Editors’ Expressions: It Was 20 Years Ago Today

I’m old. That hasn’t gained me much wisdom, but I’ve collected a lot of stuff. Among it is a complete archive of EMS World print issues going back to the year 2000. We’ve published this thing since 1972, but I’m not sure anyone has a more complete collection. (If you do, contact us!)

It was a different time then. Bill Clinton was president. The top film was Stuart Little, back when rodents were cute, not cannibalistic. EMS World was Emergency Medical Services Magazine, owned by a little publishing mom-and-pop called Summer Communications and housed in the back half of a drab industrial building in a San Fernando Valley back alley. It had just split in a business divorce from a beautician magazine, which was why the only reading material in the men’s room was NailPro and why I still know the secrets to an unforgettable pedicure.

For this blog in the summer of 2020, I thought it might be interesting to comb back through those Y2K issues and see what’s different, what’s not, and how our efforts aged. It was fascinating. I didn’t get farther than January’s.

Oh, right, those stupid gatefold covers. They were split down the middle and opened to create an extra ad spread. You could sell five covers instead of three. They didn’t save, or outlast, Summer Communications.

The advisory board: Huge shouts out to Ken Bouvier, Erik Gaull, Paul Maniscalco, Rick Patrick, Mike Poynter, and Kathy West, on the board then and now—thanks for a remarkable two decades of service. But I’m also stricken by the weight of those we’ve lost: Ed Gabriel, Lou Jordan, Norm McSwain, and Mike Smith. Don’t forget them, please.

The January cover story: forecasts and predictions for 21st century EMS. Now we’re talking! Let’s see how prescient we all were.

The cover suggests it will be a perilous endeavor. Among the newspaper-style copy describing our imagined evolution: Sales of Personal Pocket Defib/Pager Break All Previous Records. True, we now have pocket-size defibrillators, but the idea of marrying one to something as archaic as a pager hilariously illustrates the difficulty of predicting tomorrow. "I foresee the future of computing, and we'll all have much nicer abacuses." 

On to the predictions: “It is my belief that by 2005 we will have seen the last paramedic,” wrote Smith—he saw them being supplanted by better-trained critical care medics and cheaper EMT-Is. Bold swing, Mike, but a miss on the first pitch.

But then we settled in. “The future of EMS will be in studying the science of what we do,” wrote Matt Streger, still an occasional contributor today. “Little of what we do has been proven to have a positive outcome.” Matt nailed this one, as we’ve come far toward recognizing the value of evidence-based medicine and need to be able to demonstrate the benefit of our interventions.

Hank Christen foresaw the triple challenges of new levels of patient care, violence and terrorism, and economic uncertainty—3-for-3, good day at the plate, Hank. Gordy Sachs also projected expanded care through more available technology, including prehospital ultrasound and the transmission of images. He even predicted “mobile medicine,” a future “going beyond the E in EMS” to treat minor injuries at the scene, distribute prescriptions, and refer patients to destinations beyond EDs. Very insightful, as were Dennis Rubin, who also saw expansion into “community healthcare and maintenance,” and Gaull, who anticipated more primary care and injury prevention.

Jon Krohmer, then president of NAEMSP, now head of NHTSA’s Office of EMS, saw an increased importance for medical directors and potential EMS physician specialization—nailed it. West hoped for better, more accessible infection-control and communicable-disease education and information—also mostly achieved, but with a concomitant rise in misinformation no one hoped for.

“EMS will…be challenged to justify its existence,” wrote Patrick. “Does what we do make a difference? Research is the key.” Rick also expected the return of MAST pants, but right on the big point.

This feature went on and on—it occupied an incredible 14 pages out of a book that was 104. (No one predicted shrinking page counts, the demise of print publishing, or that we’d be the only physical EMS magazine still around in 2020.)

All in all, though, this was a pretty accurate set of projections. Kudos to all our participating Nostradamii on their understanding and insight—they knew their field and saw a whole lot of what was coming.

For a more complete look back, watch for our September issue, where we’ll round some of these folks back up to review how their efforts aged. 

John Erich is the senior editor of EMS World. Reach him at john.erich@emsworld.com.