MSBMEDIC

its a joke all of us in ems have weird humors, besides the "asian" population in canada is high.

i love canadians, please tell me. besides i even went to canada once, i think its called hong kong.

ok people, i apologize. i'm not anti fire but where i'm from it seems these union fire guys act like the "second coming". i have no criminal background, not even a dui and i have family on the fire side who ride around in the "fire trucks" and rescue little kittens stuck in trees( dont tell my sister i said that). i'm just looking for a new frontier to work in doing something i like to do and for now looking at a private ambulance company called sunstar located in pinnelas countty give me some info on them any info you got, like what do they pay for a 15 yr. medic who's healthy, jokes, worked "911" side(inside a fire house) and taken gramas & grandpas to dialysis apts. if you give me this info i'll be nice, even to the canadians( for awhile). so accept my sorry for saying bad things were all in this together.

hey canadian prick, i'm not a criminal, just looking for simplicity, but you canadian pricks dont understand that do you?.

you know what i'm trying to get at, private vs. fire side. once again whats up in florida, tampa bay area?

i'm a non-union worker and not a fan of being employed by a gov.( town,city,county) that employs union workers, like most do. looking for independent company(for profit) that if has a contract with a goverment, ok, but not where i sit inside a fire house and forced to jerk off union guys while listening to there b.s. storys of heroics.

looking for private ambulance companys in florida, i know of some but need more info.

so its like jonny and roy waiting for the amb. drivers to arrive and t/p their patient with one of them on amb. and the other driving "rescue squad" 51. do we run up with stretcher and listen, not ask. follow their orders and smile and state "you are my hereo" and if they say bend over we state, "yes sir", do you want lube or not?. i'm curious, because these "fire gods" are there to assist you and provide info. about patients. let's go people give me some answers, why is southwest always hiring emt/medics is it because there expanding or because they have poor management skills, "fire gods" bother people's anal cavity too much, ect...

sorry, just got off shift(24) this a.m. and havent taken nap...

HEY PEOPLE NEED YOUR OPIONS ON SOUTHWEST AMBULANCE, NOT SO MUCH ABOUT PAY, BENEFITS,ECT.., BUT MANAGEMENT, FIRE DEPTS TX. OF SOUTHWEST EMPLOYEES AND THEIR TX. OF ONE ANOTHER. DO PEOPLE STAY AT SOUTHWEST. WHATS THE YEARLY TURNOVER OF EMPLOYEES. LOOKING FOR POSSIBLE EMPLOYMENT IN THAT AREA, FOR 911 SERVICE, NON GOVT., PRIVATE COMPANY ONLY.

