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EMS Classics is a feature column I write for Canadian Paramedicine.

It is my attempt at giving the younger generation who work in EMS today, a snapshot into the history of ambulance service.

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Winnipeg competitors Irish Ambulance and 7 Oaks Ambulance, 1974

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Column 30 April/May 2011

Ambulance Competition

Competition among ambulance services was common in Canada prior to the 1980s. Many towns and cities had two or more competing ambulance services. In Saskatchewan, for example, of 70 ambulance services registered with the Provincial Department of Health in 1973, approximately half were in competition with another firm. In Metropolitan Winnipeg, prior to the City taking over all ambulance services in 1975, there were 7 private ambulance services operating 17 ambulances, two police departments were each operating several ambulances, plus the fire department was operating three rescue vehicles.

Not all competition was friendly competition. While competitors in some locations tolerated each other, in other locations competitors were sworn enemies who took their competition tactics to an elevated level. There are stories of ambulance attendants returning to their ambulance parked outside the Emergency Department of a hospital only to hear the hissing of air escaping from the tires of their ambulance - somehow, mysteriously, their tire valve stems had disappeared or worse, the tires had been slashed. There also was the old trick of calling the competitor (in the days prior to call display) and telling them there was a horrific collision 20 miles south of town and that they needed to send all their available ambulances out there, when in fact there was no such collision.

Why did some ambulance services compete so vigorously? For the survival of their business. Most ambulance services did not have a secure source of funding and had to rely entirely on the revenue they were able to collect from their calls. By competing aggressively their competitor would receive fewer calls which would hurt them financially and hopefully force them out of business. And once the competitor was gone, rates could go up, the business could prosper, and an improved level of service could be provided.

Why did most towns, cities and provinces not regulate and not financially support their ambulance services? Because at the time ambulance service was considered by many as being nothing more than a horizontal taxi service. Ambulance services were not yet a component of the health care system. The public had not yet demanded of their elected representatives to regulate and financially support professional emergency medicl services. Fortunately, that all began to change during the 1970s and 1980s.

Copyright 2011 Peter Adsten