Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 Okay, I need to correct myself on this one. Goldstar article here: http://www.contracostatimes.com/mld/cctimes/12701588.htm The key part of the article is posted below, but certainly does not imply that Goldstar is back up and running for " business as usual " . Their otherwise many stationary ambulances were temporarily subcontracted for the hurricane's onslaught. Goldstar is not up and running again, or are they? I'm not from the Houston area, so I can't answer that. ----------------------------------------- story -------------- Questionable firms benefit from Katrina By Yochi J. Dreazen WALL STREET JOURNAL (clipped part of the story about Goldstar's current investigation) .... Then Hurricane Katrina tore through the Gulf Coast, and GoldStar's fortunes began to change. Desperate to get ambulances into flood-ravaged areas of Louisiana, the Federal Emergency Management Agency put out a call for help. C. Consulting Inc., a small East Texas firm, bid for the work and signed a federal contract to provide up to 50 ambulances a day through the end of September at a total cost of $5.2 million. Then Consulting went looking for subcontractors capable of providing dozens of ambulances immediately. The only firm it found with that many vehicles on hand was GoldStar, which soon had a subcontract to provide up to 45 ambulances a day at a profit of $800 per vehicle per day. " Most ambulance companies wouldn't be able to supply 45 ambulances on a dime like that. But ours were just sitting there in the lot, so it was a nice coincidence for everyone, " says Rothberg, GoldStar's attorney. " It would be pretty sad for the government to say that we won't use GoldStar because they're being investigated, so we'll leave people to die in the streets. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 Okay, I need to correct myself on this one. Goldstar article here: http://www.contracostatimes.com/mld/cctimes/12701588.htm The key part of the article is posted below, but certainly does not imply that Goldstar is back up and running for " business as usual " . Their otherwise many stationary ambulances were temporarily subcontracted for the hurricane's onslaught. Goldstar is not up and running again, or are they? I'm not from the Houston area, so I can't answer that. ----------------------------------------- story -------------- Questionable firms benefit from Katrina By Yochi J. Dreazen WALL STREET JOURNAL (clipped part of the story about Goldstar's current investigation) .... Then Hurricane Katrina tore through the Gulf Coast, and GoldStar's fortunes began to change. Desperate to get ambulances into flood-ravaged areas of Louisiana, the Federal Emergency Management Agency put out a call for help. C. Consulting Inc., a small East Texas firm, bid for the work and signed a federal contract to provide up to 50 ambulances a day through the end of September at a total cost of $5.2 million. Then Consulting went looking for subcontractors capable of providing dozens of ambulances immediately. The only firm it found with that many vehicles on hand was GoldStar, which soon had a subcontract to provide up to 45 ambulances a day at a profit of $800 per vehicle per day. " Most ambulance companies wouldn't be able to supply 45 ambulances on a dime like that. But ours were just sitting there in the lot, so it was a nice coincidence for everyone, " says Rothberg, GoldStar's attorney. " It would be pretty sad for the government to say that we won't use GoldStar because they're being investigated, so we'll leave people to die in the streets. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 Okay, I need to correct myself on this one. Goldstar article here: http://www.contracostatimes.com/mld/cctimes/12701588.htm The key part of the article is posted below, but certainly does not imply that Goldstar is back up and running for " business as usual " . Their otherwise many stationary ambulances were temporarily subcontracted for the hurricane's onslaught. Goldstar is not up and running again, or are they? I'm not from the Houston area, so I can't answer that. ----------------------------------------- story -------------- Questionable firms benefit from Katrina By Yochi J. Dreazen WALL STREET JOURNAL (clipped part of the story about Goldstar's current investigation) .... Then Hurricane Katrina tore through the Gulf Coast, and GoldStar's fortunes began to change. Desperate to get ambulances into flood-ravaged areas of Louisiana, the Federal Emergency Management Agency put out a call for help. C. Consulting Inc., a small East Texas firm, bid for the work and signed a federal contract to provide up to 50 ambulances a day through the end of September at a total cost of $5.2 million. Then Consulting went looking for subcontractors capable of providing dozens of ambulances immediately. The only firm it found with that many vehicles on hand was GoldStar, which soon had a subcontract to provide up to 45 ambulances a day at a profit of $800 per vehicle per day. " Most ambulance companies wouldn't be able to supply 45 ambulances on a dime like that. But ours were just sitting there in the lot, so it was a nice coincidence for everyone, " says Rothberg, GoldStar's attorney. " It would be pretty sad for the government to say that we won't use GoldStar because they're being investigated, so we'll leave people to die in the streets. