Ray Barishansky
@rbarishansky.bsky.social
š¤ 147
š„ 127
š 268
Doctor of Public Health(DrPH). Autodidact. Human. All views are my own.
When people think of New York, they think NYC. But more than 2/3 of counties in New York are rural and those areas are seeing a growing EMS crisis with longer response times, fewer providers, and systems on the brink.
#EMS
www.dailygazette.com/cjfund/healt...
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'Brink of collapse': rural EMS providers face challenges in New York
A new report released by the stateās Rural Ambulance Services Task Force describes the rural EMS system in New York as "teetering on the brink of collapseā and in need of "urgent government interventi...
https://www.dailygazette.com/cjfund/health/new-york-rural-ambulance-providers/article_4e25ce1a-e116-4f82-b15e-8a969eadd5cb.html
about 19 hours ago
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One of the most thoughtful pieces Iāve read on EMS provider mental health. The key point: protecting the EMS workforce isnāt just about resilience, itās a system design and governance issue. A must-read.
#EMS
#mentalhealth
www.linkedin.com/pulse/unengi...
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Unengineered: A Governance Argument for EMS Workforce Protection from First Shift to Last
Paramedics face high rates of injury, burnout, and suicide. EMS must engineer workforce protection from training through retirement.
https://www.linkedin.com/pulse/unengineered-governance-argument-ems-workforce-from-first-nick-nudell-qxi8c/
10 days ago
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Iāve seen a lot of back-and-forth about this incident. So, what do you think? No one wants to play Monday morning quarterback, but there are real questions to be addressed here.
#EMS
#ambulance
www.theguardian.com/us-news/2026...
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US officer having a āmild anxiety attackā took ambulance meant for man shot by police
Dyshan Best later died after having to wait 10 extra minutes for next ambulance, according to Connecticut investigation
https://www.theguardian.com/us-news/2026/mar/12/us-officer-anxiety-attack-ambulance-police-shooting
10 days ago
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The resurgence of measles cases isnāt just about measles. Itās a sign that some of the basics of public healthāvaccination coverage, trust in science, and preventionāare starting to slip. Makes me wonder what comes next.
#measles
#publichealth
theconversation.com/we-study-pan...
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We study pandemics, and the resurgence of measles is a grim sign of whatās coming
Controlling the spread of many infections, including measles, depends on trust in public health, which is eroding.
https://theconversation.com/we-study-pandemics-and-the-resurgence-of-measles-is-a-grim-sign-of-whats-coming-275059
11 days ago
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Lots to unpack here but hopefully this incident will have the City reexamine some of its processes.
#EMS
#ambulance
www.seattletimes.com/seattle-news...
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She called 911 for an ambulance. She got a nightmare instead
Seattle no longer is capping ambulance wait times for certain 911 patients, tracking those waits or penalizing its contractor when they run long.
https://www.seattletimes.com/seattle-news/times-watchdog/seattle-womans-911-calls-reveal-gaps-in-ambulance-service/
15 days ago
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I think the word failure is being nice, I think the more appropriate term here is "irreversible damage to public health"
#publichealth
add a skeleton here at some point
23 days ago
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I think every EMS provider has a story about impatient family or bystanders, but moving the ambulance while the medics are inside working is next level
#EMS
#ambulance
www.clickorlando.com/news/local/2...
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āImpatientā man arrested after moving ambulance as medics worked inside, Brevard sheriff says
A 58-year-old man was arrested on Thursday after the Brevard County Sheriffās Office say he climbed into a parked ambulance while paramedics were treating a patient and attempted to move the vehicle b...
https://www.clickorlando.com/news/local/2026/02/28/impatient-man-arrested-after-moving-ambulance-as-medics-worked-inside-brevard-sheriff-says/
23 days ago
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"For decades, EMS reimbursement has depended on moving the ambulance. TIP flips that model, rewarding clinical judgment over mileage ā if payers, protocols and QA can keep up."
#EMS
www.ems1.com/treat-in-pla...
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Treatment in place: The future of EMS ⦠and yes, someone has to pay for it
For decades, EMS reimbursement has depended on moving the ambulance. TIP flips that model, rewarding clinical judgment over mileage ā if payers, protocols and QA can keep up.
https://www.ems1.com/treat-in-place/treatment-in-place-the-future-of-ems-and-yes-someone-has-to-pay-for-it#
27 days ago
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A permanent EMS funding source is a big step forward. I worry about the county match requirement. The places struggling the most are often the least able to come up with matching dollars.
