Research Citation:

National EMS Museum People Files. NEMSM-0003. Jack Stout Collection

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Jack Stout

(1944-2020)

Jack L. Stout is known in the EMS industry as the Father of High Performance EMS and System Status Management.  Jack’s concepts were developed in the 1980’s as an answer to fix failing EMS systems that were expensive, unreliable and didn’t meet EMS’s prime directive of:

“Provide each critical patient the best possible chance of survival without disability or medical complication, given the current state-of-the-art of prehospital care technology”

An economist by trade, Jack found that applying the science, concepts, economics and techniques used in manufacturing to a service industry produced an unprecedented ability to provide high quality, highly reliable EMS systems that could also afford to provide the best prehospital medicine available.

Frequently controversial, Jack’s approach also maintains that free market competition in the EMS environment is dangerous as Jack recognized that demand for EMS services is not effected by the normal market forces of supply, price and quality, but rather is based purely on mostly uncontrollable factors like population age, socioeconomics, health, education, culture, location etc.  Given this, free market competition actually hurts patients as competing EMS agencies (that are typically geographically constrained to a certain service area) share a fixed demand for these services and therefore also share a fixed reimbursement pool that can not expand based on the supply of EMS resources.  This, plus the fact that open market competition drives down prices, creates an environment of uncoordinated care, loses economies of scale, can not provide reliable and consistent service and is unable to provide the best clinical sophistication due to the economic conditions that occurs in these environments.

Jack’s solution to this problem was the development of the Public Utility Model (PUM) and Failsafe Franchise EMS System Designs.  These approaches to service delivery provide a mechanism for cities and counties to eliminate the issues that multiple competing EMS service providers bring while preserving free market enterprise to allow to compete with each other through a competitive bid process.

Information above provided by JackStout.com

Jack Stout made his first mark on EMS with a series of writings in the Journal of Emergency Medical Services (JEMS) entitled The Public Utility Model in which he laid out his observations of a new concept in pre-hospital care system management. The Public Utility Model was conceived through a theoretical analysis of the system of pre-hospital care delivery by a team at the University of Oklahoma under the leadership of Stout.  This study and the resulting reports would shape Stout’s career and ultimately help guide system development across the county. But it was, and continues to be, radical thinking, and as we move towards community centric care, Jack’s vision for EMS systems are an ever guiding light for industry leaders today.

The Public Utility Model Report and Observations were printed in three parts in JEMS in 1980, with a retrospective printed in 1985. The articles can be read here:

The Public Utility Model Part 1: Measuring Your System. 1980, May (22-25)  JEMS

The Public Utility Model Part II: The Principal Elements. 1980 June (35-41)  JEMS

The Public Utility Model Part III: The Major Constraints. 1980 July (35-37)  JEMS

Public Utility Model Revisited: Part 1 , Origins. 1985, February (55-58, 62-63)  JEMS

Public Utility Model Revisited Part 2: 10 Essential Features. 1985, March (71-74)  JEMS

Tulsa, Public Utility Model Revisited: Part 3. 1985, May (58-64)  JEMS

Additional publications can be found in the collection listed below.

National EMS Museum Resources

Watch Todd Stout’s Coffee with Doc session to hear about Jack’s work during his lifetime and the legacy he left behind:

Jack Stout Collection is being digitized by the National EMS Museum with special funding from FirstWatch & Academy of International Mobile Healthcare Integration (AIMHI).

Thank you FirstWatch, AIMHI, and the Stout Family for ensuring these important papers are preserved for generations to come!

More information about FirstWatch can be found here: https://firstwatch.net/

Additional information about AIMHI can be found here: http://aimhi.mobi/

Archival Arrangement

Below you will find a collection of Jack Stout’s published work organized by year. The month of the publication is followed by the title, page number and journal.  Additional content notes are included in brackets.