get ready fire gods a communist city like san fran wanting competitionThe San Francisco Chronicle (California) San Francisco's public health director has decided to invite additional private ambulance firms to help the Fire Department cover 911 emergency medical calls on the city's streets. The decision by Dr. Mitch Katz to establish a "nonexclusive zone" for emergency ambulance services follows a recent state ruling that advised the city to put those services to competitive bid. But the health czar has balked at preparing a bid package for 911 medical services, a move that experts warned could create logistical problems and lower the quality of services, with private firms vying to serve neighborhoods where there are fewer homeless and uninsured patients. "This is the worst of all the solutions they could pick," said Richard Narad, a professor of health and community services at Chico State University who is an expert on California ambulance law. "You will have a system that will cost more, that will be less accountable and provide a lower level of service. And I don't understand why Katz would decline to put it out to bid, which would result in a provider who meets county standards and is accountable to the public and is likely to cost less." Narad said such competition for patients creates a highly expensive dispatch dilemma of determining which ambulance is closest, and will also result in an increasing number of ambulances flooding into the system - which will lead to higher costs that will be passed on to consumers. But Katz said dispatching the closest available ambulance to 911 calls will help reduce response times, especially in outlying areas that are not close to a fire station. On July 31, the state's Emergency Medical Services director, Dr. Steve Tharratt, ruled that San Francisco's 911 ambulance services, which have been dominated by the Fire Department since 1997, do not qualify for antitrust protection from the state because of a lack of competition among the city's emergency ambulance providers. Tharratt said private ambulance firms handle fewer than 2.4 percent of the city's 911 ambulance services. The state ruling has sparked consternation among Fire Department administrators, fire and paramedic union leaders and two private ambulance firms that already provide backup emergency ambulance services in the city. "Effective immediately, San Francisco will no longer maintain an exclusive ambulance zone," Katz wrote in an Oct. 3 letter to Fire Chief Joanne Hayes-White. "If there are additional EMS providers who meet the requirements for advanced life support ambulance services, we will welcome them into our system ... Having additional providers may enhance our system by providing additional capacity." Katz said in a telephone interview Monday that the city was in "a weak position" to challenge the state's ruling. He also said that, with his creation of an open system for qualified ambulance providers, the state has no grounds to require a competitive bid process. "Providing pre-hospital care is part of our core mission, and we're devoted to it," Hayes-White said. "We're not going to change the way we do business at all." David Nivens, president of the California Ambulance Association, said that he was unaware of another urban area in California that has successfully operated a nonexclusive zone for emergency ambulance services. But, he added: "I would think that San Francisco would be an attractive market ... It's small and there's a large population there." David Andersen, a quality improvement expert in 911 ambulance services who worked previously for the San Francisco Fire Department, said that private ambulance firms may resort to "cream skimming" - only responding to calls in neighborhoods where patients are more likely to afford these services. John Hanley, president of firefighters union Local 798, questioned the qualifications of outside ambulance firms and the impact Katz's decision will have on the city's revenues. "We have extremely high standards on patient care," he said. "Do the ambulance companies that will be doing this work have our standards on patient care?" Private ambulance firms were skeptical about Katz's latest move. "We'd hate to go back to the ambulance wars of years gone by," said Jerry Souza, general manager of American Medical Response, which already provides backup 911 ambulance services in the city. "Ultimately, we're concerned about quality and a dilution of levels of competencies by new providers who might come in." -------------------------------------------------------------------------------- Copyright 2008 LexisNexis, a division of Reed Elsevier Inc. All rights reserved. Terms and Conditions | Privacy Policy RSS Feeds for EMSResponder.com: Top EMS News Section -------------------------------------------------------------------------------- Share your thoughts, advice, opinions, and expertise @ EMSResponder.com Submit a comment Email Alerts Industry Blast EMS NewsWeek EMS Expo Alerts Product Showcase Magazine News

yes, any private amb. in this country is hiring for medics. why is this you ask. simple we dont need millions of dollars spent on ridiculas fire equipment and pretty stations with flat panel digital screen tv's hooked up to sattelites. massive amounts of time off paid to fire gods with huge pensions and all the citizens bowing down to them thinking that these fire gods are here to save them. simply put less money on fire gods side and more money on private amb. side due to the need for more medics to treat and transport the sick and injured.

let's do this, have every medic obtain a bs in physiology and then train countless hours on practicality of being a paramedic and after 4-5 years total have them apply for a medic and then get paid annual saluary of 40,000-45,000 in oklahoma. then wait after they become new employees of a company that pays low wages due to low pay of care by private, medicare, and medicaid insurance to these companys, they have to become nremt-p, cct-p, acls, phtls, pals, and dont forgrt CPR certified. after all this education and training you will not have one medic working the streets. THATS WHY YOU FORMER MEDICS ARE NOW RN'S AND ACTING LIKE SECOND COMING, BUT NOTHING MORE THAN WAITRESSES RUNNING FROM ONE RM. TO THE NEXT. SIMPLICITY IS HERE TO STAY... AND WITH 75 MILLION BABYBOOMERS NEARING THAT AGE WE WILL NEED TO STOP CPR, PUT MORE MEDICS ON THE STREET, PUT LESS MONEY INTO " FIRE EQUIPMENT" AND MORE INTO EMS ( WE SHOULD'NT HAVE FIRE STATIONS, WE NEED MEDICAL STATIONS), PAY MEDICS MORE IN SALUARY, BENEFITS, ECT... IF YOU WANT THEM TO LEARN MORE SIMPLICITY IS HERE AND IF YOU WANT US TO LEARN MORE "NURSE RATCHET", GIVE US THE MONEY.

