Insights by Matt Zavadsky, MHA focuses on the implications of recent news from around the world and it's impact on EMS nationally and in your home town.

About the columnist: Matt is the Director of Tri-State Ambulance, a not-for-profit subsidiary of the Gundersen Lutheran Healthcare System located in La Crosse, Wisconsin. Tri-State serves as the sole 9-1-1 advanced life support provider for the 2,200 square mile greater Coulee Region local in Western Wisconsin and Eastern Minnesota.

Full listing of “Insights” columns by Matt Zavadsky

He holds a Masters Degree in Health Service Administration and has 25 years experience in EMS including volunteer, fire department, public and private sector EMS agencies. He is a former paramedic and has managed private sector ambulance services from 10,000 to more than 100,000 annual call volume in locations including Fairfield, Connecticut; Augusta, Georgia and Orlando, Florida. He has also served as a regulator in Lincoln, Nebraska and Volusia County (Daytona Beach), Florida.

Matt is a frequent speaker at national conferences and has done consulting in numerous EMS issues, specializing in high performance EMS system operations, public/media relations, public policy, employee recruitment and retention, data analysis, costing strategies and EMS research.

He has served as the American Ambulance Association as Chair of the Industry Image Committee and membership on the Professional Standards, Strategic Development and Management Training Institute Committees.

Matt is an Adjunct Faculty for the UCF's College of Health and Public Affairs teaching courses in Healthcare Economics and Policy, Ethics, Managed Care and US Healthcare Systems.

We need Advocates…

That may seem like a simple statement, but as you peel away the layers of advocacy, and the role advocates play in our lives, the magnitude of the single word takes on a whole new meaning.

Webster defines an advocate as one that pleads the cause of another, one that defends or maintains a cause or proposal, or one that supports or promotes the interests of another.

Using that definition, consider the important advocate roles in our lives and in our emergency medical services profession.

In our Lives:

Parental Advocacy - Parents advocate for their children (and often the roles reverse as we parents become incapable of making rational decisions). Our kids often need us to plead their cause to peers, teachers, other parents, and siblings. It brings security for our children and is a key demonstration of our parental love.

Spousal Advocacy - Spouses advocate for each other. We should be the number one cheerleader for our life partner. This form of advocacy not only occurs when we support the interests of our spouse, but often may be done quietly, without the subject of the advocacy even aware of it.

Teacher Advocacy – Good teachers advocate for their students. This can be through providing appropriate educational experiences, but then may extend to references for higher education, employment or other life changing events.

In our EMS Profession:

Patient Advocacy – EMTs and Paramedics are the front-line patient advocates. They are caregivers, yes; but they also may be called upon to take the next step and report potential abuse (physical, sexual, emotional or financial) to the proper authorities. Occasionally, EMTs and paramedics take this role to a higher level and provide “causal” advocacy for the EMS system on behalf of the patient’s they serve. Recently in our community, the EMTs and Paramedics at Tri-State Ambulance took great leaps of causal advocacy on behalf of their patients to oppose a potential calamity of public policy. Because of their altruistic approach to the issue, not only has the patient won, but the employee’s standing in the community has been enhanced for taking the advocate role.

Employee Advocacy – Employers, WE need to be advocates for our employees. They are our most valuable assets and they need our support, openness and transparency in order to feel appreciated and part of a larger mission (see parental advocacy!). If we as employers spend our resources finding ways to squeeze every last bit of productivity from our workers, but miss the opportunity to invest resources in our employees to make it easier for them to do what’s important to them, we are not fulfilling our ‘supports the interest of another’ advocate role. EMS systems having trouble recruiting and retaining valuable employees are usually the ones who are spending vs. investing. Be an investor! More on this topic in our next Insights column…

System Advocacy – EMS systems are constantly changing or attempting to be changed by force. As EMS leaders, our role is to be advocates for not only the patients we do serve, but the patients we may serve, as well as those who subsidize our services. In the macro sense of EMS systems, the advocate role of defending or maintaining a cause can be really hard! It often requires a great deal of public education and difficult decisions. For example, what is the proper number of paramedics for a system to maintain timely advanced care, but not dilute patient:paramedic experience levels to the point of negatively impacting the quality of care? Conventional wisdom would lead us to believe more and faster is better, but current clinical research and study is demonstrating that fewer may be better -see recent news articles on EMSNetwork.org on survival rates based on fewer medics, or the recent situation of the Collier County (FL) EMS medical director removing treatments from 1^st Responders because they were not using them often and could not demonstrate proficiency for the skills necessary to administer the drugs.

While all this advocacy is going on in our lives and in our profession, who is advocating for us as a profession? In typical fashion as caregivers, we are so busy providing care, or arranging for the provision of care, that we forget that WE need advocates as well.

Advocates for EMS is a non-profit association with the singular mission of advocating for the entire EMS system. It is unique in the fact that it does not take stand on the public vs. private debate, whether the service operates in an urban vs. rural setting, is for profit or non-profit, paid vs. volunteer, first response or transport. None of that really matters to Advocates for EMS. Their mission is simply to “promote EMS, educate elected and appointed officials and the public on issues of importance to EMS, monitor and influence EMS legislation and regulatory activity, and raise awareness among decision-makers on issues of importance to EMS. A founding principle for AEMS is to support the needs of all components of EMS in every community across the country – regardless of whether it is fire-based, volunteer, third service, public or private”.

We joined Advocates for EMS in its infancy because of our belief that our industry spends too much time promoting interests of one type of EMS provider to the detriment of another. Fire-based associations have advocacy groups that promote a fire-based agenda. Private providers have associations that promote private-sector agendas. The same is true of volunteers, non-profits, aeromedical providers, first responders or whatever the niche may be. While those organizations serve the interests of their members, the interests often lead to a focus on the competitive nature of the components within the global EMS system as opposed to the system as whole.

Most EMS agencies or EMS leaders do not have the time or inclination to lobby Congress or our federal administrators for altruistic EMS system changes. We need that global voice for our patients, the system and our employees. A voice that is not slanted toward one provider-type, or system type. A voice that will represent us equally and effectively to those who can dramatically affect how we meet the challenges of today, and tomorrow.

I encourage you to make the investment in Advocates for EMS – we need advocates, Advocates needs us!

To learn more about Advocates for EMS, or to join this worthy organization, visit their web site at www.advocatesforems.org.