Read this post at Medic999 for context. I started to post a comment, but it grew so big that I decided that it needed to be a post on my own blog. Poor form to make a comment longer than the post, you know.
An nice step forward, but let’s take it in context. While blogs and social media are starting to have an impact, we have a long way to go until we get to the point where we influence policy in EMS. There are a lot of reasons for this, not the least of which is that at least in the US, there is a lot of bureaucratic inertia in EMS. I don’t know if it’s any better in the UK or anywhere else for that matter. Which brings me to a second point. San Francisco is not the UK is not Louisiana is not Providence, Rhode Island. Providence is not Connecticut for that matter. Canada is a whole different country, for that matter. Even there EMS is not as homogenized as it seems to be in the UK. Which is part of the European Union, which also doesn’t have it’s own unified standards for EMS. Take France… please. (Thank you, Henny Youngman).
While there is no one standard for EMS care, and I’m not sure there should be, one thing that almost everyone in EMS agrees upon is that the field, trade, profession, whatever it is, needs to improve. A lot. The problem is most of us can’t agree on what, where, and how to improve it.
There is going to be at least one blog get together next week at EMS Today. While I predict that the participants will share war stories, share camaraderie, share drins (maybe), and food, what they won’t share is a common vision. Sure, everyone will agree that they respond to far too many non emergencies, that protocols are too restrictive, that hospital staff abuses them, and that no one in EMS is paid enough. However, no one will agree on the best model for delivery of EMS services (THEIR model is best), what drugs should be on ambulances, whether paramedic should ride on ambulances, drive rapid response cars, be fire fighters, or something else.
Hell, we can’t even agree on what color the ambulances should be.
None of that even takes into account all of the organizations that purport to speak for EMS, but have a curious paucity of actual field providers in positions of authority or decision making. My list of those includes NAEMT, NREMT, NAEMSP, NAEMSE, NEMSMA, Advocates for EMS, and a bunch of other “national” organizations. Seems that everyone wants to have a piece of the EMS pie, but they don’t have a whole lot of interest in hearing what actual, active, field providers think about what should happen in EMS.
Without a unified message, even one that doesn’t make much sense (hello IAFF EMS Division) we’ll find that we aren’t going to get anywhere very quickly. Actually, we won’t get anywhere at all.
Which is where social media comes in. As we learned in the 2008 and are seeing now in the 2010 election cycle, political campaigns can go “viral”. As the Obama Administration (who used social media very well) how they like Sarah Palin’s use of Facebook to derail health care reform. As much as I don’t like Facebook I understand that it has potential to reach a huge audience quickly. Twitter is much the same, only abbreviated. Not to mention You Tube.
Speaking of You Tube. I hope you guys won’t take offense, but the Chronicles of EMS seems a bit too inside baseball (inside Cricket for you, Mark) to appeal to anyone outside of EMS. If you look at the view numbers on You Tube, you’ll see what I mean. Which highlights another problem with social media, in which I included blogging. It’s easy to think that you’re reaching a far more broad audience than you actually are. I won’t even delve into the potential repercussions of posting “offensive” comments or videos on the Internet.
The trick is for forward thinkers like Mark, Justin, and Chris to use those media to present their message. The problem is to have a unified message to present. A message that transcends system design, national borders, fire versus private versus third service rivalries. That is the tough part, right there. At some point EMS as an entity has to decide what it wants to be when it grows up. Then the message can be crafted and delivered. Then EMS can start to move in the direction that it should go.
First say to yourself what you would be; and then do what you have to do.
Epictetus
Anything else is self delusion. Which as we all know is what the road to Hell is paved with.
Thanks to Mark Glencourse for posting something that gave me the kick in the butt I needed to actually post this.
Excellent post.Last week I did a poll of instructors at the Wisconsin EMS Instructor Coordinator Conference. Of an audience of about 70 instructors about only about 10% regularly read EMS blogs and less than that listened to EMS related podcasts. EMS Bloggers, myself included, are clearly talking to a very small slice of the EMS profession. To the degree that audience is growing I am not sure. Also based on my experience talking to EMS conference audience there is general suspicion of any content that is from blogs, podcasts, or online videos.Nonetheless, I do sense that EMS is an important transition phase where leadership is slowly transferring from Nurses, Physicians, and Fire Chiefs to paramedics. I think that it is an interesting trend to observe. It is especially pronounced in education.
Thanks for commenting. Your experience reflects my off the cuff intuition. Which of course is not a peer reviewed study, but probably has some validity. I think that skepticism about on line content, be it blogs, web sites, or Facebook is healthy. Part of the problem is that any on line content is likely to be years ahead of the text books and months ahead of the print EMS journals. Which also have a veneer of respectability that mere bloggers don't. From my personal experience I can tell you that on days when I post political content, I get more visits than I do when I post EMS content. The exception to that being when AD posts a link to any of my posts. Now, he's an EMS blogging power house, which he was before he moved over to FireEMSblogs.com. At that he averages just under 1,000 hits per day. Huge by EMS blogger standards, but compare that to what other EMS related web sites (not blogs) get. EMS blogging is probably still in it's infancy, so it's too early to tell what the result will be.
This is a link to my proposal for a unified message.