To view any of the articles click on the link at the end of each line. If you are on a mobile devise you may need to download the articles to view them (click the link and select download on your devise).  Should you experience any difficulty accessing or using the key word search please contact us at info@emsmuseum .org

Additional writings will be added to this list as they are digitized and indexed.  Please submit written requests to copy to info@emsmuseum .org

1980

May, 1980. Public Utility Model (PUM) Part I: Measuring Your System. (22-25)  JEMS  Click Here to View Article

June, 1980. The Public Utility Model (PUM) Part II: The Principal Elements. (35-41)  JEMS  Click Here to View Article

July, 1980. The Public Utility Model (PUM)  Part III: The Major Constraints. ( 35-37)  JEMS  Click Here to View Article

1981

September, 1981. Nightmare in Kansas City. (32-45) JEMS  Click Here to View Article

1983

January, 1983. 10 Standards of Excellence: Measuring Your System. (84-91)  JEMS   Click Here to View Article

May, 1983. System Status Management: The Strategy of Ambulance Placement. ( 22-32)  JEMS. Click Here to View Article

July, 1983. Public-Private Interface. (54-61)  JEMS  Click Here to View Article

August, 1983. Letters and Jack Stout reply. (11)  JEMS  Click Here to View Article

August, 1983. Showdown in Ft. Wayne, Indiana. (54-59)  JEMS  Click Here to View Article

September, 1983. Performance Security. (53-56)  JEMS  Click Here to View Article

October, 1983. Its Hard to be Afraid. (68-75)  JEMS   Click Here to View Article

December, 1983. Trauma Center ABC Style. (52-59)  JEMS  Click Here to View Article

1984

January, 1984. Giving the Best Edge. (103-107)  JEMS  Click Here to View Article

February, 1984. How Much is Too Much? (26-34)  JEMS  Click Here to View Article

March, 1984. State Regulations and ALS. (50-60)  JEMS  Click Here to View Article

May, 1984. Kansas City Revisited. (50-71)  JEMS  Click Here to View Article

May, 1984. Special Report: Priority Dispatching vs Call Screening. (34-39)  JEMS  Click Here to View Article

June, 1984. Letters: Rx for Medical Control by Jack Stout (6)  JEMS  Click Here to View Article

June, 1984. Fire Service EMS as Public Utility Model. (91-96)  JEMS  Click Here to View Article

July, 1984. Cutting the Fog in Santa Ana. (51-57)  JEMS  Click Here to View Article

August, 1984. Letters and Jack Stout reply. (8,11)  JEMS  Click Here to View Article

August, 1984. When to Say No: Eight Tips for Evaluating Ambulance Service Contracts. (46-52)  JEMS  Click Here to View Article

September, 1984. Contract Competition: Is Your Company Ready? (73-79)  JEMS  Click Here to View Article

October, 1984. Around the Nation by Dana Jarvis: Jack Stout update on Santa Ana. (28) JEMS  Click Here to View Article

October, 1984. Federal Policies Promote Socialized Prehospital Care. (92-94, 99)  JEMS  Click Here to View Article

December, 1984. Socialized Prehospital Care, Part 2. (51-54)  JEMS  Click Here to View Article

1985

January, 1985. Ambulance Maintenance. (65-69)  JEMS  Click Here to View Article

January, 1985. 1985: A Turning Point. (105-108)  JEMS  Click Here to View Article

February, 1985. Public Utility Model Revisited: Part 1, Origins. (55-58, 62-63)  JEMS  Click Here to View Article

March, 1985. Public Utility Model (PUM) Revisited: Part 2, 10 Essential Features. (71-74)  JEMS  Click Here to View Article

May, 1985. Tulsa, Public Utility Model (PUM) Revisited: Part 3.  (58-64)  JEMS  Click Here to View Article

July, 1985. Letters and Jack Stout reply. (9-10)  JEMS  Click Here to View Article

July, 1985. Comparing Ambulance Rates. (46-51, 54-57)  JEMS  Click Here to View Article

August, 1985. Please, Don’t Call it Competition. (38-43)  JEMS  Click Here to View Article

September, 1985. Forms of Competition.  (66-71)  JEMS  Click Here to View Article

October, 1985. The Failsafe Franchise Model.  JEMS  Coming Soon

November, 1985. The Designer Dilemma. (6)  JEMS  Click Here to View Article

1986

January, 1986. Ambulance Systems Designs. (85-99)  JEMS  Click Here to View Article

February, 1986. Antitrust and You: An Overview of the Sherman Antitrust Laws, by George E. Leonard, additions by Jack Stout. (58-62)  JEMS  Click Here to View Article

March, 1986. Exemption from Antitrust: Limited Exemptions of the Sherman Antitrust Laws, by George E. Leonard in Jack Stout’s Interface column. (80-81)  JEMS  Click Here to View Article

April, 1986. Joint Ventures and Antitrust: Bringing together competitors for join ventures can be dangerous, by George E. Leonard.  (66-70)  JEMS  Click Here to View Article