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 Hehe, my " Open Records " request from the State of Texas is also delayed because the EMS data is stored in Houston. Not as important as a person's paycheck, but shows that a hurricane affects everything and everyone and is not selective. Re: Observations > > > > > > We cannot aloow nurses to take over people. I > know > > I > > have seen a great many nurses that couldn't > tell > > their > > head from their butt. Unfortunately this also > > exixts > > in our profession. You can be assured that > they > > will > > dimantle this profession as a whole if it > happens. > > > > This is our turf. But no thanks in large part > to > > those who have frauded the gov't, we have a > bad > > rep. > > In all honsety in order to see a positive > change > > we > > have to do away with the for-profit providers. > > > EMS > > belongs at the very least as a third city > service. > > > > Salvador Capuchino Jr > > EMT-P > > > > --- Terrell > wrote: > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 Hehe, my " Open Records " request from the State of Texas is also delayed because the EMS data is stored in Houston. Not as important as a person's paycheck, but shows that a hurricane affects everything and everyone and is not selective. Re: Observations > > > > > > We cannot aloow nurses to take over people. I > know > > I > > have seen a great many nurses that couldn't > tell > > their > > head from their butt. Unfortunately this also > > exixts > > in our profession. You can be assured that > they > > will > > dimantle this profession as a whole if it > happens. > > > > This is our turf. But no thanks in large part > to > > those who have frauded the gov't, we have a > bad > > rep. > > In all honsety in order to see a positive > change > > we > > have to do away with the for-profit providers. > > > EMS > > belongs at the very least as a third city > service. > > > > Salvador Capuchino Jr > > EMT-P > > > > --- Terrell > wrote: > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 Hehe, my " Open Records " request from the State of Texas is also delayed because the EMS data is stored in Houston. Not as important as a person's paycheck, but shows that a hurricane affects everything and everyone and is not selective. Re: Observations > > > > > > We cannot aloow nurses to take over people. I > know > > I > > have seen a great many nurses that couldn't > tell > > their > > head from their butt. Unfortunately this also > > exixts > > in our profession. You can be assured that > they > > will > > dimantle this profession as a whole if it > happens. > > > > This is our turf. But no thanks in large part > to > > those who have frauded the gov't, we have a > bad > > rep. > > In all honsety in order to see a positive > change > > we > > have to do away with the for-profit providers. > > > EMS > > belongs at the very least as a third city > service. > > > > Salvador Capuchino Jr > > EMT-P > > > > --- Terrell > wrote: > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 OK I guess I opened a big discussion by replying to a very respected and well stated man who simply wanted to state his observations, First Bob I do want to say I hope you understand that I really was agreeing with you just simlpy asking for the so very hard to obtain souloution. I do hope that you did understand that. You know me I dont always sound as clearly as I mean. NOW. Let me dispell some of the discussion because I know some of the facts. GOLDSTAR !!! Yes there is still a Goldstar ems that is doing business still owned by one of the original 3 owners. We come to work and do our jobs just like most all of you do.Yes there was some closures of alot of our service area's but there were financial decissions made by a very good and well thought business man that does sign our paychecks that we do get on time( I have one in my pocket right now that was from friday ...on time and everything) We did have had some rough times I will admit BUT I have never not gotten my paycheck (despite what you folks might want to believe) and my bank has never had to worry about the money being there to cover it . I have been in EMS now for 20 yrs and 3 months, worked for different services across the state and also in New Mexico and have worked at some good services and some bad ones. GoldStar during the hay day would have easily been one of the 2 best . I have relocated to stay with this company and am still dedicated to helping overcome the past. And we will !!! There seems to be ALOT of talk about the status of GoldStar and a whole lot of bogus information. It is incredible, because obviously none of you have facts and would rather listen to rumors than ask... or instead worry about yourself and not about what we are doing. In my reply to Bob I mentioned the childish way that so many people in EMS act. I dont know what to say I mean you all talking without the facts is part of excatly what I meant by that. I keep hoping that more people in EMS will grow up and act as the professional that they want to be. Profession is like respect it is not given it is earned Terrell EMT-P/CCEMTP Kim wrote: Hehe, my " Open Records " request from the State of Texas is also delayed because the EMS data is stored in Houston. Not as important as a person's paycheck, but shows that a hurricane affects everything and everyone and is not selective. Re: Observations > > > > > > We cannot aloow nurses to take over people. I > know > > I > > have seen a great many nurses that couldn't > tell > > their > > head from their butt. Unfortunately this also > > exixts > > in our profession. You can be assured that > they > > will > > dimantle this profession as a whole if it > happens. > > > > This is our turf. But no thanks in large part > to > > those who have frauded the gov't, we have a > bad > > rep. > > In all honsety in order to see a positive > change > > we > > have to do away with the for-profit providers. > > > EMS > > belongs at the very least as a third city > service. > > > > Salvador Capuchino Jr > > EMT-P > > > > --- Terrell > wrote: > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2005 Report Share Posted October 8, 2005 OK I guess I opened a big discussion by replying to a very respected and well stated man who simply wanted to state his observations, First Bob I do want to say I hope you understand that I really was agreeing with you just simlpy asking for the so very hard to obtain souloution. I do hope that you did understand that. You know me I dont always sound as clearly as I mean. NOW. Let me dispell some of the discussion because I know some of the facts. GOLDSTAR !!! Yes there is still a Goldstar ems that is doing business still owned by one of the original 3 owners. We come to work and do our jobs just like most all of you do.Yes there was some closures of alot of our service area's but there were financial decissions made by a very good and well thought business man that does