that was awesome. good laugh

I had the opportunity to attend a life-saving ceremony about 15 years ago. The EMS service involved was featuring and touting its EMTs and paramedics as walking messiahs who could bring virtually anyone back from the dead. One EMT or paramedic after another paraded onto the stage to receive a medal for bringing someone back to life after the patients heart and lungs stopped functioning. At one point, the ceremony was stopped, and the master of ceremonies asked one paramedic to turn and face the crowd as he proclaimed that this individual was responsible for saving eight people in the previous year. Wow! That was fantastic. I thought this guy must be like one of those preachers I see on television who can lay hands on someone and cure a disease that had plagued the person for years. The ceremony continued and the long line of employees continued to parade onto the stage as family, friends and fellow employees applauded their achievements. After the ceremony, there was plenty of picturing taking as the EMTs and paramedics held up their awards for the cameras or posed for group photos. At the eat-and-greet function after the ceremony, I told the EMS division chief that it would be great if some of the cardiac arrest survivors could have been at the ceremony to be reunited with their rescuers. The division chief replied that the department could find only one such survivor and that the person was already scheduled to be out of the country on a cruise. Wait a minute youre telling me that out of all these saves that you handed out medals for today, you could only find one patient? Yes, the division chief confirmed. I told him I did not understand. He explained that the agency defined a save as anytime a paramedic restored a heartbeat on a patient and the person made it to the floor of the hospital. He said the agency also considered anything a save if the emergency room restored a heartbeat and the patient made it to the floor after the crew began resuscitation efforts in the field. What happens, I asked the division chief, if the patient dies on the hospital floor three days later or remains the rest of his or her life on a respirator because there is no brain function? The division chief said that his service still considered that a save. I left the ceremony a bit confused, since I considered a save someone who walked out of a hospital. A series of articles in USA Today last year looked at the 50 most populous cities in the United States and found cardiac arrest survival rates ranging from nearly zero to claims by some cities of survival rates topping 20%. The series made some cities look terrible at saving victims of cardiac arrest while other cities like Seattle (45% save rate), Boston (40%) Kansas City (20%), San Francisco (22%), Houston (21%), Tulsa (26%) and Oklahoma City (27%) looked great. Why the discrepancy? Were the other cities so bad or were places like Seattle and Boston so good? Part of the secret of success may be the system, but the way in which cities measure cardiac arrest survival rates can provide favorable or unfavorable statistics. It all depends on how some cities measure cardiac arrest survival or, as one may suggest, cook the books. The cities that can claim cardiac arrest survival rates over 20% use a standard for measuring cardiac arrest survival called the Utstein template. In the 1980s, all around the world, the survival of cardiac arrest victims was measured in different ways and different formats. In response to these differences, the Utstein template came about after an international group of scientists met in June 1990 to address their concerns with research involving out-of-hospital cardiac arrest. These scientists met at the Utstein Abbey in Stavanger, Norway. A second meeting was held in December 1990, in Brighton, England, and was referred to as the Utstein Consensus Conference. Recommendations from the follow-up conference were published simultaneously in American and European medical journals. The report included uniform definitions, terminology and recommended data sets (the Utstein style) to assist clinical investigators in reporting human resuscitation studies. With the Utstein template, only those victims who have a good chance to be saved are counted. Further, the Utstein template counts only those survivors who leave the hospital without serious brain damage. Looking at the Utstein template, you begin to realize how some cities have over a 20% survival rate while others linger below 5%. The Utstein template removes any victim who is in cardiac arrest because of trauma. Think about how many trauma victims you have seen survive cardiac arrest. If your experience is like mine, hardly any survive. If you measured cardiac arrest survival rates and included trauma victims, it would immediately lower your percentage. The Utstein template counts only patients who suffered a witnessed arrest and had an initial EKG of ventricular fibrillation in the percentage numbers. Other rhythms like asystole are not counted. One benefit of a witnessed arrest is that there is a good possibility that a bystander started CPR, which also increases success percentages. Unfortunately, few EMS systems in the U.S. use the Utstein template for determining survival of cardiac arrests in their communities. And since most EMS systems are judged based on their cardiac arrest survival rates, (although they usually make up less than 1% of calls), a low survival rate reflects poorly on the EMS system. Bottom line if you measure only those cardiac arrests that involved witnessed arrests and the patients were in ventricular defibrillation, your numbers would improve. Some people would say this is cooking the books. Id say it is better to be accurate than to parade a bunch of people to receive medals when they really did not save anybody. -------------------------------------------------------------------------------- Gary Ludwig, MS, EMT-P, a Firehouse® contributing editor, is deputy chief of EMS in the Memphis, TN, Fire Department. He has 28 years of fire-rescue service experience, and previously served 25 years with the City of St. Louis, retiring as the chief paramedic from the St. Louis Fire Department. Ludwig is vice chairman of the EMS Section of the International Association of Fire Chiefs (IAFC), has a masters degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally. He can be reached through his website at www.garyludwig.com. To purchase single article reprints (minimum 250) for distribution please contact: PARS International at 212-221-9595 x431 or at www.magreprints.com/quickquote.aspx?ID=cygnus -------------------------------------------------------------------------------- Share your thoughts, advice, opinions, and expertise @ EMSResponder.com Submit a comment

