An Open Letter to the City of Springfield

Tuesday afternoon at 3:30pm, there will be a meeting held at Springfield City Hall to discuss American Medical Response and their ability to provide prehospital care to the citizens of Springfield.  Below is something I would like to share with the City Councilors who will be in attendance Tuesday.

City Councilors of Springfield,

Despite the favorable findings of WGGB in their investigation on emergency response, you have decided to hold a forum to discuss potential short comings of the current EMS provider to the City of Springfield.  Yes, that is right, I said it was favorable.  Although the ebb and flow of the story might not have showed it, all of the information provided shows that AMR exceeds the expectations set for it.  But maybe you should dig a little deeper.  Prior to walking in the door to Tuesday’s meeting, I would like to urge you to do a little research and maybe expand your vocabulary a bit.

For instance, for just a second, let’s forget about response times.  They don’t nearly matter as much as you might think.  Try researching what a ROSC rate is, or how CPAP has reduced the mortality of shortness of breath patients, particularly in Springfield.  Ask Baystate Medical Center about the success of their ST-Elevation Myocardial Infarction program (STEMI for short) and ask them how many of those patients are delivered by AMR.

Still not convinced?  Why not take a good hard look at other communities around the country and see for yourself how good you have it in Springfield.  An ambulance is on scene in a preset amount of time or less 97% of the time.  How do you think that compares to communities like Detroit, Washington DC, or Philadelphia just to name a few?

Or how about closer to home?  Ask around to some of the neighboring more rural communities and see what their response times are like.  I guarantee that some will be longer than the average time publicized by AMR in WGGB’s article, but the patient outcomes will still be favorable.

Just like with in-hospital medicine, perfection will never be obtained in prehospital medicine.  Errors are going to happen because not only are the paramedics, EMTs and dispatchers human but so are the citizens that call 9-1-1.  Mistakes get made.  Addresses get entered wrong, and the severity of an emergency is not always reported properly.

It is not the vehicle and the response that make for a successful EMS system; it is that person behind the wheel and the tech in back.  It is the people.  If you look at response times alone, you will find that AMR exceeds the expectations of the contract and have for a number of years.  As a former paramedic and supervisor in the system, I encourage you to dig deeper.  The successes that the paramedics and EMTs in Springfield have had after the arrival of the ambulance is what really indicates the level and quality of service that Springfield is getting.  That is not always measured in numbers but if you dig deep enough you will find it.

Hopefully all of this information will be provided for you on Tuesday, but if it is not just ask.  The data is there, and the people who can provide it to you will be there as well.  Don’t do a huge disservice to your constituents.  There is no better company in the area to care for Springfield, and more importantly no one has the experience and the skill that the EMTs and paramedics in Springfield possess.


  1. Message #1 – “ambulance service” is not the same thing as “EMS.” Ambulance service is one component of an EMS system. Too many folks, including elected officials, don’t grasp the difference. If you choose to contract out your community ambulance service, you (the community) still have to provide a lot of other pieces – and often you do not.

    Message #2 – response time matters little to not at all in influencing the outcome of people who use the EMS system. 99% of the time it matters not at all. Stop playing the “response time” game or you give way on something else. The great EMS economist, Jack Stout, PhD, put it well – “You can have ambulance service that is good, fast, or cheap – pick any two.” Far too many communities opt for fast and cheap, and quality suffers.

    Message #3 – there are validated “evidence based” quality measures for any community EMS system – that look at the quality of care provided. Read the article and put them to work in your community, and your whole perspective on EMS will change.

  2. I thought Paramedics were EMTs?
    Addresses can be entered wrong, but more often than that is callers who can’t even accurately tell you where they are to begin with! (either don’t know or are too hysterical)

  3. Caity /

    Joel, paramedics have a higher level of education and experience, and are allowed to perform more difficult procedures.