Should Volunteer Squads Be Eliminated ?

[n5iln]

If there was no one to volunteer to do the job of EMS, even the rural townships would figure out a way to get paid personnel to do the job. Rid hit on something that is the absolute lynch-pin of the matter. Supply and demand. When the demand for a product or service is high, supply is soon to follow. No, I repeat, No county, city, or township would forfeit their denizens safety because there wasn't enough coins in the coffers. If there were NO volunteers at all anywhere to do EMS or fire calls, do you think the Government would stand idly by and let the country slip into safety oblivion? I don't think so. New rules, new regulations, and yes, new money would be developed and appropriated as needed. There would be federal money coming out the wazoo if there was a revolt. We are talking about a country that spends trillions of dollars on frivolous programs and experimental ideas that never come to pass. If something as important as total lack of public safety knocked on the front door, the government would race to answer it.

Also, no one is saying that EMT's in rural quarters of the nation have to be paid like MD's. Pay commiserate with economic and regional standards would be fine. I just don't believe that something as important as pre-hospital emergencies should be an un-compensated vocation. Not because volunteers aren't good at it, but because this field "deserves" to be paid. I agree that donating your time to the community is a fantastic, and worthwhile thing. But why not get paid for this particular service, and volunteer for something else? Go paint over some graffitti, mentor a fatherless child, go listen to some war stories at the local nursing home, pick up litter on the weekends, get involved with your local legislation. There are plenty of other excellent things you can be doing with your time that SHOULD be volunteer. EMS should not.

I agree 100%. But I also know a bit more about economics than I like to think about. And while local governments would step up, would it be fast enough to fill the void? I can't see it happening, given the inherent inertia that any bureaucracy has. And in the interim, people die for lack of care. I can't accept that as an option.

As far as pay scales go...I'm not looking for an MD's pay. I'd be happy with pay somewhere on the same level as a typical staff secretary at a medium-sized corporation, or even as much as someone who changes tires at the local Goodyear store. Even a professional firefighter's salary -- entry-level. Something that demonstrates the level of responsibility I have as a member of the EMS system. But until the US healthcare system gets out of the hands of the insurance companies, that ain't gonna happen. So I have to accept that I'll never be paid what my services are truly worth (a common lament, I know), and still provide the best care I'm capable of...whether I'm in my paid rig or my volunteer rig. And yes, I do both. Happily, and with a professional attitude.

Just my two cents' worth...save up the change for a root beer or something...

[cosgrojo]

I agree 100%. But I also know a bit more about economics than I like to think about. And while local governments would step up, would it be fast enough to fill the void? I can't see it happening, given the inherent inertia that any bureaucracy has. And in the interim, people die for lack of care. I can't accept that as an option.

Just my two cents' worth...save up the change for a root beer or something...

Would it be fast enough? No, 'fraid not. But nothing our government does is fast enough, but it would get done. We didn't get in after Katrina fast enough, but now we are doing the right things and everyone is getting fingered with their part of the blame-pie. And soon it will be just an unfortunate blip in our rear-view mirrors. We are incredibly forgetfull people. There would be a heck load of hubbub at first, but it would eventually get calmed down and the loss of life swept under the rug.

Calous? very much so... I don't like any option that sacrifices lives, but how many have we lost already because the town couldn't get a crew together fast enough? I know it has happened in towns around where I work. Sometimes, not all the time, but sometimes, every second counts.

No thanks on the root beer. I'm savin' for a Vodka, straight up, frozen, not stirred.

[Dustdevil]

Calous? very much so... I don't like any option that sacrifices lives, but how many have we lost already because the town couldn't get a crew together fast enough? I know it has happened in towns around where I work. Sometimes, not all the time, but sometimes, every second counts.

Meh... that assumes that we actually save lives on a regular basis. Statistics say this may not even be true. Most of those who die would have done so even with our intervention. And most of those who live would have done so even without our intervention. So really, I have serious doubts as to whether there would be much "sacrifice" at all in the interim.

But of course, I agree with everything you're saying. Just supporting your theory.

[alexeden]

I strongly feel that volunteers are great! As with volunteer and paid services, you have people that do it to feel good about themselves, and also you have volunteers that actually care about the service, and patient care. People do not appreciate volunteers enough. They can be better thatn some of the paid EMTs! I have seen it.