sign our paychecks that we do get on time( I have one in my pocket right now that was from friday ...on time and everything) We did have had some rough times I will admit BUT I have never not gotten my paycheck (despite what you folks might want to believe) and my bank has never had to worry about the money being there to cover it . I have been in EMS now for 20 yrs and 3 months, worked for different services across the state and also in New Mexico and have worked at some good services and some bad ones. GoldStar during the hay day would have easily been one of the 2 best . I have relocated to stay with this company and am still dedicated to helping overcome the past. And we will !!! There seems to be ALOT of talk about the status of GoldStar and a whole lot of bogus information. It is incredible, because obviously none of you have facts and would rather listen to rumors than ask... or instead worry about yourself and not about what we are doing. In my reply to Bob I mentioned the childish way that so many people in EMS act. I dont know what to say I mean you all talking without the facts is part of excatly what I meant by that. I keep hoping that more people in EMS will grow up and act as the professional that they want to be. Profession is like respect it is not given it is earned Terrell EMT-P/CCEMTP Kim wrote: Hehe, my " Open Records " request from the State of Texas is also delayed because the EMS data is stored in Houston. Not as important as a person's paycheck, but shows that a hurricane affects everything and everyone and is not selective. Re: Observations > > > > > > We cannot aloow nurses to take over people. I > know > > I > > have seen a great many nurses that couldn't > tell > > their > > head from their butt. Unfortunately this also > > exixts > > in our profession. You can be assured that > they > > will > > dimantle this profession as a whole if it > happens. > > > > This is our turf. But no thanks in large part > to > > those who have frauded the gov't, we have a > bad > > rep. > > In all honsety in order to see a positive > change > > we > > have to do away with the for-profit providers. > > > EMS > > belongs at the very least as a third city > service. > > > > Salvador Capuchino Jr > > EMT-P > > > > --- Terrell > wrote: > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2005 Report Share Posted October 9, 2005 I am presently in a country with nationalized health care (Australia). While they have a great ambulance system, their medical system is in financial straits. People here wait months for surgery and often have to drive great distances for specialized medical care. The private (non-state) hospitals are hurting because of falling reimbursement. While the US health care system is out of control, we must proceed with caution in its revision. If left to its own devices, the federal government would establish a health care system that would be a cross between the US Postal Service and the IRS. (Consider that for a moment-or look at the VA system). Reform in healthcare is needed (as it is in the legal system). We must be careful not to destroy our healthcare system, but we must reel it in. BEB _____ From: [mailto: ] On Behalf Of , Sent: Saturday, October 08, 2005 8:17 PM To: Subject: RE: Observations and while we're at it, lets take ALL healthcare away from those who make a profit. No more Hospitals, clinics, Dr's, Nurse practioners, RT's and X-ray techs, NO ONE can make money off Healthcare. Lets dismantle the entire system as this country has known it, and start over. How much of that was sarcasm? You decide! Mike Re: Observations We cannot aloow nurses to take over people. I know I have seen a great many nurses that couldn't tell their head from their butt. Unfortunately this also exixts in our profession. You can be assured that they will dimantle this profession as a whole if it happens. This is our turf. But no thanks in large part to those who have frauded the gov't, we have a bad rep. In all honsety in order to see a positive change we have to do away with the for-profit providers. EMS belongs at the very least as a third city service. Salvador Capuchino Jr EMT-P --- Terrell wrote: > Bob > > These are all very well thought and well stated > observations. I always respected your sit back and > watch to find the problem way of approaching a > problem. and once again you have nailed a large part > of the problem right on the head. > > But the problems have been stated more than once and > in more than one way. Now how do we fix them. We > talk a good game about getting together " unionizing " > etc. the thing is we have moved beyond the put up or > shut up point. > As you have stated here we have allowed the > emergency medicine profession to pass us up and > forget about us and move on. We allows the nursing > profession to run us down and rumor has it they want > to take us over and it almost appears overall we are > going to roll over and let them. > Why? > As individuals everyone can talk tough But there is > so much I am better than you BS going on that " WE " > cannot get along. Until that happens well the old > saying divided we fall united we stand. > Over all can we as a group Grow up and act like a > professional group and maybe earn what we want and > stop acting like selfish children. That will start > us in a positive direction. > > As you have told me in the past come to me with a > problem only if you have a solution to it. There is > an answer it is time for us all to find it and quit > talking/bickering about it. > > Terrell EMT-P/CCEMTP > > > > bkellow@... wrote: > I've been reading all of the posts related to > working conditions, benefits, > operational models, and the general acrimony > associated with same. It's my view > that we've arrived at this place in the EMS > industry's history, not by > circumstance, but rather by abdication. What has > happened is the result of a > confluence of events and beliefs over the past 30 or > so years that have led to > todays state of aggitation, frustration, > intellectual paralysis and > dissatisfaction. > > 1. EMS lacks a true medical professional identity. > > Despite early exitement about the possibilities