#EMS
#funding
wchstv.com/news/local/h...
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W.Va. House votes to create permanent EMS funding source; counties to match state dollars
The West Virginia House of Delegates has passed a bill aimed at stabilizing emergency medical services as squads across the state struggle with rising costs.
https://wchstv.com/news/local/house-votes-to-create-permanent-ems-funding-source-but-counties-must-match-state-dollars
28 days ago
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Grateful Pittsburgh EMS is getting new ambulances. But bigger question: why are core emergency services being ārescuedā by hospital systems like UPMC? EMS is essential infrastructure and shouldnāt depend on charitable gifts to stay operational.
#EMS
www.publicsource.org/upmc-gifts-p...
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UPMC to give Pittsburgh $10 million for new ambulances
Mayor OāConnor announced a $10 million gift from UPMC that will pay for new ambulances in Pittsburgh, freeing up funds to buy 35 new trucks that can plow snow.
https://www.publicsource.org/upmc-gifts-pittsburgh-millions-new-ambulances/
30 days ago
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It's always impressive when authors come up with a title that is as eye-catching as the actual article content.
#EMS
#fatigue
www.jems.com/mental-healt...
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Exit Light, Enter Dispatch: Chasing Sleep and Fighting Fatigue in EMS
Fatigue in EMS poses risks to patient safety and provider health, with many providers reporting severe fatigue symptoms.
https://www.jems.com/mental-health-wellness/exit-light-enter-dispatch-chasing-sleep-and-fighting-fatigue-in-ems/
about 1 month ago
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The short answer is yes, we collectively have forgotten the hard-learned lessons of COVID.
#publichealth
#COVID
www.gavi.org/vaccineswork...
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Have we already forgotten the lessons of COVID-19? We asked an expert in anticipating crises
Bureaucracy, politics and fraying trust in institutions could mean that warnings about the next health crisis fall on deaf ears, says a leading expert.
https://www.gavi.org/vaccineswork/have-we-already-forgotten-lessons-covid-19-we-asked-expert-anticipating-crises
about 1 month ago
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This is what a vaccine-preventable disease looks like when vaccination rates drop ā the U.S. is facing its largest measles outbreak in decades, and clinics are overwhelmed
#publichealth
#vaccineswork
www.reuters.com/business/hea...
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Doctors bear the burden as āmedical freedomā fuels worst US measles outbreak in 30 years
About a dozen times each day, medical staff at Parkside Pediatrics in Spartanburg, South Carolina, head to the clinicās parking lot, reaching inside cars and minivans to check children and their paren...
https://www.reuters.com/business/healthcare-pharmaceuticals/doctors-bear-burden-medical-freedom-fuels-worst-us-measles-outbreak-30-years-2026-02-13/
about 1 month ago
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This is just unacceptable. If we stop naming and prioritizing preparedness, what comes next ā denial? neglect? dismantling?
#publichealth
#preparedness
www.nature.com/articles/d41...
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Exclusive: Key US infectious-diseases centre to drop pandemic preparation
Staff members have been instructed to scrub this topic and ābiodefenseā from the agencyās website.
https://www.nature.com/articles/d41586-026-00468-1
about 1 month ago
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Is it time to take the word "emergency" out of emergency medical services? This article seems to advocate for that change and I don't know that I disagree.
#EMS
www.jems.com/mobile-integ...
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EMS at the Crossroads: How MS Can Lead a Rural Healthcare Revolution
The One Big Beautiful Bill Act includes $100 million for Mississippi's EMS transformation.
https://www.jems.com/mobile-integrated-health-and-community-paramedicine/how-ms-can-lead-a-rural-healthcare-revolution/
about 1 month ago
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"The last 60 years have taken us from funeral homes and MAST pants to capnography, ultrasound, and whole blood. The next 60 will do the same, steady gains, mixed with stubborn struggles" Amazingly solid read about the past, present and future of EMS.
#EMS
#ambulance
www.jems.com/patient-care...
