EMS Challenge 3 – Shortage of Paramedics

The shortage of paramedics is the final of the issues that I believe are the top three challenges facing the Emergency Medical Service (EMS).

Stories are reported across the U.S. regarding a shortage of paramedics. In April 2008, the Washington Post reported actions taken by Washington DC fire departments, “to curb a critical shortage, fire departments across the Washington region have pursued paramedics like star athletes in recent years, enticing them with signing bonuses, handsome salaries and the promise of fast-track career paths”.  Arlene Barrios-KFOX News Reporter Story in January 2009 reported The El Paso Firefighter’s Association president stated, “there’s a dire need for more certified paramedics in El Paso, otherwise, they’ll burn out”. In a discussion with ABC News, May 2007, Topeka AMR Manager Ken Keller stated “a paramedic shortage also means larger workloads”.  In the same report Topeka paramedic Tommy Hendrickson said “a shortage of paramedics could lead to poor decision making”.  In Las Vegas Nevada, CBS news’ Travell Eiland reports Las Vegas “Officials say it’s a nationwide shortage of paramedics. But that shortage hits Las Vegas hard because of the thousands tourist that pack into the city every weekend”.

This perceived paramedic shortage is generally believed to be caused by high work load and the abuse of the EMS system by individuals who are not suffering from a life threatening illness or injury.  Paramedics, trained to treat patients with life threatening injuries, often work in systems where 80% of their call volumes are to patients with minor injuries. While paramedics are treating and transporting these patients to overworked hospitals, the paramedics are removed from the system, where they may be needed for a life threatening patient.  The response to the critical patient is then delayed.

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EMS Challenge 2 – The Economy

The waning economy is another of the top three challenges facing the Emergency Medical Service (EMS).

The Congressional Budget Office (CBO) report, (The Budget and Economic Outlook: Fiscal Years 2010 to 2020) provides startling information “The Congressional Budget Office projects that if current laws and policies remained unchanged, the federal budget would show a deficit of $1.3 trillion for fiscal year 2010.” Identified further, “The budget picture remains daunting beyond this year, with deficits averaging about $600 billion annually from 2011 through 2020.” Finally the CBO finds, “As a result, interest payments on the debt are poised to skyrocket; the government’s spending on net interest will triple between 2010 and 2020, increasing from $207 billion to $723 billion”.

In his article, The U.S. economic crisis: Causes and Solutions, Fred Moseley observes the U.S. economy is currently experiencing its worst crisis since the Great Depression. (ISR Issue 64, March – April 2009). In a March 2010 story, reported by ABC News, a panel of leading economists, financiers and former federal regulators state:

“Even as many Americans still struggle to recover from the country’s worst economic downturn since the Great Depression, another crisis – one that will be even worse than the current one – is looming.”

As the economy staggers, local jurisdictions face serious challenges balancing their budgets with decreased revenues. Typically two options are available, raise taxes or decrease expenditures. In addition, health care professionals are aware; as citizens struggle to maintain economically, many turn to the EMS system as their primary health care provider. The increased call volume stresses an EMS system already facing serious budget cuts.

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EMS Challenge 1 – Baby Boom Generation

The first of the top three challenges facing the Emergency Medical Service (EMS) is the effect of increased demand faced by the aging of Baby Boomers.

In a 2008 article (Baby Boomer Health Care Crisis Looms) published in Science Daily, John W. Rowe, MD, Committee Chair of the Gerontological Society of America (GSA) was quoted:

“The combination of the aging of the Baby Boom generation and the increase in life expectancy is going to yield a doubling of the numbers of older people,” he said. “And it’s important to understand that older people themselves account for a disproportionate amount of the utilization of health care resources.”

Heath Atchison, in his article Baby Boomers – A Healthcare Crisis Nears, stated: as baby boomers, 28% of our population, retire they will require more healthcare as a part of the aging process.  Furthermore, nationally recognized emergency medical service expert, Gary Ludwig, clarifies the issue in his 2008 article (Now What Do We Do? What Effects Will Aging Baby Boomers Have on Your EMS Operations) “ First, as people grow older, their demands for health care increase. As demands for health care increase, so will demands on EMS systems”

Fire and ambulance services across the U.S. have been experiencing a regular and steady increase in the number of EMS calls for service.  As Baby Boomers become older, the EMS systems will become even more strained.   Additional call volume requires the addition of EMS resources, ambulances, equipment and paramedics.  By not adding resources to a growing system has and will result in slow response times and poor patient outcomes.

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Top Three Fire/EMS Challenges

I recently was asked what I believe are going to be the top three challenges that the fire/EMS service will see in the next five – ten years on a national front. After some thought, I feel the following are the most pressing issues:

  • Increased strain on the EMS system due to baby boom generation.
  • National economic struggles to fund an effective EMS system.
  • Shortage of paramedics in the EMS system.

Over the next few days, I will present the reasoning and logic as to why I feel these issues will be the top three challenges.

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