Traditionally EMS leaders have assumed that if they do a good job, make effective use of scarce resources and stay off the front page of the local newspaper, all is well. Nothing could be further from the truth. Myriad forces are at work that can undermine your best efforts to provide quality service to a large and vulnerable segment of our society.
Defining Public Affairs
In general, public affairs deals with external stakeholder relations. Although it may be debated in some circles, most will agree that EMS is essentially a healthcare profession. In fact, we are the largest provider of health services in the nation. Many of our stakeholders are healthcare-related. In addition to the healthcare function, we also operate in a key public safety role, often bringing a totally different set of stakeholders.
• Patient family members
• Accountable care organizations
• Skilled nursing facilities
• Long-term acute care centers
• Home health agencies
• Physicians (including medical control)
• Payers (Medicare, Medicaid, commercial)
• Trade associations
Public safety stakeholders:
• First responders
• City government
• County government
• State government
• Federal government
• Emergency management
• Local business associations
An effective public affairs strategy engages stakeholders so we can explain what EMS is and our role in various communities, provide statistical and factual information on operations, and lobby on issues that could impact our ability to operate successfully. The work combines government relations, media communications, dissemination of corporate and social responsibility information, and strategic communications.
Platforms like text messaging, Facebook and Twitter present both a unique challenge and an opportunity for public affairs. Never before have people been able to share information on such a global scale. We will devote an entire column to this in the near future.
Three of the most significant goals of public affairs are to influence public policy, build and maintain a strong brand and reputation, and find a common ground with stakeholders. It is our desire with this column to help the EMS profession identify ways to focus on these goals locally and nationally.
Influence Public Policy
A plethora of national associations represent EMS interests: the National Association of EMTs (NAEMT), American Ambulance Association (AAA), Advocates for EMS (AEMS), International Association of EMS Chiefs (IAEMSC), National Association of EMS Physicians (NAEMSP), National Association of EMS Educators (NAEMSE), National Association of State EMS Officials (NASMSO), International Association of Fire Fighters (IAFF), International Association of Fire Chiefs (IAFC), National Emergency Medical Services Management Association (NEMSMA), among others.
While there have been some limited successes, the difficulty with having all these associations has been the lack of a unified voice for EMS on the larger issues facing our profession. Having served on numerous national lobbying efforts, a common message I’ve heard from legislators is that very few of these associations agree on any one position for EMS. Consequently, many of our initiatives are discounted or kicked back to us to try to determine a unified position—something that often eludes this collection of special interest groups.
Build a Strong Brand
A common mantra of our industry is the statement, “If you’ve seen one EMS system, you’ve seen one EMS system.” While funny and perhaps true, this does not bode well for fostering any type of brand loyalty. We often fall prey to the discord created by our own vehement opinions on how—or by whom—EMS is delivered (fire-based, private contract, third service, volunteer, hospital-based, public utility model, etc.) without focusing on the fact that we all deliver EMS to our local communities in the best way we know how, regardless of the uniform we wear.
Only a few EMS agencies have been able to rise above the fray and create such strong brands in their local communities that they are no longer referenced as the “ambulance” service. Subsequent columns will provide you tools to build brand loyalty and to gain the respect your employees deserve.
Establish Common Ground
On a national level, our industry has a dismal record of identifying, let alone building, common ground with stakeholders. There are many worthy and powerful things we can do in partnership with patients, physicians, hospitals, payers and regulators, but too often we are too busy finding ways to survive and maintain our patch of turf to focus on working with stakeholders to change the environment we operate in. If we fail to change this environment, we run the risk of becoming merely a commodity to be auctioned at the lowest price. If you think that idea is far-fetched, consider the fact that Kaiser Permanente recently held an auction on eBay for interfacility ambulance service to its patients.
The healthcare marketplace is rapidly evolving, thanks in large part to the looming federal deficit and the role healthcare financing is playing in it. Changes are also occurring at local levels as elected officials and policy makers deal with more budgetary red ink than they have ever faced.
EMS is the largest provider of healthcare in the nation, and we should leverage that advantage to take action to help fix the nation’s healthcare challenges, in collaboration with stakeholders who can work with us toward effective solutions. This is the only way we can avoid the financial and healthcare train wreck many of us fear will occur without significant change to the U.S. healthcare system.
Matt Zavadsky, MHA, is director of public affairs for MedStar Mobile Healthcare, the public utility model system in Fort Worth and 14 surrounding cities in north Texas.