Dear State of Illinois EMS…

State of Illinois EMS… It’s time that you and I had a little talk. You see, I’m an EMT-Paramedic holding licensure in your fair state. I’m also a mostly life long resident except for a short, torrid affair with residency in the State of Iowa. I moved back, you welcomed me back with your open arms and I’ve been here ever since.

Except for now, State of Illinois EMS, while your EMT-Paramedic licensure will always be the first card I carry… I’ve been flirting with other states. Yes… it’s true. I have my licensure in Iowa as a Paramedic Specialist, and my Paramedic card from Wisconsin too. I don’t want to hurt your feelings, State of Illinois EMS but frankly their paramedicine is more exciting than yours is. Yes, State of Illinois EMS… the magic just seems to have gone out of our relationship. I can do so much more in the other states. They UNDERSTAND me and my need to take care of my patients to the best of my ability. They’ve given me exciting advanced techniques, medications, protocols, training and technology that enables me to breathe new life into my practice. They let me LIVE, State of Illinois EMS! They help my patients to live longer, fuller lives.

And now, State of Illinois EMS, this conversation comes on to the prospect of what we should do about our relationship.

Yes it’s been a torrid love affair, State of Illinois EMS. Really it has. Unfortunately, I’ve changed. It’s not you… it’s me.

Literally. It’s like you haven’t changed in ten years. What’s up with that? Medicine’s changed. Techniques and research have changed. Evidence based EMS practice has changed… but, State of Illinois EMS… you haven’t hardly changed a bit. You’re not a national state, your CE requirements are strange, your license hasn’t gotten easy reciprocity anywhere I’ve tried, and your policies are dictated by the ‘Little Kingdoms’ that you call EMS systems and EMS regions, and well… it’s just not working for me anymore.

I’m not leaving you, State of Illinois EMS. I wouldn’t, you mean too much to me and a good chunk of my income is dependent on that little green card I carry with your picture on it. Remember when you gave me that card, State of Illinois EMS? It seems like just yesterday… but it was a while ago I guess. We’ve been together a long time, haven’t we? I think that our relationship is worth salvaging, don’t you?

Here’s what I think we should do, State of Illinois EMS: Let’s work together on a plan that I’ve come up with. It’s a plan that I think will help fix everything that is wrong with our relationship. I think that the way you’re all set up, the way you’ve parceled yourself into EMS regions and the Little Kingdoms that you call “EMS Systems” has given too much control to local politics and individual egos without enough accountability. I think that the EMTs and Paramedics that work within these EMS systems, you know the ones working for actual EMS agencies, are actually “customers” of these EMS systems. Only these EMS systems seem to treat the EMTs and Paramedics like “Bothersome Bastard Stepchildren”  instead of the customers they are and don’t give them any support or service.

Yes, I know that not all of these Little Kingdoms that you call EMS systems function like this, State of Illinois EMS… some actually treat their EMTs and Paramedics like (gasp) People. However, in my decade or so of toiling in these Little Kingdoms, State of Illinois EMS, I’ve seen that to be the exception and not the rule.

So here’s what I propose to you, State of Illinois EMS. I propose that we inject these three things into the whole system: Information, Competition, and Accountability.

Yep, I think that we will both benefit by adding healthy dashes of those three items into our relationship. I’ll explain:

  • Information: I want to put every little policy, procedure, and standing medical order from every EMS system in Illinois on the interwebs. I want every form, personnel roster, and individual quirk of every Little Kingdom in the land to be posted up for scrutiny by every individual EMS provider and provider agency in the state and elsewhere. If they do something, I want everyone to know how and why they do it.
  • Competition: When EMS systems compete, we win. Really, if your hardware store sells your widgets for cheaper than the store across the street, you’ll get more business. If they lower their prices to match yours but your service is better, you still get the business. If their service is just as good but your widgets are of better quality, you still get the business. They have to improve their service, quality, and price just as consistently as you do. It’s called competition and it’s healthy in any food chain or market. Right now as things stand, there’s barely any competition in the EMS systems in the state. EMS provider agencies stay within their systems usually no matter what the conditions are and only rarely change. It’s difficult for new and better ideas to flourish in the current system. It’s also hard for the EMTs and paramedics working under the systems to get any kind of service. Remember, I think that the EMTs, paramedics, and EMS provider agencies are customers of the EMS systems. Now they kneel… with competition and information, they can vote with their feet. EMS systems will be forced to improve or wither and die. The cream will rise to the top, the others… well they may be floaters or sinkers if you know what I mean.
  • Accountability: Are EMS systems accountable to anyone? I mean, if there are complaints against them, to whom are the complaints addressed? If the paramedics and EMTs working under the system are treated like diseased cattle and they are unhappy mooing and coughing like that, whom do they complain to… their EMS provider agencies that don’t want to switch systems due to the immense amount of effort for no real perceived benefit? We need to make them accountable not only to competition, but accountable to a public airing of grievances and peer evaluation.

So there you have it, State of Illinois EMS. Three little words that I’ve come up with that I think will fix our long-term relationship. Sure, I’ll probably keep dabbling in the other states… but I feel entitled to because I know that I’m not your only one either. We can tell people that we have an “arrangement”.