Simple guideline can identify which patients should be brought to hospitals when emergency efforts to revive them aren't working ANN ARBOR, Mich. , Sept. 23 /PRNewswire-USNewswire/ -- When someone's heart suddenly stops beating -- a condition called cardiac arrest -- there's a lot that bystanders and ambulance crews can do to get it started again. But if the victim doesn't respond, when should such efforts stop? And when should emergency crews rapidly transport a patient to a hospital with lights and sirens on, potentially endangering the lives of paramedics and other motorists and pedestrians -- even though the care provided by the emergency crew is the same as what can be provided in the emergency department? Currently, there's no one "right" answer to these questions, which arise in the majority of the cardiac arrests that strike 166,000 Americans each year -- and kill 93 percent of them. As a result, emergency medical services crews and hospital ER teams spend countless hours and healthcare resources on patients who have no chance of making it home alive -- at the expense of other patients who need an ambulance or have spent hours in an ER waiting room. Now, a new study in the Journal of the American Medical Association shows that a single standard guideline could help EMS and ER teams determine which cardiac arrest victims might benefit from a trip to the hospital, while at the same time reducing futile efforts on patients who have no chance of surviving a cardiac arrest. The study shows that EMS teams can use either a simple five- or three-part rule to determine when they should discontinue efforts to revive cardiac arrest patients on the scene where their heart stopped beating. The same rule will also tell them when they should keep trying to resuscitate the patient while transporting him or her to the nearest ER. The three-part rule may be sufficient to identify 99.8 percent of those who need to be transported to the hospital for further care, the researchers say. The study was performed by a team from the University of Michigan Health System, Emory University and the Henry Ford Health System, using data from 5,505 cardiac arrest patients treated in eight metropolitan areas around the U.S. It did not include patients who suffered a cardiac arrest after a non-heart incident such as drowning. It was funded by the Centers for Disease Control and Prevention. Comilla Sasson , M.D., M.S., is the study's lead author and a Robert Wood Johnson Clinical Scholar at the U-M Medical School. An emergency physician herself, she began the study after many frustrating experiences in a Chicago ER where she had to stop caring for other critically ill patients whenever a cardiac arrest patient came in the door -- no matter how futile it might be to try to bring the patient back, and no matter how time-sensitive the needs of the other patients in the ER. Now at the U-M Department of Emergency Medicine, Sasson teamed up with an Emory University group that has been tracking cardiac arrest response. The Emory effort, called CARES, helps EMS crews and hospitals find ways to improve care. "Many cardiac arrest patients are successfully resuscitated at the scene, with the help of automated external defibrillators and CPR, and the hospital is the right destination for them," Sasson says. "The question has been what to do about patients who fail to respond, despite the best efforts of an EMS team. This study confirms previous findings, and shows that a standard rule could ensure that the right patients get to the hospital while allowing us to use scarce resources wisely." Sasson notes that many advanced EMS crews now have nearly all the tools and training that ERs have for reviving cardiac arrest patients, including artificial airways, heart-starting injectable drugs and more. Many have radio contact with an emergency doctor at the local medical control authority. In addition, automated external defibrillators (AEDs) are now available in many public places for bystanders to use to restart a stopped heart, in the crucial minutes before an EMS team arrives. But even still, some patients just don't respond, or their heartbeats are too erratic for the AED to determine that a shock can be delivered. Then, the question for the EMS crew is whether it's worth the risk to the patient, the crew, and nearby motorists and pedestrians to race to the hospital with sirens blaring and lights flashing, and then to tie up the ER team to try to revive the patient. In the new study, EMS crews pronounced 947 (17 percent) of the 5,505 patients dead at the scene between late 2005 and early 