ABSTRACT
This chapter aims to paint a picture of the internal challenges medical transport services face in trying to survive in a business and health care environment of constant change and uncertainty. The ground ambulance business is equally diverse. Many ground ambulances are part of a 911 system and are operated by municipalities. Some of these systems are part of fire-rescue services and some are independent of fire services. Helicopter shopping is the practice of calling, in sequence, various air medical providers until one is found who will fly a mission. Emergency departments and Emergency Medical Services have been engaged in this practice when they are frantically trying to find transport for a critical patient. Most Emergency Medical Technicians and paramedics are young, at lower pay scales, starting families and “burning the candle at both ends” to find additional income.
