menla

I'm having this same conversation with spenac over in another topic, so I thought I'd pitch in here. There will always be volunteers in professions with such a high degree of personal satisfaction as medicine and fire. Hospitals have had to deal with volunteers for a very long time, and the good hospitals do it very well. We should take that into consideration when planning our response to volunteerism in EMS. So let's be rational. Volunteerism contributes to something that's called a "local maxima" in quantitative analysis. That is, something that was extremely useful in the past that has become a negative contributing factor to future growth. That's all... it's not some sort of pervasive evil that's destroying the world. This doesn't mean you should remove it entirely, or even that you can. The cost in human suffering and loss of life if all volunteers stopped volunteering today would be significant. What it means is that you have to mitigate. This means that you have to manage the problem. If EMS professionals were truly professional they would step up and take responsibility for the field rather than step back, throw up their hands, and just complain. Or, as I suspect some are doing, make volunteers so uncomfortable that they volunteer somewhere else. They might, for instance, start an national level organization for EMS volunteers that was free to join and used donated funds to work with states and federal organizations to increase funds for EMS to the point where the volunteers could go paid without impacting patient care. Or help (gasp! volunteer!) organizations that already do this. Another option would be to work with local legislators or political organizations to address the issue of funding at a local level. Or even forming (or working with) a group that raises awareness of the issue. If we in EMS want to be taken seriously as professionals, we've got to start acting like it. Tom White

I can agree that communities need to be pushed to give the money. There are some interesting new funding mechanisms, like utility bill subscriptions, that help. But one could argue that those also hinder (a town of 300 can't support EMS for a county, but now they aren't going to vote for a tax millage either). Pretending it isn't complex, to me, is far more harmful than volunteering as an EMT. Attitudes toward healthcare expenses are just plain weird right now. Everybody expects an ambulance at the door a few minutes after they call 911, but I'm not sure they understand what it is that they need to do to ensure that it will happen. There's no excuse for ignorance, but it's inevitable. Joe Bob and his three dogs in a trailer probably have no clue that there's a way to get funding for EMS. And to be honest, he's been lied to so much about taxes by politicians, that he'd probably vote against it anyway. The pay for EMS is one of the many atrocities in our society. We can disagree on the causes, but I agree with you 100% that that is bad. There will always be volunteers in the medical field, that's just a fact of life. That's because there's more that appeals than the money. If I recall correctly, the profession of nursing began as a volunteer service. In Oklahoma, some of the poorest counties have full-time EMS staff, others don't. Yes - if people knew that fact maybe they could do something about it. And so awareness is very much the key to resolving the problem. But I don't agree with the method. You're saying that not having EMS to work that wreck with four teenagers in it will raise awareness so that maybe something will be done. I'm saying that we should still get those kids to a hospital, but look into other ways to raise awareness of the problem. Tom White

Ok. So the argument really is rather idealistic then. The same argument means we shouldn't have volunteer anything, including fire. It'd be great if the government would pay for that, and healthcare too (while we're at it). Hmmm... and broadband internet. :-) I guess I just see it otherwise, EMS services are dropping here like flies. Lots of the smaller agencies wouldn't survive without volunteers. For example, there are still some counties that are ALL volunteer, or so I'm told. So perhaps the argument against vollies is something else entirely. The usual one I hear is lack of professionalism, and I'm not sure one has to be a volunteer to be unprofessional. But I'll admit that I've noticed less enthusiasm for uniforms in the volly world. But, oddly, not for taking classes. That's just me, though. So to address the original complaint head-on, the answer to funding probably lies in state legislative branches. Rather than complaining about vollies, a better tactic is to encourage EMS professionals to write letters to their lawmakers. Each lawmaker has a threshold for a topic to be brought to his or her attention. Usually three to five letters are all that are required for a lawmaker to take notice. I've seen knitting circles change the world just because they each took the time to write a letter. We can do that to, if we bother to. Make a website, publish nice pamphlets that coach people through writing personalized letters to their lawmakers. It's worked before. Cheers, Tom White

Ok, I've read the arguments against volunteers, and really just don't get it. I work unpaid shifts at a paid EMS / volunteer fire station. The only reason I don't want the money is so they can spend it on things like supplies, or whatever. I'm trained just the same as the other medics, got my NREMT and state licenses like everybody else did. I have more experience than some EMTs, much less than others. This is a service that has come close to shutting down for lack of funds many times over the years. And it's also a place about 30 to 45 minutes from a hospital. Yes, there's EMSA, but why add another 30 to 45 minutes to the response time? We're talking Osage County, Oklahoma here. Very rural, very sparsely populated, and not very much money. Yes, I understand that we need better funding mechanisms. I just don't see how helping to keep the ambulance in service while waiting for it to work out is going to affect that process. This area has been without ambulance service before, and the community got together and started the ambulance service after people died. Closing the doors just means that will happen again - not that there will be some immediate public outcry of support for changing the laws. To me "whackers" are the guys who jump in their POVs with flashy lights and show up having no clue what to do but getting off on taking charge any way. Or is this just complaining about pay in EMS in general? I can agreee with that, and I think we should work toward making that happen. Congratulations, by the way, to EMSA. I hear they got a 12.5% pay increase.

You guys are miracle workers. Oklahoma has been ignoring this for a long time. I got my EMT-Basic so I could volunteer and maybe prevent at least one small EMS provider from shutting down. The jury is still out on it. Did this ever pass? I can't find it on the oklahoma.gov site. Thanks!!!