Northlanders with minor ailments or injuries could be redirected to GPs as St John rethinks its allocation of resources in the region.
Record numbers of 111 calls have prompted a review of the St John service in Northland.
In the past five years, Northland's St John workload has risen by 10 per cent, compared with the national average of 4.4 per cent.
The service is considering providing more medical care for patients at home rather than transferring people to hospital emergency departments.
Northlanders with minor injuries or ailments could also be encouraged to see a GP rather than have an ambulance attend their accident/incident.
Northland St John boss Tony Devanney said his staff received about 1400 calls every month or about 17,000 a year - an increase of 50 per cent over the last five years. At that level of growth, he said, frontline St John Ambulance services and patient transfers were unsustainable.
The increase in demand on the service was partly due to people using St John as a "taxi service" for the treatment of minor injuries.
Paramedics have in the past arrived at Northland homes only to find people complaining of tummy aches, flu symptoms, runny noses and cut toes.
Mr Devanney said someone seriously injured may need an ambulance straight away while his paramedics were tied up with these unnecessary calls.
"We are co-operatively working with the Northland DHB to find other options to help each other. One option is to use GP practices to receive minor injured or minor ailments under a Ministry of Health-funded scheme."
He said his paramedics could from this year write prescription for antibiotics, to temporarily treat patients until a GP became available. "Another aspect we need to explore is to encourage the public to use their GPs more and not inundate the ambulance service or hospital emergency departments.
"In the future we may look at other options available to the public from St John, as opposed to transporting them in an ambulance to the emergency departments."
He praised the work put in by his 330 volunteers in 19 stations throughout Northland.
His comments on cost-cutting followed those of Peter Bradley, the new chief executive of St John NZ, who warned that public expectations would need to change if it was to balance demand with a Ministry of Health directive to reduce emergency department presentations by 80,000 nationwide.
However Mr Bradley - the former head of the London Ambulance Service - said his main priority would be the patient, not the bottom line.