of > being legitimized and > accepted as medical professionals (See: Emergency > Medical Services ACT of 1973, > et seq), the EMS workforce has yet to break through > the barriers of professional > and academic acceptance. > > Emergency medicine was designated as the 23rd > medical specialty due almost > exclusively to its relationship with the development > of EMS systems. > Unfortunately, emergency medicine and its > professional medical society (ACEP) > spent most of its time fighting for legitimacy with > other medical and surrgical > specialties. Viewed as the snotty-nosed kids on > organized medicine's block, > emergency physicians generally avoided the EMS > workforce, which it viewed as a > captive audience, and spent its time fighting turf > wars with the surgical, > pediatric and cardiology communities. Because the > fight for collegial > acceptance continues to this day, it is unlikely > that emergency medicine will > embrace (share power with) the EMS workforce in the > grounds of professional and > academic purity. > > Because EMS workers have not been invited to the > " table " of emergency medicine, > the industry continues to resonate on a closed > frequency - and can't find the > means to break out. In fact, the lamentations > expressed on this list are a > sterling example. The problem is that no one's > listening because the workforce > poses no political or economic threat. Thus, we are > left to complain to one > another - a practice that is not only guaranteed to > go nowhere, but only serves > to intensify growing frustration and > dissatisfaction. > > 2. EMS workers openly resist academic responsibility > and accountability. > > As EMS educators continue to emplore the workforce > to become smarter and better > versed in the ways of academic medicine, there seems > to be an exponential level > of resistance. Educators suggest that higher > learning will result in higher > incomes, while the workers sit with arms folded, > intransigent, saying " show me > the money first " , while viewing educators as being > overly pedantic and > self-serving. > > The truth is that organized medicine will not view > the EMS workforce as being > legitimate until same embraces the concept that true > medical professionals > investigate and contribute to a well defined body of > knowledge, and do not hang > their academic " hats " on non-peer reviewed > contributions such as " Tricks of the > Trade " , etc. In this regard, higher incomes and > professional identity and > acceptance have become tangled into one big " who'll > blink first " amorphous > empass. > > When was the last time you heard an EMS worker > observe and state that a > particllar prehospital procedure or piece of > equipment wasn't working, and they > were going to recommend to their medical director > that it be abandoned as an EMS > intervention? I thought so. And, yet again, no one > on the outside is listening. > > 3, Payers are not paying more for EMS. > > Because of #1 and #2 above, payers are not convinced > of the indispensibility of > prehospital care. Federally sponsored studies on > behalf of CMS, and most > recently the OPALS study. have brought questions to > the minds of payers. This > combined with the workforce's reluctance to > participate in its own > professional, academic and economic destiny as led > to the steady errosion of > EMS wages in terms of ajdusted spending power over > the past 30 years. > > As technology and manpower costs continued to climb, > while reimbursement > flattened out, EMS companies sought means to > increase efficiencies - thus SSM > and other systems of administrivia were born - not > out of some perverse > Machiavellian death wish for EMS workers, but rather > out or economic necessity > and long-term survival. > > Finally, we should consider that all of the > eye-poking, hair pulling and > infighting will not garner a shred of sympathy from > EMS's medical overlords > because they, too, had to struggle and fight for > their recognition, autonomy > and place in organized medicine back in the '60's > and 70's. The emergence of > some bright and energized new EMS leaders would go a > long way in establishing a > rational agenda for pulling the industry out of its > " stuck on stupid " mentality. > > Bob Kellow > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2005 Report Share Posted October 9, 2005 Terrell, Bob offered a solution. In his last paragraph he stated: > The emergence of some bright and energized new EMS leaders would go a long way > in establishing a rational agenda for pulling the industry out of its " stuck on stupid " > mentality. I took that as a challenge, that it is up to us to locate appropriate candidates for leadership positions, then groom them for the task. We will only accomplish this if we can somehow put petty differences aside and begin to think globally. We must also do as Gene Gandy says and start actually educating the candidates. The answer is simple. Implementing the cure is not so simple, but we must start somewhere. Roy Strange, REMT-P > Bob > > These are all very well thought and well stated observations. I always respected your sit back and watch to find the problem way of approaching a problem. and once again you have nailed a large part of the problem right on the head. > > But the problems have been stated more than once and in more than one way. Now how do we fix them. We talk a good game about getting together " unionizing " etc. the thing is we have moved beyond the put up or shut up point. > As you have stated here we have allowed the emergency medicine profession to pass us up and forget about us and move on. We allows the nursing profession to run us down and rumor has it they want to take us over and it almost appears overall we are going to roll over and let them. > Why? > As individuals everyone can talk tough But there is so much I am better than you BS going on that " WE " cannot get along. Until that happens well the old saying divided we fall united we stand. > Over all can we as a group Grow up and act like a professional group and maybe earn what we want and stop acting like selfish children. That will start us in