IFR for hospital transfer flights is certainly doable, eventually. But I do about 70% or so scene flights, and there is no way to do those IFR, in any really meaningful way. If the scene is 10 miles away, on a road or out in a field, trying to get there IFR takes longer for just the planning than it would for the fllight, and then how are you going to do an instrument approach to an unprepared scene for which you don't even have precise coordinates on departure? IFR from the scene to the hospital is possible, if the regs are changed to allow departure from a scene, and there is an instrument approach to the hospital, but with current equipment and procedures, it's out of the question. The US is too large, and has too many different areas and environments for a one-size-fits-all solution. I enjoy IFR flying, but it's not suitable for the EMS flying I do. It may be for other type operations. There has to be some amount of flexibility.