By Allison G. S. Knox, professor at American Military University
Emergency medical services (EMS) is an important component of the 911 system in towns and cities. Many citizens realize the importance and value of EMS—as these agencies respond to medical and traumatic emergencies—but many do not realize that EMS agencies can be structured in many different ways.
EMS policy is different from jurisdiction to jurisdiction: Some agencies are staffed by volunteers, some by paid emergency medical technicians (EMT) and others have both paid and volunteer staff. Protocols vary from town to town, county to county and state to state, which can create rifts in the national 911 system. If EMS were to have a cohesive organizational structure at the local, state and federal levels, emergency medical services might find unity instead of the fractured state it can appear to be in.
Emergency medical services straddle two very different areas: health care and public safety. Because it falls into the health care bracket, medical directors need to create and maintain protocols for the care they want patients to receive within the specific health care system. Different protocols, while important in various counties and states, create certain rifts in the EMS system because there are a lack of unity from one EMS agency to the next. However, because EMS falls into the public safety bracket, it is difficult for lawmakers to understand where emergency medical services should go in the various branches of government. These difficulties lead to larger problems creating rifts that are difficult to overcome.
For emergency medical services to come together in a unified fashion, EMS needs to be unified on a local, state and federal level of analysis. The Office of EMS needs to have one complete organizational structure that encompasses every single EMS agency throughout the state. If every single procedure, protocol and chain of command was unified into one organization, EMS may begin to find the unity from agency to agency that it so desperately needs.
Beyond the state and local levels, EMS also needs to fall under one agency at the federal level. Emergency medical services are unique as it falls within the realms of health care and public safety. With these unique demands, having one federal agency to oversee it would help to strengthen all of the policies within EMS. With management condensed overseeing all of EMS, it would have a stronger voice as a whole.
Public administration in America is complex in a variety of different ways. Congress enacts policies and departments within the federal government enforce these policies. In such a complex system of governance, it can sometimes be difficult to find a means of what might work for a particular policy. Emergency medical services appears to be fractured in its overall national organizational structure. Perhaps with a restructuring of EMS in public administration, can bring about the unity it needs to thrive on a local, state and federal level of analysis.
About the Author:
Allison G. S. Knox, M.A., B.A., EMT-B is a faculty member at American Military University. She is also a faculty adviser for the West Virginia Iota Chapter of Pi Gamma Mu International Honor Society. In addition to teaching, Allison is an Emergency Medical Technician and worked in a level one trauma center emergency department throughout college. She participates annually in “EMS on the Hill”, advocating for legislation that will benefit Emergency Medical Services. Allison is also currently a Ph.D. Student at Virginia Polytechnic Institute and State University.
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