Question: EMS is evolving at breakneck speed--medically, technologically and operationally. How can you possibly be expected to keep up with it all and still meet the day-to-day practical obligations of meetings, payroll, insurance, training, licensing, utilities, fleet maintenance and a dozen or so projects you've simply got to finish on time? (Of course, that's presuming there are no surprises, like vehicle failures, collisions, complaints, injuries or new political developments.)

Answer: When you think about it, you have some rare assets for which most leaders would give anything: namely, your paramedics. Think about it. Good paramedics are great observers. They wonder about stuff all the time, and they make critical thinking look easy. When they're not running calls, they're basically idle. Of course, there's always training, equipment maintenance and station duties. And you can't predict your system's call volume from day to day, so you know better than to schedule them too tightly. But most days, they have time on their hands.

Smart paramedics with too much time can be scary. What if you post a list of things you need to stay on top of, like protocols, ACLS guidelines, new equipment, safety and litigation, and ask folks to make themselves subject matter experts in one of those areas? We're talking opportunities for them to specialize in things that interest them personally. You can support them with software, journals, contacts and so on. In return, they can keep you up to date on aspects of your service that are important but to which you can't devote enough personal time. By letting them choose their own specialties, you open doors for them to develop marketable knowledge and expertise--increasing their value and versatility. The eventual result would be a stronger, smarter team with vested interests in their own organization.

Speaking of which, that would be another thing most leaders only dream about.

Thom Dick has been involved in EMS for 39 years, 23 of them as a full-time EMT and paramedic in San Diego County. He is the quality care coordinator for Platte Valley Ambulance Service, a community-owned, hospital-based 9-1-1 provider in Brighton, CO. Thom is also a member of EMS Magazine's editorial advisory board. Reach him at boxcar_414@yahoo.com.