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NJ and EMS… Not Perfect Together

Contact Information

Email: kcms@me.com
Phone: 856-419-6856
Hours: By Appointment Only

Vital Stats

Kenneth Szwak, MHS, PA-C

Physician Assistant

Emergency Medicine
Family Medicine

State Licensed:
New Jersey

Board certification:

Professional memberships:

AAPA- Fellow member

SEMPA- Fellow member

Arcadia University
Faculty Appointment:
Clinical Preceptor

Drexel University
Faculty Appointment:
Clinical Assistant Professor

'Tis not always in a physician's power to cure the sick; at times the disease is stronger than trained art.  ~Ovid

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So, it has just come to my attention that Governor Christie is more than likely going to veto the NJ EMS Bill. Just when I was starting to like him, he caves to whoever has his ear. And from everything I here, it is the volunteer organizations that stand in its way.

Now, let me digress for a bit. While I currently work as an Emergency Medicine PA, my roots are in EMS, paid and especially volunteer EMS. I love and miss my volunteer days. Many a time I wish I could just leave my current career and go back to it. And even in my hey day, many of my colleagues and I would talk ad nausea about how something needs to change. Even back then in 1994 we could see volunteer EMS was heading for bad times, specifically in regards to personnel and response percentages. It’s 19 years laters, 19, and we are still seeing the same issues.

From everything I read of the NJ EMS Bill, it centers mostly around changes that will make squads more professional, more accountable, safer, and more in tune with risk management issues. Shouldn’t that be at the forefront of every EMS Agency, paid or volunteer? And while there are some volunteer agencies who have managed to maintain a high level of professionalism, maintain their membership, and keep a high call percentage, I don’t see that as the norm. And granted, being a paid agency is not a guarentee of high standards, I’ve seen examples of that too. However, they are not the one’s impeding the passing of the bill.

EMS agencies are siting the cost of implementing these changes. I’m not saying that there will be no cost, but that is also a cop out. If you want to run a tight ship and a professional organization, these are changes that should be done. Period. While my heart will always be that of a volunteer, and while I hate saying this, it’s noble time has past, as least as the norm. EMS has become too complicated, too busy, to demanding for the volunteer squad, especially those of small 1 square mile towns to be the mainstay of EMS in this state.

And at the same time, I’m not saying they have to disappear entirely. Volunteer squads could easily exist and operate successfully to augment paid services for example and I’m sure there are others. However, for volunteer EMS to continue, there must be minimum standards in place for all. Standards for education, SOP’s, minimum crew (2 EMT’s), medical direction, minimum equipment, identification, and especially background checks. Honestly, I don’t see how the latter can be argued. These are people working around children and other vulnerable people. Background checks are required in all other medical positions, having them done in EMS should be a no brainer.

I know I will likely catch a lot of flack for this. Many will probably disagree with me, vehemently. That’s OK. I welcome any and all responses in opposition. In the end though, for the safety of EMS personnel and the safety of their patients, these changes are necessary.


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May 2013
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