EMS advocacy: Putting providers front and center

As a child, Austin-Travis County EMS Capt. Selena Xie was set on becoming a U.S. Supreme Court justice.

“In my very limited worldview, that was the only way I could think of how to help people,” she said. “That was the driving motivation.”

Xie, who now serves as the president of the Austin EMS Association, carried her SCOTUS dream through adolescence and into college. During her freshman year, she joined several social justice groups in preparation of defining her planned career path – until she and a few friends took a trip to New Orleans during Spring Break to help with disaster relief in the aftermath of Hurricane Katrina.

“We were gutting houses during the day and partying at night,” she said. But their lack of experience compared to other volunteers forced her to recognize they may be doing more harm than good.

“I realized how inefficient we were, and what we were doing was perpetuating disaster tourism – which is terrible,” she said. So, Xie returned to New Orleans in the summer and lived at a Habitat for Humanity camp directing and organizing volunteers – and found her calling.

“I just remember the joy and really feeling alive when I was working at the disaster relief camp that was more moving than any other experience I’d had,” she said. “It’s almost feeling you can be creative, but in a way that is practical and very meaningful.”

Because her time in New Orleans impacted her in such a profound way, Xie felt pulled toward the medical field – but where?

“EMS is, in a lot of ways, local disaster relief,” Xie says. “When you’re on scene, although we have protocols, there’s so much creativity and interesting interpersonal work and skills you have to work on.”

Still, Xie considered becoming a nurse as a path to working for Doctors Without Borders, but the nursing program waitlist forced a change in plans. Eventually, she ended up starting with Austin-Travis County EMS as an EMT-B before earning her paramedic certification and later joining the Austin EMS Association.

Making EMS work for both providers and patients

Xie began her term as association president one year before the COVID-19 pandemic struck the country, which she says helped sharpen her view of what needs to change in the industry.

“It was a really good time to president,” she said. “There were so many changes; I was on the phone with our chief of staff every single day from April until the end of 2020, as procedures and policies were changing so fast.”

During the pandemic, Xie advocated for more transparency when it came to organizational procedures by answering all questions with the intention of explaining the “why” behind the decision.

“Management often answers questions about policies by saying ‘that’s just the way it is,’ but I think it’s important for our medics to understand there’s a reason for everything,” she said.

From her current position, Xie sees an industry that could do with an overhaul, including the suspension of all talk to combine EMS with the city’s police or fire department.

“I am always telling people we should not merge, because 90% of what the fire department does is EMS and, honestly, 90% of what we do is public health,” she said. “It’d probably be better for us to merge with public health than the fire department.”

Though a controversial idea, Xie doesn’t shy away from her vision for the future of EMS.

“I think about what public safety should look like in this century, with the issues we’re having, and the traditional public safety models that we currently have are not for this time,” she says. “It’s not efficient.”

With a new leader now at the helm of ATCEMS, Xie is hopeful for changes on the horizon to make “public safety departments make sense,” she said, “because we are more adaptable and more flexible. We can usher in a public safety model that really works for our community.”

Recognizing and respecting providers’ community dedication

As president of the association, Xie fiercely advocates for and on behalf of the providers in the city, who she says showed her the direct impact – both medically and emotionally – that EMS can have on the communities they serve.

“I developed an appreciation for how kind paramedics can be to people and what a difference they can make in somebody’s life in just an hour,” she said. “That compassion is really moving to me, and I don’t think we, as a profession, get the respect and admiration we deserve.”

In 2020, Xie strived to boost the morale of an exhausted workforce.

“I remember sending an email that said, ‘I don’t know how many times I can tell you how proud I am of you,’ because that was in every single email before that, too,” she said.

And Xie is proud of the EMS personnel she works for and with.

“Our providers are pioneering awesome things,” she said. “When you look at some of the biggest issues facing our city – homelessness, substance use disorder, mental health issues – EMS is really the forefront when these things reach an emergent point.”

Over the last few years, Xie said the association has tried to “blow out” EMS Week for providers – distributing yard signs, putting up billboards featuring medics in full PPE and working to get community impact stories of paramedics and EMTs into the news.

Elevating the work of those in the field is where Xie finds her true joy and helps her know she made the right career choice.

“I really love my job,” she said. “It’s the perfect job. I both get to be in the field and help people, and I also get to help our medics. I would not go back for anything.”