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EMS at 60: The Past, Present, and Future of Our Profession
In 2026, EMS in the United States marks its 60th anniversary, evolving from untrained services to evidence-based systems since the 1966 Highway Safety Act.
https://www.jems.com/patient-care/ems-at-60-the-past-present-and-future-of-our-profession/
about 1 month ago
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EMS leadership is about bridging the gap between administration and operations. Budgets and policies matter but so does understanding the reality of the street. The best leaders connect the why behind decisions to the work crews do every day.
#EMS
#leadership
www.jems.com/ems-manageme...
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Bridging the Gap Between Administration and Operations in EMS Leadership
Chief Clifford Mungavin emphasizes the need for EMS leaders to bridge administrative and operational gaps to prioritize patient care.
https://www.jems.com/ems-management/bridging-the-gap-between-administration-and-operations-in-ems-leadership/
about 1 month ago
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EMS system leaders, as well as elected officials, need to understand the "cost of readiness" and how that impacts their budgets and operations.
#EMS
#funding
www.butlereagle.com/20260206/is-...
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Is the cost of readiness too steep? EMS services seek balance amid rising costs and little relief
If ambulance services canāt cover their costs, they canāt cover the emergency needs of Butler County ā and itās becoming increasingly difficult to be ready for an emergency, according to the leaders o...
https://www.butlereagle.com/20260206/is-the-cost-of-readiness-too-steep-ems-services-seek-balance-amid-rising-costs-and-little-relief/
about 1 month ago
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This article shows how pandemic-era public health leadership is becoming political leadership and what that means for trust, governance, and experience on the campaign trail. These races will be interesting to watch.
#publichealth
#politics
www.washingtonpost.com/politics/202...
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They ushered their states through covid. Now they want to lead them.
Why doctors who led the pandemic response in their states are running for office.
https://www.washingtonpost.com/politics/2026/02/06/politics-covid-pandemic-election/
about 1 month ago
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I applaud the move but this is a patchwork approach to public health in the US and simply not optimal. Remember - diseases don't recognize borders.
#publichealth
www.chicagotribune.com/2026/02/03/i...
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Illinois joins World Health Organization network, after Trump administration withdraws from group
Joining the World Health Organizationās Global Outbreak Alert and Response Network is the stateās latest move into an area that was previously the domain of the federal government, before theā¦
https://www.chicagotribune.com/2026/02/03/illinois-world-health-organization-trump/
about 2 months ago
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"At least 33 states were below herd immunity in the 2024-25 school year, compared with 28 states before the pandemic in 2018-2019"
#measles
#publichealth
stateline.org/2026/02/02/s...
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States that once led in child vaccination fall as they expand exemptions ⢠Stateline
States that were leaders in childhood vaccination before the pandemic are among those losing ground as exemptions and unfounded skepticism take hold, encouraged by the Trump administrationās stance un...
https://stateline.org/2026/02/02/states-that-once-led-in-child-vaccination-fall-as-they-expand-exemptions/
about 2 months ago
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Is the EMS profession stalled between expectation and reality? Great question!
#EMS
www.jems.com/ems-manageme...
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The EMS Profession Is Stalled Between Expectation and Reality
Weāve stripped the āemergencyā out of EMS. Now itās just medical services. Itās time to put the āEā back where it belongs.
https://www.jems.com/ems-management/the-ems-profession-is-stalled-between-expectation-and-reality/
about 2 months ago
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Although I am a fan of this move, it just makes me wonder about the further fragmentation of public health efforts in the United States and the "every state for itself" potential
#publichealth
www.abc10.com/article/news...
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California joins WHO public health network following US exit, marking a first for any state
California joined WHO's Global Outbreak Alert and Response Network, countering federal withdrawal from the organization.
https://www.abc10.com/article/news/local/california/california-joins-who-public-health-network-following-us-exit-marking-a-first-for-any-state/103-07ba6111-1915-44f8-bebf-13b40e43bcd8#
about 2 months ago
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Is it time to turn off the sirens? A great question for modern day EMS systems and leaders to answer.
#EMS
#ambulance
www.ems1.com/paramedic-su...
