State of Illinois EMSÖ Itís time that you and I had a little talk. You see, Iím an EMT-Paramedic holding licensure in your fair state. Iím 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†Iíve been here ever since.
Except for now, State of Illinois EMS, while your EMT-Paramedic licensure will always be the first card I carryÖ Iíve been flirting with other states. YesÖ itís true. I have my licensure in Iowa as a Paramedic Specialist, and my Paramedic card from Wisconsin too. I donít want to hurt your feelings, State of Illinois EMS but frankly their paramedicine is more exciting than yours is. Yes, State of Illinois EMSÖ 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. Theyíve 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 itís been a torrid love affair, State of Illinois EMS. Really it has. Unfortunately, Iíve changed. Itís not youÖ itís me.
Literally. Itís like you havenít changed in ten years. Whatís up with that? Medicineís changed. Techniques and research have changed. Evidence based EMS practice has changedÖ but, State of Illinois EMSÖ you havenít hardly changed a bit. Youíre not a national state, your CE requirements are strange, your license hasnít gotten easy reciprocity anywhere Iíve tried, and your policies are dictated by the ĎLittle Kingdomsí that you call EMS systems and EMS regions, and wellÖ itís just not working for me anymore.
Iím not leaving you, State of Illinois EMS. I wouldnít, 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 yesterdayÖ but it was a while ago I guess. Weíve been together a long time, havenít we? I think that our relationship is worth salvaging, donít you?
Hereís what I think we should do, State of Illinois EMS: Letís work together on a plan that Iíve come up with. Itís a plan that I think will help fix everything that is wrong with our relationship. I think that the way youíre all set up, the way youíve parceled yourself into EMS regions and the Little Kingdoms that you call ďEMS SystemsĒ 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 ďcustomersĒ of these EMS systems.†Only these EMS systems seem to treat the EMTs and Paramedics like ďBothersome Bastard StepchildrenĒ† instead of the customers they are and donít 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 EMSÖ 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, Iíve seen that to be the exception and not the rule.
So hereís 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. Iíll 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, youíll 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. Itís called competition and itís healthy in any food chain or market. Right now as things stand, thereís 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. Itís difficult for new and better ideas to flourish in the current system. Itís 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 kneelÖ 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 othersÖ 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 toÖ their EMS provider agencies that donít 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 Iíve come up with that I think will fix our long-term relationship. Sure, Iíll probably keep dabbling in the other statesÖ but I feel entitled to because I know that Iím not your only one either. We can tell people that we have an ďarrangementĒ.
Look, Illinois EMS could use some repairs. Not every EMS system behaves badly or treats their members poorly, and thatís just it. Those systems should be encouraged to flourish and expand. I donít think that one blog, one blogger, or one paramedic can disband the Illinois practice of creating EMS systemsÖ but I do think that there should be competition and accountability injected into the system.
So, could we do that?
If thereís any fellow Illinois EMS people out there reading this, feel free to interject. Iíd love to get a conversation going on this. Grassroots activism to change EMS from the professional level up? Wow, thatís way EMS 2.0