————————————

Look, Illinois EMS could use some repairs. Not every EMS system behaves badly or treats their members poorly, and that’s just it. Those systems should be encouraged to flourish and expand. I don’t think that one blog, one blogger, or one paramedic can disband the Illinois practice of creating EMS systems… but I do think that there should be competition and accountability injected into the system.

So, could we do that?

If there’s any fellow Illinois EMS people out there reading this, feel free to interject. I’d love to get a conversation going on this. Grassroots activism to change EMS from the professional level up? Wow, that’s way EMS 2.0

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  • http://www.999medic.com Medic999

    It would be really good if some of you colleauges could pitch in on this one. I hope you are not a lone voice in the wilderness for these changes in your service.
    Would you actively show this post to your management?

    Wouldnt it be great if they were so receptive that they would enter into a debate on your blog.

    Im sure that wouldnt happen though as most senior health managment are still 'afraid' or dont understand the benefit of 'new media'.

    Good luck with your ideas though Chris!!

  • http://www.lifeunderthelights.com Ckemtp

    This isn't directed to my personal EMS service. The State of Illinois is the governmental body that I live in, it's a state of 11million (or so) people. Yes, they regulate one of the services that I work for… but they're not who I work for.

    I'm not attacking any one individual, merely expressing a desire to change the system in a way that I think is entertaining and challenging at the same time. I think that our state EMS as a whole has some fantastic people working within it… but the system could use a tweak that would spark very positive change for our profession and our patients.

    I'd love for people to get interested and join the debate. I hope they do.

  • doc1490

    Oh My God….There's….There's….There's another SURVIVOR out there? I thought the evil gods of EMS in Illinois had successfully stomped out any will to think (or live, depending on how badly they screwed with you) from all my fellow medics. I work for a private in the Chicago area on their critical care team and have stradled/battled Region VIII and Region X for the entirety of my career. At the moment, I'm completing a Bachelor's of Science in EMS in Omaha, NE (mainly to escpae Illinois…the EMS Wasteland). In the course of that career, I've suffered the following:
    1) My resource hospital (where I attended paramedic school) in Region VIII refused to allow me to do 3 additional shifts of ride time (since paid time couldn't count toward my degree) in order to satisfy requirements for my college degree.

    2) I tested into the most evil resource hospital of Region X (I call it Stupid F*ing Hospital) in mid August, 2008, immediately before leaving for Omaha. I told them I would be gone till May. I told them I was studying EMS. I asked to be put on inactive status. Instead, on January 16th, I received my system suspension letter, along with an angry phone call from my employer threating termination.

    Dear CKEMTP, my soul was nearly crushed…until I called the Nebraska Department of Health and Human Services. When I reached them, a REAL PERSON answered the phone. That person even took the time to look up the contact information of the individual I needed to speak to. They transfered me to that individual…who also answered his phone. He spoke to me for 30 minutes, clearly outlined the things I needed (mercifully little) for reciprocity. He mailed the forms to me AND CALLED TO FOLLOW UP!

    I've been shocked by the efficiency, professionalism, and helpfulness of the State EMS office here in Nebraska. They are helpful and actually care to facilitate development as a provider (they even accepted the crap I had to do in Region X for CE). I think the best answer for Illinois is to clean up IDPH's EMS office, staff it adequately, and take all licensing/CE power away from the regions except for mandatory SOP updates. Maybe if they focused more on the practice of EMS rather than the governance of EMS, the Regions/Systems would actually function. Not that it will matter too much to me…I graduate in December and will be going for greener pastures in another state.

  • http://www.medicthree.fireemsblogs.com medicthree

    I thought I posted here…. Hmm…. Don't you like me CKEMTP?

  • http://www.medicthree.fireemsblogs.com medicthree

    LOL… I guess I didn't. WIll have to dredge that back up!

  • tclemans

    OK so you want to change the system. How do you plan about do just that? Details please.

  • http://www.lifeunderthelights.com Ckemtp

    Medic3, You're always welcome to post. But I can't post comments you didn't write :)

    Doc1490 – I smiled when I read your post. Not because of what you went through… but because I've been there… and I *AM* there a lot of the time. Local pockets of intense political and bureaucracy that belie their size. EMS systems are the sacred cows of IL EMS. They need to be held accountable to their customers, which are us.

    Other than that, Nebraska is flat. I mean, really flat… asystole flat. I'd go nuts.

    Tim, through accountability, communications, and competition. Also by stirring up the people who really control Illinois EMS, the medics and EMTs with boots on the ground.