[JakeEMTP]

I strongly feel that volunteers are great! As with volunteer and paid services, you have people that do it to feel good about themselves, and also you have volunteers that actually care about the service, and patient care. People do not appreciate volunteers enough. They can be better thatn some of the paid EMTs! I have seen it.

First off, Welcome to EMT City.

I don't think anyone is saying or even questioning volunteers skills, well perhaps some, but you have to admit, there are some real wankers out there. What the general consensus is, is that volunteer services aren't really necessary except for the most remote areas. Therefore, they are taking away paid full time jobs from ppl who invested 2 yrs of school (medic) because they want to give their services and education away for free and that's just crazy.

It has been posted many times in this thread so I won't reiterate. But ask the trash man next time and see if he is doing it for free. I doubt he'll say yes.

[n5iln]

What the general consensus is, is that volunteer services aren't really necessary except for the most remote areas. Therefore, they are taking away paid full time jobs from ppl who invested 2 yrs of school (medic) because they want to give their services and education away for free and that's just crazy.

For the sake of { discussion || argument }, could someone please define "remote"? I don't consider myself as living in a "remote" area -- the closest Level II trauma center is only about 45 minutes away by ground, 15-20 by air -- but volunteer emergency services are all there are for us. (Sidenote...it's only a Level II center because they don't have neuro in house 24/7 right now, or so I'm told.)

[Ridryder 911]

These are the spefic definitions from the U.S. Census Bureau. It has defined what is rural by exclusion

."An urbanized Area (UA) has an urban nucleus of 50,000 or more people. Individual cities with a population of 50,000 may or may not be contained in these UAs. Urbanized Areas have a core (one or more contiguous census block groups or BGs) with a total land area less than 2 square miles and a population density of 1,000 persons per square mile. They may contain adjoining territory with at minimum 500 persons per square mile and encompass a population of at least 50,000 people. An urban cluster (UC) also has a core as identified above with a total land area of less than two square miles and a population density of 1,000 persons per square mile. They may contain adjoining territory with at minimum 500 persons per square mile and encompass a population of at least 2,500 but less than 50,000 persons. The Census Bureau's classification of "rural" consists of all territory, population, and housing units located outside of UAs and UCs"

There are other set defiitions depndent on what buraucracy is defining it . remember there are rural, frontier etc...

I find it difficult to see a city, that is that close a major hospital being called remote.... and as well having a population requiring volunteers. Again, it might be the old "traditonal system"...that we have discussed.

R/R 911

[speed graphic]

I think this is a big problem that's not going away any time soon, for a few reasons.

I'll give my analysis of the situation in the suburbs of Rochester, NY, where I worked as a volunteer before moving out to California (where I am a now a paid EMT).

My corps was pretty damned good. We had a great base, great equipment, and most importantly great medics. All of the basics wre volunteers, and the ALS techs were paid... and it worked really well. However, some of the other suburbs were terrible when it came to responding to pages, getting there in a professional manner... sometimes response times would have 5 or more minutes added to them until the commercial agency was paged out. While it would be easy to rally around shutting down that corps... how could you get the residents of the community to rally around making my corps all-paid when the service wouldn't change?

As a paid EMS provider, I realize now what a difficult position volunteers put us in. It's really not fair that I get paid what I do. But let's face it: EMS is fun, especially in small doses, and the entrance requirements are quite low for such a dynamic job. The only way that I see to make our dilemma better is to radically increase education requirements... or take the lights and sirens off of the rigs.

[akflightmedic]

ALMOST AT 10 PAGES!!!!

We havent had a 10 pager in a while....

Anything that generates this much discussion is usually shut down by page 6....

Keep it up!!!!!!!

[hfdff422]

I would say that if you have less than 5,000 people for a township (depending on the size of the township- as some will encompass several "towns"), it would be hard pressed to have the tax base for paid municipal service or the run load to attract a private service. My vollie agency is in the process of switching over, but we are well over 6,000 people now and it is over due. We are almost to a full time BLS bus and pretty much have full time ALS as well. A few years ago, it would have been almost impossible to do though.