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Is it time to turn off the sirens? Podcast explores lights & siren use and unintended risks
An episode of Malcolm Gladwell's podcast āRevisionist History" dives into the data ā and the noise ā behind why EMS sirens may no longer be worth the risk
https://www.ems1.com/paramedic-survival/is-it-time-to-turn-off-the-sirens-podcast-explores-lights-siren-use-and-unintended-risks?utm_sf_cserv_ref=8984788623&utm_source=facebook&utm_sf_post_ref=658594792&utm_medium=referral&fbclid=IwdGRjcAPhzR1leHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEej6QXgXZ4JoWadAcg2fSKdNwCh6WzzG8T7bU78-BiHjbYK4KcVZUmYsLve1Y_aem_XiOrLpMpN0V4InR56QAo6w#
about 2 months ago
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Will you be attending the event built specifically for EMS leaders, supervisors, and emerging leaders who want practical insight, meaningful connection, and leadership tools they can take back to their organization? I hope to see you!
#EMS
#leadership
nemsma.org/page/2026NEMSMā¦
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https://nemsma.org/page/2026NEMSMā¦
2 months ago
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I am beyond happy to see this law has passed but wondering why it took so long.
#EMS
#paramedic
www.lex18.com/news/coverin...
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Kentucky paramedic's death leads to landmark law protecting EMS families 9 years later
A Kentucky paramedic's tragic death nine years ago continues to save lives and protect EMS families across the state.
https://www.lex18.com/news/covering-kentucky/kentucky-paramedics-death-leads-to-landmark-law-protecting-ems-families-9-years-later
5 months ago
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if you think that this will not be impacting you and your family, think again.
#publichealth
add a skeleton here at some point
5 months ago
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Very interesting piece about how EMS providers may, at times, have to operate in an area that the author calls "the moral gray zone of Modern EMS".
#EMS
www.ems1.com/ems-protocol...
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When doing the right thing breaks the rules
Paramedic Eddie Barnes saved a life with skills he wasn't authorized to use ā prompting an investigation that reveals the moral gray zone of modern EMS
https://www.ems1.com/ems-protocols/when-doing-the-right-thing-breaks-the-rules
6 months ago
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What do you think? Should these EMS providers be in danger of losing their licenses for these life-saving actions?
#EMS
www.wkyt.com/2025/09/24/k...
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Ky. EMS team under fire for treating man with antivenom
In May, we brought you the story of James Harrison, the director of the Kentucky Reptile Zoo. He was bitten by a highly venomous Jamesonās Mamba while working.
https://www.wkyt.com/2025/09/24/ky-ems-team-under-fire-treating-man-with-antivenom/
6 months ago
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Is EMS too "stuck in tradition"? Great piece from on how our field still carries relics from its transportation-era rootsāeven as our role has expanded many times over.
#EMS
www.jems.com/ems-operatio...
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Stuck in Tradition: How Our Past Continues to Shape EMS Today
EMTs and paramedics remain certified rather than licensed due to historical regulations focused on transport safety.
https://www.jems.com/ems-operations/stuck-in-tradition-how-our-past-continues-to-shape-ems-today/
6 months ago
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Can you teach situational awareness? Interesting piece from
EMS1.com
about this important topic
#EMS
www.ems1.com/safety/can-s...
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Can situational awareness be taught?
Scene safety and awareness are critical to prehospital patient care
https://www.ems1.com/safety/can-situational-awareness-be-taught
6 months ago
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And once again, ambulance response times are shown to not be as important as once thought.
#EMS
#Ambulance
www.oregonlive.com/politics/202...
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Portland-area ambulance responses got faster, but quality of medical care might be declining
One year after AMR was cleared to change how it staffs its ambulances, signs show it may have had consequences for patient care.
https://www.oregonlive.com/politics/2025/09/portland-area-ambulance-responses-got-faster-but-quality-of-medical-care-might-be-declining.html
6 months ago
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Floridaās anti-vaccine push isnāt just a local issue. The stateās policy creates ripple effects that endanger neighboring states, the entire U.S., and potentially global public health. Simply put, infectious diseases do not respect borders.
#PublicHealth
www.newscientist.com/article/2495...