    Keep it going y'all. Change could be a comin' if we work together

  • CHITOWNMEDIC13

    I agree with what's being said here regarding the 11 or so different EMS regions (systems) through-out Illinois. I'm licensed in Massachusetts, & have been licensed in Colorado & Maine as well. These States do not have the issues that plague Illinois, in those States your EMT-P license is accepted through-out that State un-less you have a naughty no-no in your letter of standing from your present EMS region in those particular States. Region X is only positive towards participants from the F.D. EMS agencies, if you're with a private or contract service they are a 'B' towards you! EVERY medic/EMT has to voice their issues about this & YES it is a major problem here in the Prairie State. EMS directors/officials from other States shake their heads in dis-belief when they speak of IDPH & the problems here with the EMS regions. Simple put THERE'S TOO MANY POLITICAL HACKS working in these offices. 5 years ago the State under then Gov.Blago layed off IDPH employees from EMS. But when I had called & it was after hours, I had the voice mails for 6 people who had the same last name's that had something to do with the EMS offices at IDPH in Springfield! Until WE grow spines & start standing up for ourselves as EMT's & Paramedics, we are going to be treated like 7 year olds by the Nurses,Doctors & Administrators that govern our licenses in Illinois. I've been in pre-hospital care here since 1982 & have seen & been subjected to B.S. attitudes by medical professionals & administrators higher up when having to 'test in' to a different EMS system, no matter if I'm ACLS & everything else optional for a medic's credentials! Time to stop this B.S. selective treatment towards us & treat us like the nurses & Docs when they come for a new job at a different Hospital…
    Kevin J. Redmond
    EMT-Paramedic
    Chicago,Illinois.

  • CHITOWNMEDIC13

    I agree with what's being said here regarding the 11 or so different EMS regions (systems) through-out Illinois. I'm licensed in Massachusetts, & have been licensed in Colorado & Maine as well. These States do not have the issues that plague Illinois, in those States your EMT-P license is accepted through-out that State un-less you have a naughty no-no in your letter of standing from your present EMS region in those particular States. Region X is only positive towards participants from the F.D. EMS agencies, if you're with a private or contract service they are a 'B' towards you! EVERY medic/EMT has to voice their issues about this & YES it is a major problem here in the Prairie State. EMS directors/officials from other States shake their heads in dis-belief when they speak of IDPH & the problems here with the EMS regions. Simple put THERE'S TOO MANY POLITICAL HACKS working in these offices. 5 years ago the State under then Gov.Blago layed off IDPH employees from EMS. But when I had called & it was after hours, I had the voice mails for 6 people who had the same last name's that had something to do with the EMS offices at IDPH in Springfield! Until WE grow spines & start standing up for ourselves as EMT's & Paramedics, we are going to be treated like 7 year olds by the Nurses,Doctors & Administrators that govern our licenses in Illinois. I've been in pre-hospital care here since 1982 & have seen & been subjected to B.S. attitudes by medical professionals & administrators higher up when having to 'test in' to a different EMS system, no matter if I'm ACLS & everything else optional for a medic's credentials! Time to stop this B.S. selective treatment towards us & treat us like the nurses & Docs when they come for a new job at a different Hospital…
    Kevin J. Redmond
    EMT-Paramedic
    Chicago,Illinois.

  • CHITOWNMEDIC13

    I agree with what's being said here regarding the 11 or so different EMS regions (systems) through-out Illinois. I'm licensed in Massachusetts, & have been licensed in Colorado & Maine as well. These States do not have the issues that plague Illinois, in those States your EMT-P license is accepted through-out that State un-less you have a naughty no-no in your letter of standing from your present EMS region in those particular States. Region X is only positive towards participants from the F.D. EMS agencies, if you're with a private or contract service they are a 'B' towards you! EVERY medic/EMT has to voice their issues about this & YES it is a major problem here in the Prairie State. EMS directors/officials from other States shake their heads in dis-belief when they speak of IDPH & the problems here with the EMS regions. Simple put THERE'S TOO MANY POLITICAL HACKS working in these offices. 5 years ago the State under then Gov.Blago layed off IDPH employees from EMS. But when I had called & it was after hours, I had the voice mails for 6 people who had the same last name's that had something to do with the EMS offices at IDPH in Springfield! Until WE grow spines & start standing up for ourselves as EMT's & Paramedics, we are going to be treated like 7 year olds by the Nurses,Doctors & Administrators that govern our licenses in Illinois. I've been in pre-hospital care here since 1982 & have seen & been subjected to B.S. attitudes by medical professionals & administrators higher up when having to 'test in' to a different EMS system, no matter if I'm ACLS & everything else optional for a medic's credentials! Time to stop this B.S. selective treatment towards us & treat us like the nurses & Docs when they come for a new job at a different Hospital…
    Kevin J. Redmond
    EMT-Paramedic
    Chicago,Illinois.

  • http://www.1union801.blogspot.com/ John Broyles

    Here in Region 2 (Central IL–PAEMS) we have the same problem as the rest of IL and the state of Chicago (blago-dailyville).

    I honestly think it would be nice if IDPH (how I dread typing that) would take the training that a combat medic or corpsman has and license in the state accordingly.

    But that won't happen until we're both long gone.

  • PGSilva

    You wanna see screwy? Come to R.I. Oh wait a sec, I forgot to mention corrupt…screwy and corrupt!

  • PGSilva

    You wanna see screwy? Come to R.I. Oh wait a sec, I forgot to mention corrupt…screwy and corrupt!

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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