It’s Emergency Medical Services Week! The Northern Michigan Center for Rural Health met with Gary Wadaga, Service Director of Bay Ambulance Inc. in Baraga, Mich, to get his input on the state of EMS in rural Michigan. Here is his #MiEMSstory.

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When Gary Wadaga was hired by Bay Ambulance Inc. of Baraga, Michigan in 1982, he was one year out of paramedic school and their first full-time director. At the time, the agency was a basic life support service struggling to recruit volunteers. Today, under Wadaga’s leadership, Bay provides full advanced life support paramedic service to most of Baraga County as well as parts of Ontonagon and Houghton counties. In his 40 years as an EMS professional, Wadaga has witnessed extensive changes within his own agency as well as the industry at large.

“Bay Ambulance started with baby steps and we’re fortunate that certain individuals wanted to make a difference and help people,” Wadaga said. “The fact that this industry captured people’s interest, and they wanted to advance their skills and knowledge, that’s how we were able to achieve advanced life support paramedic service.”

Bay Ambulance currently employs six full time paramedics on 24-hour service and has a combined staff of 34 paid and volunteer members. In recent years, issues involving recruitment and retention of volunteers and full time employees have begun affecting not only Wadaga’s agency, but EMS nationwide. Wadaga attributes this to lack of public knowledge of the industry and education in the region that may not be entirely accessible to interested candidates. 

There are currently two Upper Peninsula institutions providing paramedic courses: Bay College in Escanaba and Lake Superior State University in the Sault Ste. Marie. Scheduling wise these college level programs, which result in an associate’s degree, are difficult for many individuals traditionally studying to become a paramedic. Often, those interested in attending a paramedic course are working full time and pursuing the course after a day's work. 

“It used to be that we never had an issue finding paramedics. We always had somebody locally who was interested in becoming a paramedic. They would complete the course and have a job here...and now we just don’t have the interested candidates that have the availability to go to paramedic school,” Wadaga said.

In addition to recruitment and retention, Wadaga sees need for improvement when it comes to funding and community awareness of the EMS industry. In his opinion, all of these issues are linked: recruitment is needed to bring in a profit, while funding is needed to execute recruitment, and community awareness assists in both areas. Wadaga said if more EMS professionals share their stories and bring awareness to not only the victories but the struggles, it may assist in change on many levels.

“I don’t think we’re telling our story to local government officials. We’re not telling our story to our local communities and I know we’re not telling our story well enough to public officials at the city, township, county, state, and federal level. Overall, as an industry we have not done a good job of telling how we’re struggling, because we certainly are.”

Read on for more of Gary Wadaga’s first hand account of working in rural EMS.

Q&A

What do you think is one of the most crucial issues affecting EMS systems in rural Michigan communities? What are some steps that can be taken to improve this issue? 

We have to find a different way to fund EMS, especially rural EMS. What’s happening now doesn’t work like it did 15 or 20 years ago. We don’t have volunteers like we used to, and that isn’t a new development, it has been catching up with us. It boils down to people and money; you need people to run a service to bring in profit, but you need money to support people doing their jobs, whether it be stipends for volunteers or help with wages and benefits. When equipment phases out, like cardiac monitors and ambulances, you need money to replace it. In smaller communities, if you’re involved in the ambulance service you’re involved in the fire department or the Knights of Columbus or school programs.

How has the current pandemic affected the EMS situation in rural Michigan?

Bay Ambulance was fortunate that people stepped up to the plate and said, “We’ll do what we have to do to protect ourselves and our families, but we’ve got a job to do.” They’ve done it, and we’re very grateful for that. 

In your experience, what are some common misconceptions or lack of information about the EMS system and EMS agencies?

Many people expect that when they call 911 we’re going to be there within minutes. With rural services, buildings aren’t staffed 24 hours a day, seven days a week. First response services aren’t staffed that way. They have to get out of bed, defrost the windshield, get to the garage and grab the first response truck and the ambulance. There’s this belief that you make the phone call and we’re minutes away and unfortunately that’s not the case. Some EMS workers choose to live outside the city limits. When you allow responders to do that, the further away from the building they get the longer your response time is. There’s a delicate balance there as for people agencies will accept for service and that certainly has to be weighed. If you allow someone to live 10 miles away you can be assured that person is not going to get to the garage or to the race in 15 minutes...that’s not even possible.

Describe your connection with the Northern Michigan Center for Rural Health. How does this partnership benefit your center?

I’ve worked closely with the Michigan Center for Rural Health for years and more recently with their new full-time EMS Program Manager, Andrea Abbas. When Northern Michigan University received funding to develop the Northern Michigan Center for Rural Health, I was invited to participate in their EMS subcommittee. I think that there are some resources the typical service director doesn’t have the time or ability to access such as marketing, training, and grant writing. There are resources that certainly could be tapped into, and Elise continues to work with us on identifying potential opportunities. We’ve discussed doing a region wide survey to find out what people know about EMS, and that’s something I, and most agencies, don’t have the capacity to take on independently. Telling our story effectively starts by figuring out what people know and don’t know about EMS. If they know very little, survey results will benefit us in understanding what’s our starting point to begin educating our communities. I think that if we work as a partnership perhaps we could get some of these issues resolved, from recruitment and retention to exploring funding opportunities. 

It all boils down to somehow we have to tell our story and I think that both the Michigan Center for Rural Health and the Northern Michigan Center for Rural Health can be great assets in helping us figure out our plan to do just that. 

The Northern Michigan Center for Rural Health seeks to improve the health and well-being of Upper Peninsula residents and communities by developing collaborative partnerships that enhance the access and availability of affordable, quality healthcare services. For questions or comments related to this story, contact ruralhealth@nmu.edu.