As a profession, EMS is just a mere child, struggling to come to terms with its identity and wishing to make its own mark in the world. A benefit to being so young is that we are not so far removed from the true beginnings of the organized delivery of prehospital emergency care. The "hows" and "whys" of our origins are still easily available—and, for the most part, from the very people who were instrumental in establishing the systems and practices we take for granted today.
Understanding both where we come from and our past successes and failures helps us to plan and prepare for the future. By recognizing our heroes, we bring recognition to the EMS service and the community, enhancing public awareness and understanding.
The last 40 years have been a time of incredible progress and daunting challenges for EMS in America. From the seminal "white paper" in 1966 that gave rise to modern American EMS to recent discussions about which lead federal agency should oversee EMS, the profession has seen drastic changes in terms of advances in technology and prehospital medicine, educational opportunities and systems management. However, if we are to learn anything from our history, it could be that while we have made great advances, we remain divided on many issues. We are still debating whether EMS belongs in the fire service, who should be responsible for overseeing EMS in the federal government and states' rights versus federal oversight. In order for EMS to continue to develop and grow as a profession, the EMS community must find a way to work together and resolve some fundamental issues. Becoming informed about how our current system of prehospital care developed will go a long way toward enabling you to have a voice for the future of EMS.
While the history of our modern EMS system is a relatively short one, there is no shortage of individuals who have proven to be heroes in regard to their commitment and passion for advancing the prehospital profession. The term founding fathers is often used in reverential treatments of history, and the achievements and motivations of EMS' founding fathers are appropriately impressive. Their accomplishments—from establishing standardized training for providers to improving prehospital cardiac resuscitation to creating better system management—helped move EMS forward. Many individuals have taken personal and professional chances on fledgling ideas in order to build systems they believed would save lives, allowing the next generation to build on a foundation with clinical, operational and administrative improvements that helped EMS survive and thrive. Knowing these individuals and their contributions is a critical step in coming to terms with where we've been, understanding where we are and identifying future directions for our profession.