The problems of public access to emergency medical services systems can decrease the effectiveness of emergency care. Much of the public is unable to recognize signs of serious illness, such as myocardial infarction, and dose not know how to obtain emergency medical help. In addition, emergency facilities and personnel are used for more non-emergency care than true emergency cases. Suggestions for the improvement of public access to emergency care include the use of telephones for triage and for providing information; ambulatory centers for non-emergency care; physician extenders such as paramedics or midwives, and improved systems of alerting emergency personnel that an emergency exists.