Daren Zigler chuckled when he heard the "Necessity is the mother of invention" quote applied to the Emergency Medical Technician certification program being launched Nov. 30 by LifeStar Emergency Services.
Zigler, LifeStar's EMS manager, has overseen the Winston-Salem private ambulance service's expansion into also being a credentialed teaching institution.
LifeStar's primary focus is providing convalescent transportation on an appointment basis and in response to nonemergency calls in Forsyth and Stokes counties.
The LifeStar EMT Academy has received state approval to condense what is normally a four- to five-month certification program at a community college into an eight-week schedule. It will provide state-credentialed EMT instructors.
The necessity in this instance is keeping LifeStar supplied with EMT candidates.
"We did this out of the necessity for continuing education in this field," Zigler said. "It was a matter of paperwork, equipment and the set-up to do it in terms of credentials for the instructors."
To work on an ambulances in North Carolina, employees must hold a minimum certification level of an EMT.
Zigler said LifeStar currently has 97 EMT technicians for its six-county territory, whereas the company would prefer between 120 and 125 to meet its growth potential. It has 118 employees overall.
"We're a transitional employer, taking someone with no experience," Zigler said.
The pipeline is crucial, Zigler said, because LifeStar experiences about a 25% turnover rate annually.
Mike Hoots, LifeStar's director who founded the company in 2009, said that "because so many of LifeStar’s EMT’s go on to work at either a county EMS agency in the area, often becoming paramedics, or they enter PA/medical school, we expect a certain number of our EMTs will only stay limited time."
Zigler said LifeStar averages hiring one person a week, "but it's not at the rate we need to grow. Overall, we need more people coming in than going out."
"The demand for our services is getting greater, not less. As our population changes, that's not going to change."
"COVID just accelerated the opportunity for this teaching concept, but you can't flip a switch on something like this," Zigler said.
The EMT Academy classes will be held from 8 a.m. to 5 p.m. Mondays through Thursdays except the week of Christmas.
"We're putting in more hours than is required by the state," Zigler said. "It will be intense coursework, but most major tests will be done on Mondays, which gives students three days to prepare."
The cost is $390, which includes books and all classroom fees. Those interested in signing up must contact LifeStar by Tuesday at either www.LifeStar911.com, emailing to email@example.com or calling 336-722-LIFE.
The pipeline has become somewhat drier because of the COVID-19 pandemic, either from potential candidates becoming leery of being exposed to the coronavirus or affordability concerns in the current high unemployment times.
For example, the sign-up goal for the first class was up to 25, but it has since been scaled back to no more than 10 with four slots remaining.
"We're not intending this to be a one-and-done offering," Zigler said.
"But, by having a smaller group, it will be easier to manage and work all the kinks out, consider different formats, and be ready to do it again."
Zigler said the current economy could prove beneficial in attracting people wanting or needing to change careers or finding new work motivation.
“Traditionally, in North Carolina, community colleges have been the primary provider of EMT certification training," Hoots said.
“The demand for EMS workers is so great that we felt it was necessary for LifeStar to join with other teaching institutions by providing the certification program with the ultimate goal of bringing more individuals into the EMT field," Hoots said.
Hoots founded LifeStar in October 2009, fulfilling a five-year entrepreneurial dream.
The company has experience with expanding during rough economic times. It received a six-figure loan from BB&T Corp. in 2009 during a time when many banks remained reluctant to lend to start-up or entrepreneurial companies.
Hoots said that about 35% of LifeStar's EMT employees are getting hands-on hours to go on to PA/medical school. About 10% work part time at LifeStar and work for fire departments, EMS and other health care service groups.
"For about 40% of our EMTs, LifeStar is their primary employer and (they) are on track to expand their career in EMS," Hoots said. "Another 15% have varied reasons to working at LifeStar. This has evolved greatly since 2009."
Hoots said that part-time EMTs work at least 20 hours per week, while full time EMTs work at least 32 hours per week.
"Many of our employees are considered full time, another shift since 2009," Hoots said.
"We are geographically more spread out because our service area is much broader since 2009.”
LifeStar recently expanded to providing convalescent transportation in Davidson, Durham, Orange and Surry counties.
After launching with 40 employees, it now has more than 120 at its facility at 3475 Myer Lee Drive, off Old Greensboro Road.
“Our call volume for transportation services here at LifeStar has greatly increased in recent months,” Hoots said.
"We could add 25 EMTs right now at LifeStar alone, and the need is just as great across North Carolina."
Hoots cautioned that "there is no promise of a job at LifeStar after completing our EMT academy."
"However, for those who do begin work at LifeStar, we will reimburse them for the cost of our study program after they have worked for us for six months.”
Filling the void
Zigler said the pandemic meant a stable workforce for the past eight months, but also served to limit the next wave of potential EMT candidates.
The pandemic also required community college EMT coursework to be reduced in terms of participants to meet social-distancing guidelines.
"It caused a big void for EMT candidates coming into the workforce," Zigler said.
"When medical providers began hiring again in June and July, that was great for our employees ready to move on, but there wasn't the backflow to feed into our system as we were trying to grow in the communities we serve."
At that point, Zigler said, "we decided to fill the candidate vacuum ourselves and train and credential them to where we'd and others would want to hire them."
Zigler said that he joined LifeStar after retiring from Forsyth County EMS in 2018. He wanted LifeStar to "become a teaching institution through the N.C. Office of EMS to provide continuing education and be able to re-credential our own employees."
"We kept an open mind about the teaching educational possibilities, but you typically don't see private companies like ours doing that, maybe five in the state."
For those who desire a career in the medical field, Zigler said a selling point for the academy is that what "they will train on is exactly what these folks will be doing in the field."
"If there's any medical group personnel prepared to handle infectious diseases, it's EMTs."
Zigler said LifeStar is deliberate about its expansion plans, viewing it as a three-legged stool.
"You have to have the demand for services in a new community," Zigler said. "You need the logistical support in terms of equipment and vehicle fleet, and you've got to have the people.
"One can't get longer than the other, and we're very in tune with that. We would rather under-commit and outperform. That's how you keep a good name."
Zigler said that "it sounds weird, but we celebrate our employees when they leave us because typically they are moving on to what they have intended as a career, whether as a physician assistant, paramedic or other medical field.
"They don't forget that they got their start here. We get a lot of referrals from former employees. They tend to say that we're a good place to start.
"That's a good word-of-mouth tool, that we've played a role in molding that future medical person.
"What you learning working for us, you'll carry forward with you the rest of your career."