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Florida's anti-vaccine push leads dangerous shift for US public health
Florida may soon become the first state to end all vaccine mandates, including those for schoolchildren, setting the stage for deadly infections to make a comeback
https://www.newscientist.com/article/2495372-floridas-anti-vaccine-push-leads-dangerous-shift-for-us-public-health/?utm_term=Autofeed&utm_campaign=echobox&utm_medium=social&utm_source=Twitter#Echobox=1757672887
6 months ago
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I appreciate the opportunity to share my thoughts about EMS as an essential service with
@ukrobl.bsky.social
at the 2024 EMS World Expo!
#EMS
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6 months ago
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Great to have the opportunity to speak with you all about such an important topic.
#EMS
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6 months ago
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I think the saddest thing about reading this is that it is all happening in the wake of a world-altering pandemic.
#publichealth
www.cbsnews.com/news/trump-h...
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In the fallout from Trump's health funding cuts, states face tough budget decisions
The Trump administration has pushed a significant amount of health costs to states, whose budgets may already be strained by declining state tax revenues, a slowdown in pandemic spending, and economic...
https://www.cbsnews.com/news/trump-health-funding-cuts-state-budget-decisions/
7 months ago
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Yeh, we are totally not ready for the next pandemic but, at this point, who is really surprised by that statement.
#publichealth
#pandemic
nypost.com/2025/09/07/s...
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The next pandemic could rattle civilization ā and a new book warns weāre not ready for it
Michael Osterholm, University of Minnesota Center for Infectious Disease Research and Policy director, was driving to the airport the morning of Dec. 30, 2019, when his cellphone rang. A colleague ā¦
https://nypost.com/2025/09/07/science/the-next-pandemic-could-rattle-civilization-and-a-new-book-warns-were-not-ready-for-it/
7 months ago
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Honoluluās EMS director went the wrong way on a highway to reach a patientāsparking debate. Without second-guessing, this situation begs the question: how do we weigh urgent response, safety, and community perception when making these split-second decisions?
#EMS
www.civilbeat.org/2025/09/hono...
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Why EMS Director Says He Drove Wrong Way On H-1 Freeway
Nobody got hurt, but one council member said she's concerned the director put public safety at risk.
https://www.civilbeat.org/2025/09/honolulu-ems-director-defends-drive-the-wrong-way-h-1-freeway/
7 months ago
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Florida says vaccine mandates are over. Measles, mumps, polio⦠your VIP passes to the Sunshine State are ready.
#publichealth
#vaccineswork
www.nytimes.com/2025/09/03/u...
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Florida Moves to End Vaccine Mandates for Schoolchildren
https://www.nytimes.com/2025/09/03/us/florida-vaccine-mandates.html
7 months ago
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The CDC is the worldās foremost public health agency. Its leadership collapse isnāt just D.C. dramaāitās a direct threat to our preparedness. You donāt sideline the fire department in the middle of fire season.
#publichealth
www.scientificamerican.com/article/cdc-...
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CDCās Leadership Is in Chaos. Experts React to Crumbling U.S. Public Health Systems
Public health experts warn that the Centers for Disease Control and Preventionās leadership crisisāsparked by the White Houseās efforts to oust CDC director Susan Monarezācould jeopardize national bio...
https://www.scientificamerican.com/article/cdc-leadership-chaos-could-disrupt-pandemic-preparedness-national/
7 months ago
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Itās only a quiet collapse⦠until the next public health emergency.
#publichealth
#preparedness
thehill.com/opinion/heal...
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https://thehill.com/opinion/healthcare/5473546-white-house-pandemic-preparedness-collapse/
7 months ago
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A new national survey shows that 76% of Americans trust their personal physician for health information, compared to only 32% who trust local or state health departments. That gap begs the question: Why?
#publichealth
#publictrust
www.nature.com/articles/s41...
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U.S. trust in physicians as key public health messengers during the H5N1 avian influenza outbreak - Scientific Reports
Scientific Reports - U.S. trust in physicians as key public health messengers during the H5N1 avian influenza outbreak
https://www.nature.com/articles/s41598-025-12304-z
7 months ago
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EMS isnāt glamorousālong nights, tough calls, low pay. But nothing matches being the calm in someoneās worst moment. The best ābadā decision youāll ever make.
#EMS
www.jems.com/ems-operatio...