While I respect the fact that you mentioned Youtube, they are not our primary delivery method for our content and has only been one tool in which we get our programs out to the masses. In the last 2 weeks our videos have been seen by over 15k times and have been seen by EMS and non EMS folks alike, why? because the healthcare debate transcends barriers of profession and allows us to speak from our profession to those outside it. As we move forward in our production of content, we understand that we will need to create content that appeals to both the EMS crowd and the EMS enthusiasts. Once we have proved to this audience our value, the message will spread. We have currently 4 different web series with discussions with TV/ cable networks to distribute our content. Remember we are only 3 months old as a concept, but we are growing strong. Our goal is to simply inspire conversation about what EMS is and what it could be. If you ever care to know more contact us today or joining the http://chroniclesofems.com community.Thank you for making this forum available.Sincerely,Thaddeus Setla – Series Creator
Hi There TOTWTYTR,Have you been speaking to my wife???We had a conversation based on exactly the same thing the other day. Basically, it centred around how easy it is to get caught up in your own hype. It came down to this….It is very easy to be surrounded by similar like minded people who have enthusiasm for what you are doing, and you are right when you say that our numbers are small, but they are definitely growing.It would also be very easy to say to yourself that you can never make a change in anything big, because not enough people listen to you. We all have to start somewhere though, don’t we?I have spoken and wrote numerous times about the difficulty that we have as bloggers to influence change. Mainly due to the fact that the people who take time out of their day to read my EMS blog are virtually by definition, just as passionate about EMS as I am. The challenge that faces us is to engage the other 95% who never want to read anything extra about what they do during their day job. These are the people that need to be engaged, and it wont be until we can capture a significant amount of this audience and empower them somehow to think that they can be part of changing the system for the better, that we see things moving forward.I completely agree with every thing that you and Greg have said, but I just want to believe that if we try hard enough, then we can do some good with this thing.
Mark, Belief is wonderful, but it's not enough. Perhaps we'll have a better idea of how this is going in six months or a year. Thaddeus, what is the EMS crowd? And what are "EMS enthusiasts"? I'll give you a little insight based on 30 years in the business. When people call for an ambulance, they expect transport. When they don't need an ambulance, they think of EMS not at all. The fire service has been building awareness for over 100 years. EMS has an awful lot of catching up to do. As I pointed out, EMS is not the same everywhere. Justin and Mark spent some time and money to understand some of the differences, but it's those differences that make a unified message difficult, if not impossible. So, what is your goal with these videos? Raising awareness is wonderful, but what do you hope to accomplish once you do that?
Our goal with this content is to bring more awareness of how EMS Systems operate all over the world. Knowledge is power and without more people knowing how different things can be they won't know how to make change. I have received countless emails, tweets and calls now from EMT's and Paramedics that have brought up things they have learned from our first episode already. It didn't change the healthcare system this time, given a few years down the road and 3-5 seasons later we will have more content, more experiences and more chances for people to understand how to get involved in their own system and help create change even if it is on a very small scale. We are a ground up model of change, not top down, so we expect this to take time and a lot of effort. We are also in pre-production on 2 other web series that will undoubtedly bring more attention to our cause in the near future. more to come on that later. Thanks again for all your posting and interest in this as I appreciate skeptics a lot. Your many years of experience is what this movement needs as with skepticism comes new ways to change the content in a way that makes believers out of you. The EMS Crowd all all those who either are involved directly or have family members in EMS so it has a direct effect on their lives or loved ones. EMS Enthusiasts are those who appreciate good dramas on TV or have an affinity to watch EMS shows on TV. Wishing you well!Thaddeus
In one of the recent episodes of 'A Seat at the table' I mentioned that I cant see us ever getting to a conclusion with what we are doing.There is never going to be a single delivery model that crosses international boundaries (or even state boundaries), but if we create an awareness and an understanding of what EMS is now, but more importantly, what it may one day become, then hopefully the communication channels will open up and discussions can take place where previously there may only have been a one sided view of the way to go forward.One thing is for sure, we are and never have been about trying to find a 'one size fits all' solution to the pre-hospital healthcare scenario, because that is just an impossible task.
Like you said, we're 100 years behind on public education in EMS. Everyone says something has to be done, so we're jumping in.Your post is right on the money TOTW, indeed Mark and I focus on differences, but also on similarities between ourselves and our systems.The future of EMS is whatever we make it. All those bureaucrats you speak of are the ones responsible for where we are now and we're all responsible for letting them bring us to this point."EMS 2.0" or however you choose to speak of improving EMS doesn't have a unified message yet, but it is, as you mention, impossible to rally everyone around a unified statement.I prefer to think of unified concepts and principles and leave it to local providers to build their systems around the principles.Great post as always.HM
TOTWTYR… well said. We maybe need to think of social media as a way to mobilize the masses (when it picks up momentum), and not as a way to drive policy. Policy is driven by factors that are WAAAAAY above the fray of social networking. Don't get me wrong… I am not saying that it is above field personnel… I am just saying that the agendas of the 20-30 agencies and organizations that go into EMS policy (and thanks for pointing out that that is merely at a local level) making will never be corralled by a few blog posts. Follow the money!Where I think social networking has a place is in getting the rumor mill out of the ambulance bays, so that the people running calls don't get run over by the people running the system.By listening to each other in this realm, we can figure out each others feelings, but we can't drive policy this way. On the flip side, I would hope that when (and if) this social media blimp turns into a jetliner, and we have more people on board, we can start to see more discussion that keeps the policy makers (like myself) informed, while the field can have better access to and a better understanding of what goes into keeping the system running.The field runs the calls, the EMS policy wonks run the system, but we can never forget that it is the PATIENT that rules the roost. Blogging and Tweeting can't change EMS faster than research end education can. But it canhelp keep us all informed… thanks again for the post!-joshuahttp://acgov.org/ems/Podcast/allhttp://bapjc.org