The Emergency Medical Services Program

In the early and mid 1970s, the lack of a responsive emergency medical system began to command national attention. Physicians in a number of states established local emergency systems; the National Academy of Sciences issued reports on the need for an organized emergency medical system; veterans returning from Vietnam provided a pool of skilled medics capable of handling medical emergencies; and a popular television show brought the feats of emergency physicians and paramedics into the nation's living rooms.

A new philanthropy, the Robert Wood Johnson Foundation, launched as its very first national multisite demonstration the Emergency Medical Services Program. It was soon followed by a much larger federal program that aimed at expanding emergency medical care throughout the nation.

In this chapter, writer, book reviewer, and radio and television commentator Digby Diehl takes a look back at the Emergency Medical Services Program. In addition to chronicling the times and the evolution of the Foundation's and the federal government's programs, Diehl raises some fascinating social policy issues. How much credit can one foundation take in bringing about a sophisticated emergency response system in this country? How important were the other forces in play before the Foundation became involved? Would the innovations have occurred whether or not the Foundation made its series of grants?

These questions, difficult to answer under any circumstances, are surely more difficult after more than two decades: some key players are no longer available, memories fade, and the good and the bad become enlarged in the minds of those involved with the program. In his examination of the Emergency Medical Services Program, Diehl nevertheless reaches some conclusions. He finds that the Foundation did play a critical role in seizing an opportunity, providing a spark, and helping to shape the changes that produced today's emergency medical system.