a positive direction. > > As you have told me in the past come to me with a problem only if you have a solution to it. There is an answer it is time for us all to find it and quit talking/bickering about it. > > Terrell EMT-P/CCEMTP > > > > bkellow@i... wrote: > I've been reading all of the posts related to working conditions, benefits, > operational models, and the general acrimony associated with same. It's my view > that we've arrived at this place in the EMS industry's history, not by > circumstance, but rather by abdication. What has happened is the result of a > confluence of events and beliefs over the past 30 or so years that have led to > todays state of aggitation, frustration, intellectual paralysis and > dissatisfaction. > > 1. EMS lacks a true medical professional identity. > > Despite early exitement about the possibilities of being legitimized and > accepted as medical professionals (See: Emergency Medical Services ACT of 1973, > et seq), the EMS workforce has yet to break through the barriers of professional > and academic acceptance. > > Emergency medicine was designated as the 23rd medical specialty due almost > exclusively to its relationship with the development of EMS systems. > Unfortunately, emergency medicine and its professional medical society (ACEP) > spent most of its time fighting for legitimacy with other medical and surrgical > specialties. Viewed as the snotty-nosed kids on organized medicine's block, > emergency physicians generally avoided the EMS workforce, which it viewed as a > captive audience, and spent its time fighting turf wars with the surgical, > pediatric and cardiology communities. Because the fight for collegial > acceptance continues to this day, it is unlikely that emergency medicine will > embrace (share power with) the EMS workforce in the grounds of professional and > academic purity. > > Because EMS workers have not been invited to the " table " of emergency medicine, > the industry continues to resonate on a closed frequency - and can't find the > means to break out. In fact, the lamentations expressed on this list are a > sterling example. The problem is that no one's listening because the workforce > poses no political or economic threat. Thus, we are left to complain to one > another - a practice that is not only guaranteed to go nowhere, but only serves > to intensify growing frustration and dissatisfaction. > > 2. EMS workers openly resist academic responsibility and accountability. > > As EMS educators continue to emplore the workforce to become smarter and better > versed in the ways of academic medicine, there seems to be an exponential level > of resistance. Educators suggest that higher learning will result in higher > incomes, while the workers sit with arms folded, intransigent, saying " show me > the money first " , while viewing educators as being overly pedantic and > self-serving. > > The truth is that organized medicine will not view the EMS workforce as being > legitimate until same embraces the concept that true medical professionals > investigate and contribute to a well defined body of knowledge, and do not hang > their academic " hats " on non-peer reviewed contributions such as " Tricks of the > Trade " , etc. In this regard, higher incomes and professional identity and > acceptance have become tangled into one big " who'll blink first " amorphous > empass. > > When was the last time you heard an EMS worker observe and state that a > particllar prehospital procedure or piece of equipment wasn't working, and they > were going to recommend to their medical director that it be abandoned as an EMS > intervention? I thought so. And, yet again, no one on the outside is listening. > > 3, Payers are not paying more for EMS. > > Because of #1 and #2 above, payers are not convinced of the indispensibility of > prehospital care. Federally sponsored studies on behalf of CMS, and most > recently the OPALS study. have brought questions to the minds of payers. This > combined with the workforce's reluctance to participate in its own > professional, academic and economic destiny as led to the steady errosion of > EMS wages in terms of ajdusted spending power over the past 30 years. > > As technology and manpower costs continued to climb, while reimbursement > flattened out, EMS companies sought means to increase efficiencies - thus SSM > and other systems of administrivia were born - not out of some perverse > Machiavellian death wish for EMS workers, but rather out or economic necessity > and long-term survival. > > Finally, we should consider that all of the eye-poking, hair pulling and > infighting will not garner a shred of sympathy from EMS's medical overlords > because they, too, had to struggle and fight for their recognition, autonomy > and place in organized medicine back in the '60's and 70's. The emergence of > some bright and energized new EMS leaders would go a long way in establishing a > rational agenda for pulling the industry out of its " stuck on stupid " mentality. > > Bob Kellow --------------------------------- Yahoo! Music Unlimited - Access over 1 million songs. Try it free. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2005 Report Share Posted October 9, 2005 Terrell, Bob offered a solution. In his last paragraph he stated: > The emergence of some bright and energized new EMS leaders would go a long way > in establishing a rational agenda for pulling the industry out of its " stuck on stupid " > mentality. I took that as a challenge, that it is up to us to locate appropriate candidates for leadership positions, then groom them for the task. We will only accomplish this if we can somehow put petty differences aside and begin to think globally. We must also do as Gene Gandy says and start actually educating the candidates. The answer is simple. Implementing the cure is not so simple, but we must start somewhere. Roy Strange, REMT-P > Bob > > These are all very well thought and well stated observations. I always respected your sit back and watch to find the problem way of approaching a problem. and once again you have nailed a large part of the problem right on the head. > > But the problems have been stated