May, 1986. You Ain’t Seen Nothin Yet.  (32-36)  JEMS  Click Here to View Article

May, 1986. What The Feds Should Know: An Open Letter to the Inspector General.  (70-75)  JEMS  Click Here to View Article

July, 1986. No Hard Feelings. (99-100)  JEMS  Click Here to View Article

August, 1986. Letters: July Letters Revisited. (12)  JEMS  Click Here to View Article

August, 1986. Peas in a Pod. (63-64)  JEMS  Click Here to View Article

September, 1986. Strong Words Weak Arguments.  JEMS  Coming Soon

October, 1986. Why Subscription Programs. (71-75)  JEMS  Click Here to View Article

November, 1986. Our Elected Officials. (67-72)  JEMS  Click Here to View Article

December, 1986. Computer Aided What?  (89-94)  JEMS  Click Here to View Article

January, 1987.  Correction to December 1986: Computer Aided What? (11)  JEMS  Click Here to View Article

1987

January, 1987. Who’s Really the Primary Provider: Another View of the 150 City Survey.   JEMS  Click Here to View Article

May, 1987. Letters: Salary Controversies. (6 & 9)  JEMS  Click Here to View Article

May, 1987. Letters: The Great Debate. (13-14)  JEMS  Click Here to View Article

May, 1987. Was It Good For You: Ten Great Expectations for Management and Paramedics. (53-55)  JEMS  Click Here to View Article

June, 1987.  Fire vs Private EMS. (84-86)  JEMS  Click Here to View Article

July, 1987. Privately Speaking About…The Battle of the Bids.  JEMS  Coming Soon

August, 1987. Contracting for Vehicle Maintenance. (81-85)  JEMS  Click Here to View Article

September, 1987. Measuring Response Time Reliability. (106-111)  JEMS  Click Here to View Article

October, 1987. Accreditation for What?  (79-85)  JEMS  Click Here to View Article

November, 1987. Emergency Vehicle Driver Training : Two Schools of Thought. (80-83)  JEMS  Click Here to View Article

December, 1987. To Bid or Not to Bid. (65-67)  JEMS  Click Here to View Article

1988

January, 1988. The Inflation-Indexed Charge.  (120-122)  JEMS  Click Here to View Article

February, 1988. Lets Dump the Prevailing Rate Approach. (63-68)  JEMS  Click Here to View Article

March, 1988. Organizing Quality Control in EMS. (67-74)  JEMS  Click Here to View Article

April, 1988. Corporate Image. (69-70)  JEMS  Click Here to View Article

May, 1988. Passing the Gear, by Jim Page. (5)  [observation on Jack Stout system operations]  JEMS  Click Here to View Article

June, 1988.  A Concept Worth Stealin’.   JEMS  Click Here to View Article

August, 1988. The EMS Subsidy: Price Tradeoff.  JEMS  Click Here to View Article

October, 1988. My Sector, Right or Wrong. (70-80)  JEMS  Click Here to View Article

October, 1988. The Black and White World of Private EMS, by Nancy Peterson. [Jack Stout quotes]  JEMS  Click Here to View Article

November, 1988. The Black and White World of Private EMS, by Nancy Peterson. [Jack Stout quotes]  JEMS  Click Here to View Article

1989

February, 1989. Letters: Jack Stout reply.  JEMS  Click Here to View Article

February, 1989. Controlling Emergency Fleet Operating Costs. (67-69)  JEMS  Click Here to View Article

April, 1989. System Status Management: The Fact Is, Its Everywhere. (65-71)  JEMS  Click Here to View Article

June, 1989. Wrestling with the Big Three Policy Issues. (79-81)  JEMS  Click Here to View Article

August, 1989. Peak-Load Staffing: What’s Fair for Personnel and Patients.  JEMS   Click Here to View Article

September, 1989. In the Industry:  Jack Stout to USSR.  JEMS  Click Here to View Article

November, 1989. Charting the Path of Clinical Progress. (79-87)  JEMS  Click Here to View Article

December, 1989. EMS in the Soviet Union: The Granddaddy of Socialized Prehospital Care.  (60-65)  JEMS  Click Here to View Article

1997

September, 1997. Capture the Competitive Edge, Part I.  JEMS  Coming Soon

October, 1997. Capture the Competitive Edge, Part II.  JEMS  Coming Soon

Additional Resources

A collection of Jack Stout’s writings can be found at:   jackstout.com