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By Guest Editorial Dave Lapof
Operations Manager for Klickitat County EMS District No.1 

Triage Vol. II, No. 6: Some things change, some don't


I recently realized as I took my EMT written test to become a Washington State EMT (still one in Oregon) that it has been 30 years since I first became an EMT. There have been significant changes in our industry.

Just this week one of the founding magazines devoted exclusively to pre-hospital care, JEMS, the Journal of Emergency Medicine, decided to stop printing its magazine and convert to an all-electronic format. I learned EMS from this magazine, as did many others. I read what other professionals across the country were doing and learned tricks of the trade and research from around the world. The days of seeing the magazine’s cover on the kitchen table, creating the nucleus for discussion, may be gone, but the education hasn’t stopped. Today’s crews still get this information but from their phones.

Also this week I attended the Washington State Ambulance Association meeting, and in discussion it was mentioned that Washington’s DHS reimbursement program for ambulance rates hasn’t been raised since 2004; that’s 14 years ago. Needless to say, everything costs more than it did 14 years ago, and our industry is no different. Wages, health care, ambulances, fuel, medical devices, have at the very least increased 3 percent a year and, in most cases, more like 8-10 percent.

There was a time when one of our ambulances used to cost $95,000, and now it’s closer to $160,000.

We just had an internal review of our expenses completed by some very smart folks, and it was determined that on average it cost us $1,275 to run one EMS call. Our average reimbursement is $825. DHS reimbursement is less than $300. I suppose this is one thing that hasn’t changed—the significant difference in cost versus revenue. EMS is almost an unsustainable industry without either volume of transports or other sources (taxes) of revenue outside of fees for transports.

Another change is we have a website While we are still updating and adding content, we’d be glad if you visited it.

One thing that hasn’t changed is those involved in providing the service. They are still passionate about their profession, helping those who can’t help themselves, and their desire to be there when they are needed. I suppose we all can find comfort in that.

On behalf of the woman and men of KCEMS District 1, have a safe Fourth of July.

Oh, I passed my test, by the way.


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