more than once and in more than one way. Now how do we fix them. We talk a good game about getting together " unionizing " etc. the thing is we have moved beyond the put up or shut up point. > As you have stated here we have allowed the emergency medicine profession to pass us up and forget about us and move on. We allows the nursing profession to run us down and rumor has it they want to take us over and it almost appears overall we are going to roll over and let them. > Why? > As individuals everyone can talk tough But there is so much I am better than you BS going on that " WE " cannot get along. Until that happens well the old saying divided we fall united we stand. > Over all can we as a group Grow up and act like a professional group and maybe earn what we want and stop acting like selfish children. That will start us in a positive direction. > > As you have told me in the past come to me with a problem only if you have a solution to it. There is an answer it is time for us all to find it and quit talking/bickering about it. > > Terrell EMT-P/CCEMTP > > > > bkellow@i... wrote: > I've been reading all of the posts related to working conditions, benefits, > operational models, and the general acrimony associated with same. It's my view > that we've arrived at this place in the EMS industry's history, not by > circumstance, but rather by abdication. What has happened is the result of a > confluence of events and beliefs over the past 30 or so years that have led to > todays state of aggitation, frustration, intellectual paralysis and > dissatisfaction. > > 1. EMS lacks a true medical professional identity. > > Despite early exitement about the possibilities of being legitimized and > accepted as medical professionals (See: Emergency Medical Services ACT of 1973, > et seq), the EMS workforce has yet to break through the barriers of professional > and academic acceptance. > > Emergency medicine was designated as the 23rd medical specialty due almost > exclusively to its relationship with the development of EMS systems. > Unfortunately, emergency medicine and its professional medical society (ACEP) > spent most of its time fighting for legitimacy with other medical and surrgical > specialties. Viewed as the snotty-nosed kids on organized medicine's block, > emergency physicians generally avoided the EMS workforce, which it viewed as a > captive audience, and spent its time fighting turf wars with the surgical, > pediatric and cardiology communities. Because the fight for collegial > acceptance continues to this day, it is unlikely that emergency medicine will > embrace (share power with) the EMS workforce in the grounds of professional and > academic purity. > > Because EMS workers have not been invited to the " table " of emergency medicine, > the industry continues to resonate on a closed frequency - and can't find the > means to break out. In fact, the lamentations expressed on this list are a > sterling example. The problem is that no one's listening because the workforce > poses no political or economic threat. Thus, we are left to complain to one > another - a practice that is not only guaranteed to go nowhere, but only serves > to intensify growing frustration and dissatisfaction. > > 2. EMS workers openly resist academic responsibility and accountability. > > As EMS educators continue to emplore the workforce to become smarter and better > versed in the ways of academic medicine, there seems to be an exponential level > of resistance. Educators suggest that higher learning will result in higher > incomes, while the workers sit with arms folded, intransigent, saying " show me > the money first " , while viewing educators as being overly pedantic and > self-serving. > > The truth is that organized medicine will not view the EMS workforce as being > legitimate until same embraces the concept that true medical professionals > investigate and contribute to a well defined body of knowledge, and do not hang > their academic " hats " on non-peer reviewed contributions such as " Tricks of the > Trade " , etc. In this regard, higher incomes and professional identity and > acceptance have become tangled into one big " who'll blink first " amorphous > empass. > > When was the last time you heard an EMS worker observe and state that a > particllar prehospital procedure or piece of equipment wasn't working, and they > were going to recommend to their medical director that it be abandoned as an EMS > intervention? I thought so. And, yet again, no one on the outside is listening. > > 3, Payers are not paying more for EMS. > > Because of #1 and #2 above, payers are not convinced of the indispensibility of > prehospital care. Federally sponsored studies on behalf of CMS, and most > recently the OPALS study. have brought questions to the minds of payers. This > combined with the workforce's reluctance to participate in its own > professional, academic and economic destiny as led to the steady errosion of > EMS wages in terms of ajdusted spending power over the past 30 years. > > As technology and manpower costs continued to climb, while reimbursement > flattened out, EMS companies sought means to increase efficiencies - thus SSM > and other systems of administrivia were born - not out of some perverse > Machiavellian death wish for EMS workers, but rather out or economic necessity > and long-term survival. > > Finally, we should consider that all of the eye-poking, hair pulling and > infighting will not garner a shred of sympathy from EMS's medical overlords > because they, too, had to struggle and fight for their recognition, autonomy > and place in organized medicine back in the '60's and 70's. The emergence of > some bright and energized new EMS leaders would go a long way in establishing a > rational agenda for pulling the industry out of its " stuck on stupid " mentality. > > Bob Kellow --------------------------------- Yahoo! Music Unlimited - Access over 1 million songs. Try it free. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 9, 2005 Report Share Posted October 9, 2005 Terrell, Bob offered a solution. In his last paragraph he stated: > The emergence of some bright and energized new EMS leaders would go a long way > in establishing a rational agenda for pulling the industry out of its " stuck on stupid " > mentality. I took that as a challenge, that it is up to us to locate appropriate candidates for leadership positions, then groom them for the task. We will only accomplish this if we can somehow put petty differences aside and begin to think globally. We must also do as Gene Gandy says and start actually educating the candidates. The answer is simple. Implementing the cure is not so simple, but we must start somewhere. Roy Strange, REMT-P > Bob > > These are all very well thought and well stated observations. I always respected your sit back and watch to find the problem way of approaching a problem. and once again you have nailed a large part of the problem right on the head. > > But the problems have been stated more than once and in more than one way. Now how do we fix them. We talk a good game about getting together " unionizing " etc. the thing is we have moved beyond the put up or shut up point. > As you have stated here we have allowed the emergency medicine profession to pass us up and forget about us and move on. We allows the nursing profession to run us down and rumor has it they want to take us over and it almost appears overall we are going to roll over and let them. > Why? > As individuals everyone can talk tough But there is so much I am better than you BS going on that " WE " cannot get along. Until that happens well the old saying divided we fall united we stand. > Over all can we as a group Grow up and act like a professional group and maybe earn what we want and stop acting like selfish children. That will start us in a positive direction. > > As you have told me in the past come to me with a problem only if you have a solution to it. There is an answer it is time for us all to find it and quit talking/bickering about it. > > Terrell EMT-P/CCEMTP > > > > bkellow@i... wrote: > I've been reading all of the posts related to working conditions, benefits, > operational models, and the general acrimony associated with same. It's my view > that we've arrived at this place in the EMS industry's history, not by > circumstance, but rather by abdication. What has happened is the result of a > confluence of events and beliefs over the past 30 or so years that have led to > todays state of aggitation, frustration, intellectual paralysis and > dissatisfaction. > > 1. EMS lacks a true medical professional identity. > > Despite early exitement about the possibilities of being legitimized and > accepted as medical professionals (See: Emergency Medical Services ACT of 1973, > et seq), the EMS workforce has yet to break through the barriers of professional > and academic acceptance. > > Emergency medicine was designated as the 23rd medical specialty due almost > exclusively to its relationship with the development of EMS systems. > Unfortunately, emergency medicine and its professional medical society (ACEP) > spent most of its time fighting for legitimacy with other medical and surrgical > specialties. Viewed as the snotty-nosed kids on organized medicine's block, > emergency physicians generally avoided the EMS workforce, which it viewed as a > captive audience, and spent its time fighting turf wars with the surgical, > pediatric and cardiology communities. Because the fight for collegial > acceptance continues to this day, it is unlikely that emergency medicine will > embrace (share power with) the EMS workforce in the grounds of professional and > academic purity. > > Because EMS workers have not been invited to the " table " of emergency medicine, > the industry continues to resonate on a closed frequency - and can't find the > means to break out. In fact, the lamentations expressed on this list are a > sterling example. The problem is that no one's listening because the workforce > poses no political or economic threat. Thus, we are left to complain to one > another - a practice that is not only guaranteed to go nowhere, but only serves > to intensify growing frustration and dissatisfaction. > > 2. EMS workers openly resist academic responsibility and accountability. > > As EMS educators continue to emplore the workforce to become smarter and better > versed in the ways of academic medicine, there seems to be an exponential level > of resistance. Educators suggest that higher learning will result in higher > incomes, while the workers sit with arms folded, intransigent, saying " show me > the money first " , while viewing educators as being overly pedantic and > self-serving. > > The truth is that organized medicine will not view the EMS workforce as being > legitimate until same embraces the concept that true medical professionals > investigate and contribute to a well defined body of knowledge, and do not hang > their academic " hats " on non-peer reviewed contributions such as " Tricks of the > Trade " , etc. In this regard, higher incomes and professional identity and > acceptance have become tangled into one big " who'll blink first " amorphous > empass. > > When was the last time you heard an EMS worker observe and state that a > particllar prehospital procedure or piece of equipment wasn't working, and they > were going to recommend to their medical director that it be abandoned as an EMS > intervention? I thought so. And, yet again, no one on the outside is listening. > > 3, Payers are not paying more for EMS. > > Because of #1 and #2 above, payers are not convinced of the indispensibility of > prehospital care. Federally sponsored studies on behalf of CMS, and most > recently the OPALS study. have brought questions to the minds of payers. This > combined with the workforce's reluctance to participate in its own > professional, academic and economic destiny as led to the steady errosion of > EMS wages in terms of ajdusted spending power over the past 30 years. > > As technology and manpower costs continued to climb, while reimbursement > flattened out, EMS companies sought means to increase efficiencies - thus SSM > and other systems of administrivia were born - not out of some perverse > Machiavellian death wish for EMS workers, but rather out or economic necessity > and long-term survival. > > Finally, we should consider that all of the eye-poking, hair pulling and > infighting will not garner a shred of sympathy from EMS's medical overlords > because they, too, had to struggle and fight for their recognition, autonomy > and place in organized medicine back in the '60's and 70's. The emergence of > some bright and energized new EMS leaders would go a long way in establishing a > rational agenda for pulling the industry out of its " stuck on stupid " mentality. > > Bob Kellow --------------------------------- Yahoo! Music Unlimited - Access over 1 million songs. Try it free. