Editors’ Expressions: Where Worlds Collide

Senior vice president, cardiovascular and public safety divisions: what a strange job title. But that’s my role here at HMP, the parent company of EMS World (and Cath Lab Digest, EP Lab Digest, Journal of Invasive Cardiology, Vascular Disease Management, and Interventional Oncology Learning, among many others). It’s not likely a title you’ll find searching on LinkedIn or Indeed, but it is the perfect combination for me. For over two decades I’ve worked in both cardiovascular education and as a paramedic, but not until I joined HMP has there been any real crossover of these careers.

I started my career at a large consulting firm, providing healthcare consulting to payers and providers trying to figure out how the emerging system of capitated healthcare would affect their practices and businesses. While this wasn’t my long-term calling, I learned a tremendous amount about the healthcare system. I can develop fancy PowerPoint presentations and perform complex manipulations and formulas in Excel files. I also became expert at sitting on airplanes and sleeping in hotel rooms. I am grateful for the experience, though, since graduating with a liberal arts degree does not always scream “Hire me immediately!”

After a few years it was time to move on. Around the same time as I started at the consulting firm, I also began volunteering as a paramedic with multiple agencies in New York City. When I decided to leave the firm, though, I decided I also needed an insurance policy on my career move, so I started working per-diem as a paramedic on the mobile intensive care units of two different hospitals in New Jersey. I worked one or two nights a week from 7 p.m.–7 a.m.

In April 2000, when everyone (including me) thought the dot-com bubble would provide for early retirements, I launched a website with a few colleagues that provided online marketing and education to interventional cardiologists. There weren’t many doctors on the Internet at the time, but we figured the earliest physician adopters would be those already extensively using technology as part of their practices. Should we start with orthopedists who use pins and drills? Radiologists who look at screens all day? We chose interventional cardiologists: The theory was they used both medical devices (such as those to deploy balloons and stents) and screens (such as those to monitor blood flow and device placement). With that we ended up creating the largest online interventional cardiovascular educational website.

Over the next few years, after multiple acquisition transactions and promotions, my role expanded well beyond managing the website to include management of several cardiovascular conferences throughout the year and world, the largest an interventional meeting of more than 10,000 attendees.

While all of this was going on during the daytime, my alter ego paramedic side continued to work as both a volunteer and paid paramedic in New York City and New Jersey. As a volunteer I’ve provided ALS care through Hatzalah on a 24/7 basis since 1998. As a paid paramedic I’ve worked at multiple hospitals and health systems, with the longest stretch (22 years and counting) as a per-diem paramedic and tour chief on a busy suburban advanced life support (ALS) and specialty care transport unit (SCTU) at Englewood Health.

Interestingly, there are more overlaps as every year goes by. Consider the arenas of STEMI and CVA. The AHA’s Mission: Lifeline project has a goal to “bring stakeholders together in a collaborative manner and reduce mortality and morbidity for these patients while improving overall quality of care and patient outcomes.” Who are some of these key stakeholders? Paramedics and interventional cardiologists. While the STEMI system of care has matured, we are now entering a similar phase for thrombotic (specifically large vessel occlusion) strokes. The need for coordination and partnership among paramedics and the neurointerventional community is paramount to provide the best possible outcomes for these patients.

These are just two examples of the nexus of my efforts—it’s where my two worlds collide.

What a vantage point this career path has provided me. Since 2000 I have been privileged to witness and play a small role in the evolution of the subspecialty of interventional cardiovascular medicine. While angioplasty and stents well predated my career, such innovations as the drug-eluting stent and transcatheter aortic valve, just to name a couple, were engineered and brought to market right in front of my eyes.

One might ask: “Josh, what the hell are you doing?” But all of you, our EMS World readers, already know why I work eight-plus hours daily and then 12-hour (or more) nights weekly, right? EMS is a calling—it’s more than a job. From my first EMT shift at age 18 to the shift I worked this week, the satisfaction I get from treating patients is irreplaceable. Yes, the “rush” of going lights and sirens to the “hot job” faded long ago, but not the appreciation for being allowed into someone’s world at what is likely the worst time of their lives—the trust that is placed in my hands from complete strangers at their most dire moments.

We hope you’re enjoying learning a little more about our EMS World staff. We love hearing from all of you, so please reach out to me at josh@emsworld.com or follow me on Twitter @joshuadhartman. Stay safe.

Joshua D. Hartman, MBA, NRP, is senior vice president of the Cardiovascular and Public Safety divisions at HMP, the parent company of EMS World.