By Allison G. S. Knox
One of the fundamental problems with EMS agencies comes from the fracturing of agencies throughout the United States, an issue that was essentially created as individual EMS agencies developed organically throughout the United States. Unfortunately, there isn’t any one agency or governing body that oversees EMS agencies at the national level.
Also, EMS agencies throughout our nation have protocols that vary from town to town or agency to agency. Some agencies have different structures because they are municipality-based, while others may be hospital- or volunteer-based.
In addition, the management of EMS agencies vary. Some organizations use paid employees, some use volunteers, and others use a combination of paid and volunteer workers.
Each EMS agency has developed their own organizational culture, systems, protocols, policies and procedures. Satisfying community needs are an important element of each agency as well.
Should EMS Agencies Come Under Federal Control?
Herbert Simon, a famous political scientist, wrote in his book, “Administrative Behavior: A Study of Decision-Making Processes in Administrative Organizations,” that managers should have no more than five people within their span of control. For Simon, the span of control was a particularly important component to managing policies and programs. His ideas now impact emergency management policies like the Incident Command System.
Simon’s advice regarding administrative behavior also extends into the difficulty of moving all EMS organizations under the administration of one agency at the federal level. Moving hundreds of EMS agencies throughout the U.S. to the oversight of one federal agency would be challenging, especially when there is already extensive fracturing in EMS agencies taking place.
If one federal agency is created to manage all EMS agencies, the policies would need to be scalable and specific. While a federal mandate would certainly help to align agencies, the amount of EMS agencies with varying structures in the United States would be difficult to pull together under one federal agency.
Ultimately, the improvement of EMS agencies should remain local. Those in leadership positions will need to focus on the internal issues their respective EMS agencies have. Looking to correct these issues with overarching federal policies will be counterproductive.