What if you called for an ambulance and there were no medics to be found? A shortage of them makes this an all-too-real possibility.
What if you’re in a car accident — easy enough at this time of year. You’re hurt, you need an ambulance.
But they’re all out on calls. What if you have to wait 30 minutes for a medic? Or 40?
What if your loved one is having severe chest pains in the night? How long can you afford to wait to get to a hospital?
A shortage of medics in the greater Cortland area — as well as the rest of New York and even across America — means those aren’t rhetorical questions.
Both paid and volunteer ambulance companies face shortages of paramedics and emergency medical technicians.
The remaining medics work longer hours under greater stress for not a lot of money — if they’re even paid. Many are volunteers.
New York, like the rest of the country, faces a shortage of emergency medical technicians and paramedics, states an email from Thomas Coyle, the chairman of the United New York Ambulance Network to TLC Emergency Medical Service.
The nonprofit trade association, which represents ambulance companies across the state, attributes the shortage to “low pay, working conditions, schedules, work type and the length of training required to become certified and maintain that certification,” according to the e-mail.
“If something doesn’t change, care will be impacted,” said Matthew Edwards, the EMS chief at Marathon Area Volunteer Ambulance Corps, Inc.
Time is a factor
It takes more work to become an emergency medical technician or a paramedic than when Kevin Westcott joined Dryden Ambulance Inc. in 2007. Today, he’s its director of operations.
Even the simplest certification takes dozens of hours of training.
• Certified first responders provide basic life-saving care, including CPR and stabilizing the patient. Certification can take 48 to 60 hours of training.
• Emergency medical technicians, depending on whether they are advanced, will provide all the same basic life-saving measures along with services like extremity splinting or providing medication. Certification can take 150 to 200 hours of training.
Paramedics do everything first responders and EMTs do as well as services like chest tube placement or chest decompression. Certification takes 1,000 to 1,200 hours of training.
Each ambulance must have a driver and at least one EMT, Westcott said. When he joined, the Dryden outfit had one ambulance and a “fly car” to transport paramedics. Today, it has two ambulances.
The company has worked to address the issue by increasing hourly pay and offering benefits for certified EMTs. The company received a budget increase to $869,264 for 2020 to help fund pay increases, more than double its 2019 budget of $462,170.
However, a problem could still arise if both of the company’s ambulances are out on call and another emergency in the town occurs, requiring an ambulance.
“If the shortage isn’t figured out, you’re looking at longer response times for an ambulance to come in and cover,” he said.
So far, the ambulance company has been able to handle its volume of calls, Westcott said.
But if a staffing shortage means it must reduce service to one ambulance, people needing help in the Dryden area may have to rely on ambulances from farther away, Westcott said. In a worst-case scenario, that could lead to waits of 30 or even 40 minutes as ambulances come from Newark Valley.
“That’s the scary part,” he said. “How are you going to cover your own calls and your area?”
Using pay to help
Like Dryden, the Marathon Area Volunteer Ambulance Corps loses medics to operations that can pay them more, said Matthew Edwards, the EMS chief for the ambulance service.
To address the issue, the ambulance company has expanded the area from which it accepts responders, Edwards said. Previously, only residents from the village were allowed to join, but now residents of Willet, Virgil and Cortlandville can join.
Additionally, ambulance drivers have started receiving stipends for trips to hospitals to help retain drivers. The company used to have volunteer drivers for the vans. The shortage, which Edwards said he began really noticing in 2016, helped lead to the payment of weekend ambulance drivers as well.
This has helped attract more workers, Edwards said, but more needs to be done.
“If something doesn’t change, care will be impacted,” he said.
‘A very special type of person’
Once a medic gets a job, the work is hard, Edwards said. Treating patients with drug or mental issues can take a toll.
“You can only do so much to get them the help they really need,” he said.
This repeated treatment of people can lead his staff to feel like they’re “not making an impact.”
The shortage means his workers have more overtime shifts and more shifts in general, he said. It also means less time to recover after calls, which he said is important for workers’ mental health.
“You have to be a very special type of person to work in this field,” said Trish Hansen, division manager for TLC Emergency Medical Services, an ambulance service provider with locations in Cortland, Syracuse and Auburn.
The workers need to be caring and compassionate while still able to do the job, she said.
She noted a burnout factor for workers who must work longer hours becausee of the shortage.
“We still have to provide service 24/7, 365,” she said. “When your loved one needs an ambulance, we have to send an ambulance.”
Hansen attributes the shortage to the low pay and the type of individual needed for the job. To address the issue, the state began allowing 17-year-olds to get an EMT card, previously available only to people age 18 and older.
Hansen sees this way of getting younger people involved a potentially good way to address the shortage.
“I think it’s just a matter of the younger someone is, the longer they will stay in it,” she said.
Medics stepping up
Hope is not lost for these companies.
They have, so far, been able to handle the number of calls, sometimes with help from outside companies, and Edwards said expanded recruitment last year has led to members joining Marathon’s company at a greater rate than before.
“If you are adventuresome, this is something to look into,” said Tammy Aiken, the director of critical care and emergency services for Guthrie Cortland Medical Center.
The new medics, though, will have to face tough conditions and situations.
“They are rising to meet our needs but they struggle to do that,” Aiken said. “You have to be OK to not have to all the resources with you. It’s not for the weak of heart.”