Our EMS Independence Day

Tomorrow in the United States, we celebrate our founding fathers declaring their independence from Great Brittan.  The free country we Americans enjoy today was once a few colonies that were a revenue source for a far away, disconnected empire.  The colonists had no voice in how much they were taxed or how their tax money was used.

For the founding fathers, declaring independence meant risking everything – lives, families’ lives, careers, and property – for the cause of liberty.  It meant that the Revolutionary War would escalate.  With little money and a much weaker military than their enemy, it was expected to be put down quickly.  Fighters who survived the battles would then be hung for treason.  Still, they realized that circumstances in the world were right to risk fighting for independence.  Against all odds, they won and built the great country we take for granted today.

There’s a lot wrong with EMS in our great nation right now.  While EMS has matured into a respected profession in the country we broke away from, it languishes as a fragmented non-system here.  Full-time EMS workers live near the poverty line.  We have lower education requirements than any other First World country.  In some areas, EMS is a job forced upon people who signed up for something else.  It is viewed as a revenue source where quantity is valued more than the quality of care delivered elsewhere.  In other areas our vital public service is overseen and delivered completely by volunteers, who do the best they can in their spare time.  Each of these service types are deeply rooted in local tradition, and insiders have a strong incentive to maintain that status quo. The needs of the communities we serve is usually much less of a consideration.
It may seem hopeless, but our struggle pales in comparison to the one overcome by the founding fathers.  I can feel our revolution coming.  The House of Representatives just passed a bill extending public safety officer’s benefits to non-profit EMS workers.  There’s also Field EMS Bill and changes – good or bad – from the Affordable Care Act.  It may also be sparked by more hostile takeovers of one EMS brand over another motivated by political power grabs – not the community’s best interested.

At the same time, a grass roots effort is underway.  Motivated, educated, and compassionate field providers are demanding something better.  Through social media, the message is spread faster than Paul Revere could ever have dreamed.  Steve Whitehead’s Non-comformists Guide to EMS Success is our Common Sense. Happy Medic’s EMS 2.0 Manifesto is our Declaration of Independence.  Our Continental Congress assembles at Blogger Meetups – that also happen to take place in pubs.  Our founding fathers are also getting promoted to higher levels within their organizations, and will be making further-reaching policy decisions.

Our revolution will be bloodless, but not painless.  EMS tomorrow will be much different than EMS today, and lots of us won’t be able to adapt.  Some of us will have to work in a different environments or with a different shift type.  Some of us will have to find new employers, and may even be chased out of town.  We’ll have to remember what we’re fighting for, what EMS could look like, and what it looks like today.

The dream of a free country, governed by the people, was enough for the founding fathers to risk much more than we have to.  They were able to defeat the mighty British Empire and create the greatest country in the history of the world.  In comparison, creating an evidence-based, patient-centered EMS system in that great country will be a piece of cake.


  1. Humbled to be included. Kelly Grayson once wrote that EMS is waiting for our Martin Luthur to nail the new EMS Doctrine to the door of those in power. Perhaps we’re all doing it, just slowly.

    • emspatientperspective says:

      Thanks Justin. Don’t be humbled, I just jumped on the train you and the CoEMS people started. I read Kelly’s article, and it put our struggles into perspective for me. Lincoln, Gandhi, & Martin Luther King are others.
      BTW, I was going to be meaner to the Brits, but then I thought of Mark.

  2. Skip Kirkwood says:

    One of the things that our Founding Fathers had was the sincere support (like, “willing to fight and die or loose everything for”) of most of their countrymen – and they were fighting for something that they sincerely believed in.

    I wish – I hope – that our EMS brothers and sisters were and are willing to to fight for the cause. Right now, I don’t see this very often. It seems like “When the going gets tough, the tough go to nursing school” or something like that – instead of joining the associations, paying the dues, attending the meetings, getting politically involved to influence the future, etc., folks simply walk away.

    What would have happened at Lexington and Concord if the Minutemen hadn’t shown up? What are we missing? A leader…or an aspiring leader….needs followers who are willing to buy in to the mission, do the work, etc. So….I have asked this question before: Who can, and how does anyone, lead those who will not follow?

  3. Thanks for the nod Bob. Yes, it will take time, and patience. I think social media, while not an answer, will play a role in driving these discussions. And now you are playing a part too. Well done.

    • emspatientperspective says:

      Thanks Steve! I’ve gotten a ton of inspiration from the EMT Spot and your book.

  4. Skip Kirkwood says:

    You’re right, Steve – social media probably will play a significant part, although there is a danger that we wind up preaching to each other, and many EMSers will not attend.

    But it’s better than riding from town to town on horseback, crying “One if by land, two if by sea….”

    • emspatientperspective says:

      I’m optomistic that the people preaching to each other will be leading everyone else soon. Like Steve said, it will take time though.

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