RE: Some interesting questions

[Guest guest]

Barry and all,

Interesting proposition. Even in the areas of trauma prevention we have a long

way to go. We tend to treat our business as a " piece work " type of business,

where we get paid by the patients carried. This is really sort of valid, since

much of the system funding is on that basis. That tends to orient us toward not

doing non-reveune producing services, like education.

In reality, there are some services that are very busy, and the economics may

not allow for a lot of prevention and education. But, most of us have excess

capacity in the time in-house between runs. The issue is how to use this excess

without negatively impacting response times.

I know a lot of folks really resist the idea that we should do things " between

calls " , and get involved in education, prevention, or other things. But, we

seem to need to find things to do other than carry patients, and utilize that

down time. And if we can generate revenue doing it, more the better.

=Steve=

Barry Sharp wrote:

> -----Original Message-----

> >From Dr. B:

> 7. Should we not direct our resources at interventions that occur much

> earlier in the death process (bronchodilators and mechanical ventilation for

> dyspneic patients, antidysrhythmics and thrombolytics for cardiac patients,

> etc.)?

>

> 9. Should money be directed at trauma care and other early interventions

> instead of cardiac arrest care?

>

> and others:

> I would like to pose an additional thought to these two questions. Should

> EMS staff expand their prevention outreach activities beyond bike helmets,

> car seats, DWI (trauma prevention) to include working with other health

> professions on chronic disease prevention including, but not limited to,

> promoting physical activity, smoking abstinance, and good nutrition? If we

> can impact the communities we serve early enough, then theoretically over

> the long haul we should be able to reduce the demand on the health care

> system while improving the quality (and possibly the length) of live for our

> fellow residents. (I'm not saying that trauma prevention isn't necessary or

> should be replaced, I'm just suggesting that we consider expanding to

> include disease prevention.)

>

> Barry Sharp

>

>

>

>

>

[Guest guest]

Bob Kellow wrote: " Because we can't even pay our personnel a livable

wage,.. "

I just wanted to pose a question to get some answers from people out there

on this list. There has been many discussions about paramedic pay

concerning different services and such but I was interested in a collective

opinion of the group on a definition of the term " living wage " .

The federal government lists a specific bottom line of what it considers a

" living wage " but I would like to hear what EMS people feel is a " living

wage " .

I have two questions:

1) What is the absolute minimum living wage for an EMS provider? (0

experience at EMT, Intermediate, and paramedic levels)

2) What is a the amount you would accept for your current job that would

make you feel like you are paid adequately and keep you from complaining

about the pay? (Seriously, not facetious)

Note: I am asking this as an EMS Person like yourselves not as a supervisor

or manager and not as a representative of my company.

Steve Dralle, EMT-P

San , TX

[Guest guest]

At the risk of being accused of comparing apples and oranges, consider

this.

Increased fire prevention activities by the fire service have reduced

fire losses. Using EMS personnel to promote life style changes may also

have the same result.

Bob Kellow makes a good point that EMS doesn't have unencumbered money,

that the feds are the source for prevention bucks, etc. This same

argument was made in fire prevention. When the fire service stepped up,

the feds started shifting funds to local departments and the reduction in

fire loss began.

This is an investment in the future. How many of you got all excited when

the fire truck came and a fireman told you about 'Stop, Drop, and Roll'?

No knock on epidemiologists, but wouldn't you think kids would be more

interested in hearing from a medic with an ambulance, or a 'guy in a lab

coat' with a bunch of charts?

" Half of the harm that is done in this world is due to people who want to

feel important. "

- T.S. Eliot, _The_Cocktail_Party_

Larry , RN NREMTP

Nurse, Teacher, Medic

[Guest guest]

Larry:

I have several lab coats and a s**t load of charts.

E. Bledsoe, DO, FACEP

Midlothian, Texas

All outgoing email scanned by Norton Antivirus and guaranteed " virus free "

or your money back.

Re: Some interesting questions

> At the risk of being accused of comparing apples and oranges, consider

> this.

>

> Increased fire prevention activities by the fire service have reduced

> fire losses. Using EMS personnel to promote life style changes may also

> have the same result.

>

> Bob Kellow makes a good point that EMS doesn't have unencumbered money,

> that the feds are the source for prevention bucks, etc. This same

> argument was made in fire prevention. When the fire service stepped up,

> the feds started shifting funds to local departments and the reduction in

> fire loss began.

>

> This is an investment in the future. How many of you got all excited when

> the fire truck came and a fireman told you about 'Stop, Drop, and Roll'?

> No knock on epidemiologists, but wouldn't you think kids would be more

> interested in hearing from a medic with an ambulance, or a 'guy in a lab

> coat' with a bunch of charts?

>

>

> " Half of the harm that is done in this world is due to people who want to

> feel important. "

> - T.S. Eliot, _The_Cocktail_Party_

>

> Larry , RN NREMTP

> Nurse, Teacher, Medic

>

>

>

>

>

>

[Guest guest]

Larry,

I completely agree with your comments. But, as I've already

demonstrated, at what point will the EMS workforce stop doing more and

more ... for progressively less and less? Also, there is a huge

difference between using municipal tax dollars for these purposes, when

compared to private services' and volunteers' allocation of finite

billing revenues.

