I started an ambulance company in Oxford about five years ago to help fill a need in the community. At CareMed, we love taking care of people and helping them get the medical care they need, but the availability of emergency ambulance response is in a crisis. Just imagine you or your family needing an ambulance and calling 911 and there is not one available to send. The pandemic has caused major challenges to an already fragile emergency health care system. Most likely, you’ve heard about issues facing nurses, doctors, hospitals, police, firefighters and of course patients, but have you heard much about the challenges with ambulances? We are the front-line responders. Many times, our ambulances in Mississippi wait for hours in a hospital parking lot or emergency department hallway before the paramedics can take their patient inside the already full hospital. In the meantime, EMTs keep the patient in stable condition until the hospital can admit them. All this time, they are not available to respond to 911 emergencies. Unfortunately, this is all too common. There’s a domino effect at work here. Hospitals are crowded and short-staffed, so it can take hours to admit patients arriving by ambulance. This creates a backlog of ambulances stuck in hospital parking lots or hallways, waiting and waiting and unable to respond to new emergencies back in the community. This is especially a problem in rural areas where 911 callers are at greater risk of having to wait for an ambulance when precious minutes can be the difference between life and death. To make matters worse, ambulance providers are facing historically high shortages of trained personnel – just like hospitals, doctors’ offices and nurses. Too few people have entered our field in recent years, so while EMTs and paramedics were already in short supply prior to the pandemic, now this fragile system is struggling to keep up with the needs and demands of the public. Just like the public depends on police and firefighters in their time of need, our communities cannot make it without paramedics and EMTs. They are the forgotten first responders – highly trained medical professionals who operate what amounts to an extraordinarily expensive Intensive Care Unit on wheels. And they are on call 24-7. Compounding all of this, medical costs are skyrocketing since the pandemic, and ambulance providers are often reimbursed for significantly less than their actual costs. These reimbursement rates are set by insurance providers and the government for Medicare and Medicaid, which both contribute to the vast majority of 911 calls. Reimbursements are not keeping up with the costs, which is putting ambulance companies like ours at risk, just like rural hospitals. Unlike most health care providers, ambulance operators serve everyone – whether or not they have insurance. Every day, we pick up patients who are unable to pay. Additionally, we do not get paid by the insurance company until the patient is delivered. And we get paid nothing extra for sitting in a hospital parking lot for hours on end, waiting to deliver their patient. Nor do we get paid a dime if we respond to a 911 call, administer care and then the patient decides not to go to the hospital – a frequent occurrence during this pandemic when patients are afraid to go to hospitals packed with COVID patients. This is a medical emergency that affects citizens across the state. Rural Mississippians who may not have a hospital in their town are particularly at risk. The ambulance industry is filled with trained people who love to serve the public but just like other segments of the healthcare industry, we are struggling to keep up with the demands amplified by COVID-19. We are pleased the nurse shortage is a major concern and topic of many news outlets, advocacy groups and elected officials. We applaud Mississippi hospitals for creatively meeting the overwhelming medical needs demanded of them. It’s inspiring, but let’s not forget the medical professionals who get the patients to the hospital in the first place. The Mississippi ambulance industry is facing a critical crisis just like the rest of healthcare providers. And there is one more difference. The federal government has sent necessary funds to the other parts of the healthcare industry to help keep the system operating in these difficult times, but ambulance providers have not received similar direct federal support. We appreciate Mississippi lawmakers and the state’s political leadership who directed a share of the first round of COVID-19 relief dollars to help cover a small portion of our early soaring costs. As we go forward, we ask everyone to continue to remember the challenges facing your community-based front-line COVID first responders – the ambulance providers. We are doing everything we can to meet every 911 call but we are sounding the alarm that we need help. We are hopeful our state and federal officials will respond accordingly.
DAVID GRAYSON is the founder and chief executive officer of CareMed EMS in Oxford.