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The Best Bad Decision Youāll Ever Make: In Defense of EMS as a Career
Being a paramedic means exhaustion, frustration and chaosābut also unmatched pride, purpose and unforgettable moments of humanity.
https://www.jems.com/ems-operations/in-defense-of-ems-as-a-career/
7 months ago
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Five years after the pandemic hit, COVID-19 still lingersānot seasonal, not mild, and often underestimated. Omicron subvariants spread year-round. Long COVID, repeated infections, and low child vaccination rates remind us: weāre not done yet.
#publichealth
#COVID
www.theguardian.com/world/2025/a...
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What do we know about the Covid-19 virus five years on?
As the virus continues to evolve, experts assess its latest variants, seasonal prevalence and levels of vaccine uptake
https://www.theguardian.com/world/2025/aug/07/what-do-we-know-about-the-covid-19-virus-five-years-on
7 months ago
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Mpox is a textbook case of what happens when biological risk collides with political & economic forcesāa clear reminder that global health crises are never just about pathogens, but about the systems that respond to them.
#publichealth
#Mpox
www.npr.org/sections/goa...
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This virus seems like it's no longer a problem. It's still a threat
A year ago, on Aug. 14, 2024, the World Health Organization declared mpox a Public Health Emergency of International Concern. Why are health experts so frustrated by the world's response?
https://www.npr.org/sections/goats-and-soda/2025/08/14/g-s1-82460/mpox-virus-emergency
7 months ago
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EMS is not just a transport mechanismāthey see the cracks in the system. Too many nursing home 911 calls arenāt emergencies. EMS knows the fixes and ignoring their perspective wastes resources and hurts patients.
#EMS
#ambulance
www.ems1.com/geriatric/we...
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We are not a taxi service: Readers respond to preventable nursing home transfers
Medics weigh in on how skilled nursing facility policies and staffing gaps overburden EMS and the ED
https://www.ems1.com/geriatric/we-are-not-a-taxi-service-readers-respond-to-preventable-nursing-home-transfers
7 months ago
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"If you're having a medical event, or I'm having a medical event, do you want an ambulance that's older than the Bush administration to pick you up?". Thats a great question.
#EMS
#ambulance
www.cbsnews.com/pittsburgh/n...
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Examining the budget challenges Pittsburgh is facing
Is Pittsburgh headed for a budget crisis, or is it already in crisis?
https://www.cbsnews.com/pittsburgh/news/pittsburgh-budget-challenges-2025/
7 months ago
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The U.S. pandemic playbook is gone. The White House office that once coordinated biothreat response has been dismantled. We simply canāt afford this level of unpreparedness, all the more so in the aftermath of what we saw during COVID.
#publichealth
#preparedness
www.theatlantic.com/ideas/archiv...
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No One in the White House Knows How to Stop Ebola
We had a playbook for handling biothreats. Then Trump pushed out the people who knew how to use it.
https://www.theatlantic.com/ideas/archive/2025/08/trump-pandemic-preparedness-ebola-outbreak/683810/
7 months ago
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"Unlike police and fire services, which are primarily funded through municipal budgets and taxpayer support, EMS uniquely relies on a reimbursement-based model financed largely through billing patients or their insurers for transport
#EMS
#funding
www.jems.com/ems-manageme...
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EMS Is Not a Business Model and We Are Paying the Price
EMS leaders face mounting pressure as Medicaid cuts, low reimbursements and flawed funding models threaten system stability and readiness.
https://www.jems.com/ems-management/ems-is-not-a-business-model-and-we-are-paying-the-price/
8 months ago
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These type of sign-on bonuses are almost never successful in the long run and, at the same time, they disenfranchise your current employees.
#EMS
#workforce
www.wboc.com/news/kent-co...
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Kent County Approves Sign-On Bonus to Combat EMS Staffing Shortage
Kent County Emergency Medical Services is sounding the alarm on a critical staffing shortage and is seeking a lifeline. To help address the crisis, Kent County Levy Court has approved
https://www.wboc.com/news/kent-county-approves-sign-on-bonus-to-combat-ems-staffing-shortage/article_38a70d7c-d484-488a-b153-e56ad48357d4.html?fbclid=IwQ0xDSwMBXzNleHRuA2FlbQIxMQABHopFnVn8vBdc_biCeFqTxRHemYHd-3ktSL-z1UHAEtqBDPQMtDS6pnOO4zmx_aem_mISEGxJv2HnvQqihebGVnA
8 months ago
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