unit 5 discussion post ems planning

Please note that there are two posts needed to successfully complete the discussion board assignment. An initial post addressing the discussion board topic is due by end of day Saturday. A response post to at least one other student is due by end of day Tuesday.

As there are multiple types of emergency medical services (EMS) systems, consider one that you have worked in or have knowledge of. There are often several misconceptions about other types of systems. For example, one might think that a privately owned (commercial agency) is only in the business of providing EMS for the money, or some may see the fire-based model as lacking in patient care methods because they care more about fire suppression duties.

Consider your own personal perceptions of various types of systems. What are some of your opinions of these systems? Are these opinions different based on the type of system for which you want to work?

When responding to classmates, try to choose those who have opinions about the systems that you work for or wish to work for in the future. This is a great opportunity to learn realistic information about systems with which you have not personally interacted.

If no initial posts exist to allow for a response to be made, you may submit an additional initial post addressing another aspect of the unit topic.

respond to this:

Shlomo Winkler

There are several different types of EMS models, including fire departmentbased, hospital-based, volunteer, private, and municipal third-service systems that operate independently. Each model has its own strengths and weaknesses, and even within the same category there can be significant differences depending on the region.

For example, in New York City, the EMS system is run by the fire department. FDNY EMS operates the majority of ambulances, but hospitals, contracted private companies, and volunteer agencies also contribute units to the 911 system. Each plays an important role in providing coverage across the city. In contrast, Nassau County has a more decentralized model. The Nassau County Police Department oversees the 911 system and operates the largest ambulance service, but most towns and fire districts run their own volunteer or paid EMS agencies. In some cases, residents can contact those agencies directly without going through 911. Both systems function, but they reflect different organizational philosophies.

Personally, I believe a municipal or third-service EMS model is the strongest overall structure. EMS should be viewed as equivalent to other first responders, not as a secondary or revenue-driven service. My concern with hospital-based or for-profit EMS systems is sustainability and mission alignment. Early in my career, I worked for a private ambulance company, Transcare, which eventually declared bankruptcy. When it closed, hundreds of employees were laid off and dozens of ambulances were removed from service in New York City and surrounding areas. That experience demonstrated how financial instability in a for-profit system can directly impact emergency coverage and workforce stability.

Ambulances exist to respond to emergencies, not to generate profit. In a for-profit model, idle time may be viewed as lost revenue, which can create pressures that do not always align with public safety priorities. While private and hospital-based systems can provide high-quality care, I believe a publicly funded municipal system is better positioned to prioritize community need over financial performance.