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A Farewell from Dr. Jon Krohmer

Jon Krohmer, MD, a board-certified emergency and EMS physician with 45 years’ experience in EMS and public policy, recently retired as director of the Office of Emergency Medical Services in the National Highway Traffic Safety Administration (NHTSA). A long-time local EMS medical director in Michigan and Maryland, he also previously served as president of the National Association of EMS Physicians and spent a decade with the U.S. Department of Homeland Security. Dr. Jon Krohmer sat down with EMS Update to share some of his thoughts on the state of affairs as he hands the reins of the Office of EMS to his successor, Gam Wijetunge.

There are a lot of ways I could start this farewell letter, but nothing seems more important than expressing my profound appreciation, gratitude and respect for everything the EMS community has done over the last two-plus years. 

The COVID-19 pandemic has brought no shortage of challenges in the Office of EMS, in the federal government and certainly within the wider EMS community. In particular, I want to call out the exceptional work done by state EMS offices, as well as local EMS agency leadership and clinicians. We always think about and prepare for disasters, but none of us had really thought about a whole-nation event that we’d all need to respond to at the same time, for months and years, not just days or weeks.

The people of EMS have truly come together to address the needs of their communities, often at the expense of the needs of EMS clinicians themselves. We’ve done what we needed to take care of patients and ensure the highest quality of care, but it has come at a cost. Putting in many hours of overtime. Giving up vacations. Wearing cumbersome PPE much longer than we ever expected we’d have to. Navigating shortages of medications and other clinical resources. In spite of this, you—the EMS community—have done a phenomenal job. The 911 community—dedicated emergency telecommunicators who often serve behind the scenes, with little public recognition—faced similar obstacles but also stepped up, developing alternative call-taking and response strategies to meet the challenges of the pandemic as well. 

I’d certainly be remiss if I didn’t also acknowledge the exceptional staff in the NHTSA Office of EMS, which also includes the National 911 Program. They have never wavered from their commitment to support the people in the field and in the communication centers around the nation.

Throughout much of my career, it was my job—and my pleasure—to bring people together to talk about issues that matter to the EMS community and identify ways they could be addressed. But it’s the people in the community who have brought those solutions and innovations to life. Ground-breaking work like EMS Agenda 2050; improvements in the collection and use of EMS data through expansion of the National EMS Information System; revisions to the National EMS Education Standards; and the release of the new National EMS Scope of Practice Model. I’ve been so fortunate over my entire EMS career to work with very talented, dedicated people. I may have been the one to bring them into a room together, but time and again, they made what needs to happen, happen.

The last few years of my career, I didn’t get to spend as much time in the field as I would like. But when I do get out there, I see EMS clinicians caring for patients day in and day out, as well as those in my own agency and how they respond. My wife says those of us who choose to work or volunteer in EMS have an “EMS blood type.” She’s absolutely right—and watching people in the field do what they do is like getting a much-needed transfusion. 

Which is not to say there haven’t been difficult days. Whether you work at the federal, state or local level, there are always systems that must be navigated. During my time in the NHTSA Office of EMS, I knew not everyone understood the logic behind having an Office of EMS in a traffic safety organization. But we certainly shared a common mission: improving public health, creating better systems of care, and supporting the collection of data to make evidence-based decisions. NHTSA has supported EMS for more than 50 years, and that support is only growing stronger. Some of you may feel similar challenges in your roles, where EMS sits somewhere at the crossroads of healthcare, public health, public safety and emergency management. What’s important is not necessarily figuring out where we fit in, but what we do, and how we can collaborate with all of our partners to do it even better. One critical challenge for my successor will be finding ways to better engage our colleagues in these other disciplines, elected and appointed officials, and the public, and to constantly reinforce to them just how important EMS is to communities in this country. People assume—rightfully so—that EMS will be there for any and every need. But this is not a given. Communities and policymakers need to support the EMS infrastructure—starting with the clinicians themselves—with not just recognition and nice words, but the resources you need to keep people healthy and safe.

Looking back at my five years at NHTSA, and more than four decades in EMS, nothing has been better than engaging with those in the profession at all levels across the country. One of those exceptional people is Gamunu (“Gam”) Wijetunge, the new director of the NHTSA Office of EMS. Gam is not only extremely talented, but he has a ton of experience, both at the federal level and inside an ambulance serving his community, which will serve EMS very well as he leads a tremendous team and works with all of you to move EMS into the future. Sometimes, like many families, the EMS community has spent more time arguing amongst ourselves than finding common ground. It’s only natural. But the pandemic has given us an opportunity—one that may not come again, at least not soon—to bring everybody together. It’s a chance to focus on our common goals and how, collectively, we can see our discipline evolve, rather than focus on specialty interests.

What do I mean by evolution? We continue to step up to fill gaps in public health and healthcare, from overdose prevention activities to administering COVID-19 vaccines. We’re collaborating much more closely with public health agencies to support the public health needs of the community. We’re getting better at data collection—a great example of state EMS data managers, software vendors and others working together to improve things. The care we provide is more sophisticated and more evidence-based than ever before.

But the most important piece is this: There are so many talented people in EMS that it’s imperative that we continue to focus on coming together. We’re better than we were, but we must continue to work together. And we’ve got to figure out ways of tooting our horn better, and making the people we serve and those we serve alongside understand our value. There is no greater joy than working with a group of people who leave their individual needs behind to focus on the collective.