarily true, but even as libertarian as I am, I do think that PD, FD, and EMS should be provided by government (or a not-for-profit, at the very least). I don't have a problem, per-se with for-profit EMS, but since it is both a public safety and medical organization, EMS ought to be, in a perfect system, funded as a service like public safety, but operate with the mentality of a medical organization -- evidence based.

Part of the problem, as I say often, is the fire services. They seem to think that it makes more sense to send an engine or ladder truck to an EMS call that doesn't require fire suppression or extrication. That is a fundamental misuse of resources. It's cheaper and more efficacious to send a BLS ambulance (EMT/EMT) with an ALS fly-car (EMT-P/EMT). That gives you three people if you need ALS (one EMT can drive the fly-car back).