People's lives often depend upon the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics, who represent for many the "front line" of caregivers in the American public health system (Occupational Outlook Handbook, 2000. EMTs provide prehospital services, including emergency care and transportation for the injured and the ill (Occupational Outlook Handbook, 2000). The purpose of this brief report is to examine, from a managerial perspective, the efficacy and efficiency of combining emergency medical services (EMS) with the operations of a city's or township's fire department. A general overview of the roles of EMTs and of EMS will be provided as a framework for this discussion.
EMS generally consist of an assortment of trauma, accident, rescue and medical care and services that are provided by EMTs who may or may not work under the aegis of a city, county or other form of government (911 emergencies..., 1999). The popular television program, Third Watch, depicts EMS services in New York City, where the EMS and fire departments work hand-in-hand with each other (and with police), sharing facilities and responding separately and jointly to emergency or crises situations ranging from fires to auto and transportation accidents to drug overdoses, shootings, and in-home injuries and accidents. This image notwithstanding, not all EMS are financed by and operated by city or country government; some EMS services, such as ambulance transportation and even emergency medical care, are privatized (Fine, 1999).
At the heart of the EMS system is the EMT. EMTs may use special equipment, monitor vital signs and give additional care as needed. Beyond these general duties, the specific duties of EMTs depend on their level of qualification and training. A fundamental responsibility of the EMT is to conserve life, alleviate suffering, promote health, do no harm, and encourage the quality and equal availab...