Bob

lanelson1@... wrote:

> At the risk of being accused of comparing apples and oranges,

> consider

> this.

>

> Increased fire prevention activities by the fire service have reduced

> fire losses. Using EMS personnel to promote life style changes may

> also

> have the same result.

>

> Bob Kellow makes a good point that EMS doesn't have unencumbered

> money,

> that the feds are the source for prevention bucks, etc. This same

> argument was made in fire prevention. When the fire service stepped

> up,

> the feds started shifting funds to local departments and the reduction

> in

> fire loss began.

>

> This is an investment in the future. How many of you got all excited

> when

> the fire truck came and a fireman told you about 'Stop, Drop, and

> Roll'?

> No knock on epidemiologists, but wouldn't you think kids would be more

>

> interested in hearing from a medic with an ambulance, or a 'guy in a

> lab

> coat' with a bunch of charts?

>

>

> " Half of the harm that is done in this world is due to people who want

> to

> feel important. "

> - T.S. Eliot, _The_Cocktail_Party_

>

> Larry , RN NREMTP

> Nurse, Teacher, Medic

>

>

>

[Guest guest]

Bob-

If EMS competes for the grants, it is a new revenue stream. Granted, it

isn't forever, but like many things first provided by National level

funds, as the grants dry up from one source, you seek other grants and

sources.

" Half of the harm that is done in this world is due to people who want to

feel important. "

- T.S. Eliot, _The_Cocktail_Party_

Larry , RN NREMTP

Nurse, Teacher, Medic

[Guest guest]

On Thu, 22 Aug 2002 10:58:37 -0500 " Dr. Bledsoe "

writes:

> I have several lab coats and a s**t load of charts.

>

>

But what you say is more interesting and your charts are probably more

exciting than your average epidemiologist. :-)

" Half of the harm that is done in this world is due to people who want to

feel important. "

- T.S. Eliot, _The_Cocktail_Party_

Larry , RN NREMTP

Nurse, Teacher, Medic

[Guest guest]

I agree Larry. But remember that grants aren't made available to private

entities unless they are redirected from non profit or governmental

entities (i.e., Bureau of Emergency Management). Have you requested that

this activity be included in the GETAC/BEM Strategic Plan? You might

still have a couple of days to get it in. That's where it should go, and

the BEM should manage the grant and distribute its funded activities.

Bob Kellow

lanelson1@... wrote:

> Bob-

>

> If EMS competes for the grants, it is a new revenue stream. Granted,

> it

> isn't forever, but like many things first provided by National level

> funds, as the grants dry up from one source, you seek other grants and

>

> sources.

>

> " Half of the harm that is done in this world is due to people who want

> to

> feel important. "

> - T.S. Eliot, _The_Cocktail_Party_

>

> Larry , RN NREMTP

> Nurse, Teacher, Medic

>

>

>

[Guest guest]

Bob, Good points and I agree that EMS agencies and the workforce are already

stretched thin. However, let me throw out (again just for discussion) this

example.

The EMS RACS receive funding from the state's tobacco settlement dollars.

(Revenue from a $100 million trust fund established by the legislature in

1999.) Would it be a stretch on the resources for local EMS providers to

then include smoking cessation and/or prevention messages in their community

presentations/patient education...using already available resources from the

local, state and federal health agencies? Or, to more directly impact the

quality of health/life for the EMS workforce, seriously look at developing

tobacco-free workplace policies at the individual agencies and/or providing

information on available cessation resources?

Again, I'm not suggesting that EMS take on a new role, just expand the

current menu of topics for outreach activities that are already taking place

when dealing with the community. Or as Bob points out, linking into and

promoting internally already established resources to improve the quality of

life for EMS providers.

Just some thoughts to further the discussion.

Re: Some interesting questions

Barry,

I believe that this is the role of the disease and injury epidemiology

agencies, who have the federal money.. No one will pay for EMS to

conduct these activities, and I can't think of many EMS services that

have that kind of unencumbered money lying around for such purposes.

Because we can't even pay our personnel a livable wage, I would oppose

any new spending on activities that are not directly linked to improving

the quality of life for the EMS workforce.

Bob Kellow

Barry Sharp wrote:

> -----Original Message-----

> >From Dr. B:

> 7. Should we not direct our resources at interventions that occur

> much

> earlier in the death process (bronchodilators and mechanical

> ventilation for

> dyspneic patients, antidysrhythmics and thrombolytics for cardiac

> patients,

> etc.)?

>

> 9. Should money be directed at trauma care and other early

> interventions

> instead of cardiac arrest care?

>

> and others:

> I would like to pose an additional thought to these two questions.

> Should

> EMS staff expand their prevention outreach activities beyond bike

> helmets,

> car seats, DWI (trauma prevention) to include working with other

> health

> professions on chronic disease prevention including, but not limited

> to,

> promoting physical activity, smoking abstinance, and good nutrition?

> If we

> can impact the communities we serve early enough, then theoretically

> over

> the long haul we should be able to reduce the demand on the health

> care

> system while improving the quality (and possibly the length) of live

> for our

> fellow residents. (I'm not saying that trauma prevention isn't

> necessary or

> should be replaced, I'm just suggesting that we consider expanding to

> include disease prevention.)

>

> Barry Sharp

>

>