now, we operate on an island,” Bourn says.
“We can’t be an island anymore.”
Using the core competencies of EMS,
there are numerous opportunities to care
for patients outside the traditional emer-
gency room setting. “Sometimes the patient
needs to be monitored at home,” Bourn
says. He doesn’t advocate replacing home
healthcare workers, but rather augmenting
their responsibilities by using interventions
within the paramedic’s skill set and expert
assessment on who’s sick and not sick to
make an informed decision on whether to
go to the hospital or stay home. “We are the
experts in remote care in EMS,” he says.
O.J. Doyle, a consultant for the Minnesota
Ambulance Association and the American
College of Emergency Physicians and the
only full-time state EMS lobbyist, couldn’t
agree more. “Healthcare reform creates a
very fertile environment for the community
paramedic,” he says. Doyle, a former para-
medic, has been both an operations director
and the owner of an ambulance service. “As
we move forward, innovation and creativity
is going to be rewarded,” he says. The goal will
be to keep people who don’t need to be in the
hospital out of the emergency department.
From an employer perspective, beginning
in 2014, employers with 50 or more full-
time equivalent employees will need to
offer full-time workers affordable insur-
ance options or incur annual penalties of
$2,000– 3,000 per employee. The rules are
slightly different for public employers.
Every agency should consult a competent
counselor to ensure compliance.
Teresa McCallion, EMT-B, is the editor of EMS Insider
and a freelance public safety writer living in Bonney Lake,
Wash. Contact her at firstname.lastname@example.org.
How Ems managErs can prEparE