“A Call For Help:” Maine’s EMS and Paramedic shortage

Published: Mar. 24, 2022 at 5:44 PM EDT
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Maine (WABI) - The EMS and paramedic shortage can be felt anywhere in our state.

After a local doctor went above and beyond for a patient in need, it highlighted how serious the problem has become.

When Doctor Mark McAllister of Pen Bay Medical Center in Rockport was faced with an 80-year-old patient who could die at any moment, he took every step possible to get them the care they needed.

“He had a particularly worrisome set of symptoms with location of his pain, the way it was affecting him. His aorta was threatening to burst. Which is a very quickly fatal condition,” said Dr. McAllister.

Due to the weather, a helicopter transport with Lifeflight was not an option.

So they had to resort to an hour and a half ride on an ambulance.

“Unfortunately that day there were no ambulance crews available to actually take someone for a transport. So that was the real dilemma of fighting an incredibly time sensitive illness that we know how to fix, we have a whole team in Portland waiting to fix it, and no way to get him from here to there to have it done,” said Dr. McAllister.

So they took an unorthodox approach since there were ambulances available, just no EMS or paramedics to staff them.

“So got on the phone with a local ambulance service. I said get me an ambulance with somebody who can drive it, someone who knows where things are in the cabinet, and I will go as the paramedic in this case to take care of the patient on the way,” said Dr. McAllister.

To assist, they called in a registered nurse who was at home but had experience on ambulances.

“I got a message from my manager and she asked me if I’d want to go on this transfer. When she told me there was no paramedic to go on the transfer you get a little bit more like, I don’t know what to think,” said Michaela Poor with Pen Bay Medical Center.

Her nerves subsided when she heard Dr. McAllister would be there to join her.

“But it’s always challenging to get in the back of an ambulance with someone you’ve never been in the back of an ambulance with before,” said Poor.

The patient made it to Portland, had surgery and survived.

While what Dr. McAllister did by getting in that ambulance was admirable, the reality is that just shouldn’t have had to happen.

“EMS is in trouble. They have been in dire straights for years and years, and it’s not getting better,” said Poor.

“Someone who needs emergency aortic surgery, I can’t get them to Maine Medical Center. Recently we’ve had several people having heart attacks that needed to get to a tertiary care center for an emergency procedure and no transport to get them there. And I think one of the most frustrating parts of working in health care isn’t working stressed, it’s not working tired, it’s not going above and beyond. It’s knowing what somebody needs and something about the system preventing you from being able to get it for them,” said Dr. McAllister.

Dr. McAllister emphasized how proud he was of everyone who had a hand in saving that patient.

But he also outlined the issues with the lack of pay and reimbursement for EMS workers.

One department facing those challenges is East Millinocket Ambulance.

Whose service area continues to grow faster than their department, almost 300 square miles larger in 2022 than the year before.

They now respond to an area of Maine about two thirds the size of Rhode Island.

“Yesterday was 48 minutes to get to one of our scenes. We went to the far side of Prentiss,” said Rob McGraw, Chief of the East Millinocket Fire/EMS Department.

At the end of last year, the town of Patten had to cancel contracts with numerous towns who they provided EMS service because of their lack of staffing.

Many of those towns along the Penobscot/Aroostock County line were forced to sign with East Millinocket Ambulance Service, much further away.

“Average mileage for just the 911 calls yesterday was 29.9 miles. So you’re looking at 32 to 36 minutes to get to somebody who’s calling 911,” said McGraw.

McGraw says the national average for rural 911 response time is around 14 minutes.

“It is at a critical fail right now. When you’re making less money then somebody at McDonald’s and we’re going into a situation with high stress of dealing with COVID, dealing with just life threatening conditions. People don’t want to do it,” said McGraw.

Volunteer firefighters and paramedics is a system that has worked in rural America for years. But the industry is being challenged now more than ever before with bringing people in. And the root of that problem? Not enough money.

“There’s not enough of us to go around. I’m currently making $21 an hour and with the new budget we’re proposing I’m trying to be at $28 to compete with places like CLC Waldoboro who have done pay increases,” said Jesse Thompson, Chief of Union EMS.

Many of the EMS staff in the town of Union work for multiple towns.

“The problem we’re running into is that people don’t have the time to volunteer like they used to,” said Thompson.

“The volunteer system was great back in the day when you had one income. Now you have multiple income families, some families have multiple jobs. They don’t want to get up in the middle of the night, they don’t want to get up from a dinner table to go on those calls. So the volunteer ideation is gone,” said McGraw.

It’s a systemic problem for rural EMS and paramedics.

“You have to make it financially feasible for them. And by financially feasible, pay is good but pay isn’t everything. Benefits, having sick time, having vacation time,” said Thompson.

“Australia and England, EMS is a career. They don’t treat it as a career so much in the U.S. I think that needs to be a significant change,” said McGraw.

Those in the industry also believe change needs to come at legislative level.

“In the state of Maine, if you call and ask for a fire department, legislative-wise a fire department has to go. If you call and ask for a law enforcement officer, law enforcement officer has to go. If you call and ask for an ambulance? There’s no legislation in place that requires an ambulance to go,” said McGraw.

I asked Chief McGraw what the future of EMS will look like if none of this is addressed.

“There’s going to be people who call 911 and no one is going to show up,” said McGraw.

There is some efforts from lawmakers going on now.

Maine Congressman Jared Golden announced $300,000 in federal funding for East Millinocket to help buy two new ambulances.

The Maine Senate unanimously passed a bill this week that would create a fund for communities to apply for grant money.

There are 272 EMS departments in Maine and fewer than 70 are paid and full-time.

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