Among those who pontificate on the future of EMS, it has become a foregone conclusion that the volunteer model of fire and EMS response is a nostalgic, but antiquated notion that as an institution, is taking its last, agonal breaths.
For more than 20 years, various industry stakeholders and overtaxed service chiefs have been harbingers of doom, convinced that societal changes and increased public expectation have rendered the concept of community-based voluntary EMS response an option that is no longer viable. But despite the formation of hundreds of focus groups and task forces, there is still no realistic solution or cohesive plan to replace volunteers in EMS or the fire service.
Nor should there be.
The idea that furthering EMS without volunteers is either practical or prudent needs to be abandoned. Our desire to band together in times of crisis, to work together to help both neighbors and strangers through tragedy and natural disaster has always reflected who we are as a nation.
Volunteerism is quintessentially American
In the 1830s, French political scientist Alexis de Tocqueville wrote extensively about the tendency of Americans to form voluntary civil associations as a means of accomplishing community, commercial and personal goals. He believed this to be fundamental to the foundation of our democratic society.
Volunteer firefighters in America can trace their roots all the way back to Philadelphia in 1763 and the establishment of Benjamin Franklin’s Bucket Brigade.
Julian Stanley Wise was organizing the first formal volunteer rescue squad in Roanoke, Virginia, in 1928.
The First Aid Council of New Jersey is celebrating its 90th anniversary this year. Member squads have continuously responded in force to catastrophic events and everyday emergencies since before the 1937 Hindenburg disaster.
Today, EMS and Fire department volunteers are the health and safety net for most of the approximately 57 million (18%) people living in rural America, and rural areas make up 95-97% of the nation’s land mass. Volunteers are also frequently the first line of defense in suburban America, where low call volume and crushing tax burdens make response by municipal and private for-profit services untenable both financially and logistically.
Identify the threats to EMS to further the profession
The truth is that behind the scene, volunteers have been doing the heavy lifting in emergency response since this country’s inception.
But in 2019, EMS in America is in crisis, and maybe the volunteer model has simply been the canary in the coal mine. At what has obviously become an inflection point, it is critical that all stakeholders in EMS drop the excuses, put down the pitchforks and face reality. It is not “time for change.” Change has already passed us by while we as a profession were busy with infighting, bickering and backstabbing each other over petty grievances, tribalism and egocentric aspirations.
To survive and succeed, many EMS organizations both paid and volunteer will be forced to accept the need for drastic organizational changes if they wish to continue their mission.
“If you dislike change, you’re going to dislike irrelevance even more.” — General Eric Shinseki, U.S. Army (Ret.)
To understand the root of the challenges facing EMS, we must understand what the problem is not:
- It is not a decline in volunteerism in America. One out of four Americans volunteers formally on a regular basis. This has not changed since research has been performed on volunteerism in America. In fact, some studies show as many as 90 percent of Americans would volunteer if they had any idea how to, or where they would be accepted.
- It is not the aging workforce. Founded in 1964, in southwest Florida, the Points of Light award-winning Sun City Center Emergency Squad answers close to 5,000 calls a year in addition to providing no-cost wheelchair van transport and a multitude of other community services and public education. Their membership consists of nearly 400 volunteers ranging in age from 18 to 80.
- It isn’t ‘kids these day’ either. Post 53 in Darien, Connecticut, has been run by high- school teenagers and adult advisors for almost 50 years. Another award- winning agency, their story has been shared worldwide. If you are an EMS volunteer, or an EMS educator looking for inspiration, find an opportunity to attend a showing of High School 911.
Every year, multiple volunteer services are recognized for excellence in service not only in their service areas and home states but nationally, including by the Zoll Excellence in EMS awards.
It is time to stop perpetuating the idea that successful volunteer EMS agencies are the black swans of EMS.
Before that deceased tag is affixed to the volunteer service model, perhaps a more feasible and rational idea would be to re-assess our volunteer EMS and fire services for life threats, by:
- Opening funding streams to allay the financial chokehold
- Stopping the bleeding of both new and experienced personnel
- Assessing and treating the pervasive, systemic infections of institutional stagnation, malignant mediocrity and maladroit leadership
Discover a way for EMS agencies to understand that forming alliances is not a threat to cultural identity, but a way to use both economies of scale, and a shared passion for this work to move forward in a nation that desperately needs to have their emergency caregivers clinically prepared and absolutely committed to showing up, holding their hands, drying their tears, tending their wounds and keeping them safe.
It’s time to make years of EMS slogans and public promises mean more than a hashtag.
- #Readytoday #Preparedfortomorrow
- #Strongertogether
- #Everydayheroes
- #Calledtocare
- #Onemissiononeteam
- #EMSmorethanaJob
- #Dedicatedforlife
- #Alwaysinservice
- #Beyondthecall
This article, originally published on May 20, 2019, has been updated.