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 14, 2005 Report Share Posted October 14, 2005 > left to its own devices, the federal government would establish a health > care system that would be a cross between the US Postal Service and the IRS. > (Consider that for a moment-or look at the VA system). Interestingly, I've long believed that some of the greatest savings we could see would be through consolidation of medicare/medicaid and the VA system. Require medicare/medicaid recipients to obtain services at VA clinics. Provide their medical supplies and medications through the VA system and its channels. Leverage the combined purchasing power of VA and medicare/medicaid to drive down supply costs. Merge the two and cut duplicate administrative and staff positions. Let doctors who don't want medicare/medicaid patients choose to not see them, and let those who do have a streamlined reimbursement process through VA/Medicare. Hell, maybe even require those who accept government loans for medical school to obtain a lower interest rate (or even a zero rate) in exchange for a few years practicing at a VA facility after residency/internship. Seems rather bulky to have two systems, and it would seem that the increased volume and census would give VA practitioners more experience, bringing a higher level of care to all their patients - military and medicare alike. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 14, 2005 Report Share Posted October 14, 2005 > left to its own devices, the federal government would establish a health > care system that would be a cross between the US Postal Service and the IRS. > (Consider that for a moment-or look at the VA system). Interestingly, I've long believed that some of the greatest savings we could see would be through consolidation of medicare/medicaid and the VA system. Require medicare/medicaid recipients to obtain services at VA clinics. Provide their medical supplies and medications through the VA system and its channels. Leverage the combined purchasing power of VA and medicare/medicaid to drive down supply costs. Merge the two and cut duplicate administrative and staff positions. Let doctors who don't want medicare/medicaid patients choose to not see them, and let those who do have a streamlined reimbursement process through VA/Medicare. Hell, maybe even require those who accept government loans for medical school to obtain a lower interest rate (or even a zero rate) in exchange for a few years practicing at a VA facility after residency/internship. Seems rather bulky to have two systems, and it would seem that the increased volume and census would give VA practitioners more experience, bringing a higher level of care to all their patients - military and medicare alike. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 14, 2005 Report Share Posted October 14, 2005 > left to its own devices, the federal government would establish a health > care system that would be a cross between the US Postal Service and the IRS. > (Consider that for a moment-or look at the VA system). Interestingly, I've long believed that some of the greatest savings we could see would be through consolidation of medicare/medicaid and the VA system. Require medicare/medicaid recipients to obtain services at VA clinics. Provide their medical supplies and medications through the VA system and its channels. Leverage the combined purchasing power of VA and medicare/medicaid to drive down supply costs. Merge the two and cut duplicate administrative and staff positions. Let doctors who don't want medicare/medicaid patients choose to not see them, and let those who do have a streamlined reimbursement process through VA/Medicare. Hell, maybe even require those who accept government loans for medical school to obtain a lower interest rate (or even a zero rate) in exchange for a few years practicing at a VA facility after residency/internship. Seems rather bulky to have two systems, and it would seem that the increased volume and census would give VA practitioners more experience, bringing a higher level of care to all their patients - military and medicare alike. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 14, 2005 Report Share Posted October 14, 2005 > > > Seems rather bulky to have two systems, and it would seem that the > increased volume and census would give VA practitioners more > experience, bringing a higher level of care to all their patients - > military and medicare alike. > > Mike > I know little of the VA system, except anecdotally & from transfer pickups & deliveries;even tho I probably qualify to use it. From what I think I do know, & have observed, could such a combination result in a routine on-site wait for services of not just hours, or all day, but days in fact? Conley Harmon Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 14, 2005 Report Share Posted October 14, 2005 > > > Seems rather bulky to have two systems, and it would seem that the > increased volume and census would give VA practitioners more > experience, bringing a higher level of care to all their patients - > military and medicare alike. > > Mike > I know little of the VA system, except anecdotally & from transfer pickups & deliveries;even tho I probably qualify to use it. From what I think I do know, & have observed, could such a combination result in a routine on-site wait for services of not just hours, or all day, but days in fact? Conley Harmon Quote Link to comment Share on other sites More sharing options...
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