NEMPAC, the political action committee of the American College of Emergency Physicians, is this year the fourth-strongest physician PAC in the country. Their “Give a Shift!” campaign encourages members to donate the equivalent of one shift’s compensation each year to advancing the cause of emergency physicians. As a result, they have lots of money to influence public policy. Sure, docs make more than EMTs and medics. But imagine if every one of the 600,000 or so credentialed EMS folks out there in the U.S. gave one shift’s worth of compensation—maybe $100 or so. That would be $60 million worth of public influence. How much do we have now? Not much—the only EMS PAC I know of is the American Ambulance Association’s Ambu-Pac, which works very hard on…increasing Medicare reimbursement. Hmm.
Address public policy—We are deeply mired in the rut of transportation-based reimbursement, and we must get out of it. We need to begin to educate our communities, especially our elected officials and senior city and county management, that it is a good thing to expend local taxpayer dollars to support EMS. If you are a typical EMS provider in the U.S. today, you can get just enough money from transport revenue to barely provide adequate response to 9-1-1 calls, with nothing left over for innovative programs, public education, leadership development, specialized equipment, etc. Now, imagine your city or county council provided you with $5 per capita to augment what reimbursement brings. Would that do good things for your service? I know it does for mine! And there is no reason national and state organizations that pay for particular services (e.g., Medicare and Medicaid) couldn’t pay for these non-transportation services—if we had the means (lobbyists and other advocates) to have it written in to law.
Do some work in your free time—It might be nice to make a couple of extra bucks from a part-time job. But would there be benefit in doing something else, perhaps under the auspices of your employee association, to improve your community? Have you noticed at Christmas time the positive press our law enforcement colleagues get from “Shop With Cops”-type programs, or the visibility of the Marine Corps Reserve Toys for Tots program? We could do the same things with the same benefits. We all say we want EMS to have the professional respect and recognition it deserves—but you get what you earn, and you don’t earn visibility and respect by doing the minimum expected by your agency or community.
We are truly at a crossroads in the development of EMS. With a little bit of vision, a little bit of effort, a little bit of money and a lot of willingness, the EMS community can step up, fill some significant gaps in the community healthcare and safety net, and provide a bright future for itself and its members. If not…well, think of those dinosaurs.