2008. The other 4,558 were transported to one of 111 hospitals by one of 19 EMS agencies. But only 7.1 percent of those transported patients survived long enough to be discharged from the hospital alive. Sasson and her colleagues, including Bryan McNally , M.D., MPH, and Arthur Kellermann , M.D., MPH of Emory's Department of Emergency Medicine, analyzed the medical records from all 5,505 patients. They ran statistical analyses to determine which patients would have been transported, or survived, if EMS crews had applied the three-part or five-part rule, both of which were developed by a Canadian team as part of the Ontario Prehospital Advanced Life Support study. The three-part rule, called a 'basic life support' or BLS rule, calls for EMS teams to end their resuscitation efforts if a cardiac arrest occurred before EMS arrived, if no defibrillator was used (for instance, because there was none for a bystander to use, the EMS crew didn't have one, or an AED did not detect a shockable rhythm), and if the team can't get the patient's blood to begin circulating again. All three must apply for resuscitation efforts to be stopped. If ambulance and fire crews had applied the three-part rule, about 47 percent of all the cardiac arrest patients in the study would not have met the criteria to be transported by ambulance to the hospital. This means that 2,592 patients would have been pronounced dead at the scene -- potentially saving 1,645 trips to the ER, compared with what actually happened. The five-part rule, called the 'advanced life support' or ALS rule, adds two more criteria to the list: the cardiac arrest had no witnesses at all, and no bystander attempted to perform CPR. If this more conservative rule had been applied to the 5,505 cardiac arrest victims in the study, 1,192 patients would have been declared dead at the scene, saving 245 trips to the ER. Then, the researchers looked at what actually happened after the patients made it to the hospital, and compared it with what might have happened if the two rules had been applied. Only 70 patients who would have been declared dead under the BLS rule survived the ER treatment and were admitted to the hospital. But only five were discharged from the hospital alive, and four of them were able to live a relatively normal life afterward. Meanwhile, only 24 patients who would have been declared dead under the more conservative ALS rule were able to be resuscitated in the ER. None of them survived long enough to be sent home from the hospital. In other words, the BLS rule misclassified only 0.2 percent of patients, and the ALS rule classified all patients correctly. Either rule, the authors say, could be used -- but the BLS rule would save the most emergency medical resources while still meeting ethical criteria for medical care. "Through our study and others, the BLS rule has now been applied to more than 10,000 patients in the U.S. and Canada , with less than a 0.1 percent misclassification rate," Sasson says. "Currently, EMS systems vary widely in the care they deliver to cardiac arrest patients. To implement the BLS rule more widely would standardize the care and transport of these patients, so that we can reduce the risk of injuries or death to EMS personnel and the public in high speed transports, decrease the pressure on our overcrowded ER's, allow our ER staff to focus on patients who can be treated, and open up intensive care unit beds." In addition to Sasson, McNally and Kellermann, the study's authors are A.J. Hegg , M.D., a third-year Emergency Department and Internal Medicine resident at Henry Ford Hospital in Detroit ; Michelle Macy , M.D., of the U-M Department of Emergency Medicine, and Allison Park , MPH, of the CARES project. CARES stands for Cardiac Arrest Registry to Enhance Survival. Reference: JAMA, Sept. 24, 2008 , Vol. 300, No. 12. SOURCE University of Michigan Health System

Sheryl Ubelacker, THE CANADIAN PRESS The Toronto Star There is a huge variation in survival rates among people who receive emergency treatment after suffering cardiac arrest - and the overall prognosis is poor at best, a study of 10 Canadian and U.S. cities and regions has found. Researchers from the two countries found that overall, less than 8 per cent of people who were treated by paramedics or firefighters for cardiac arrests in the home or elsewhere outside hospital were successfully resuscitated. Seattle had the best survival rate at 16 per cent, while Alabama had the lowest at 3 per cent. In Toronto andOttawa region, just over 5 per cent of treated victims lived, while in Vancouver, 10 per cent survived. Cardiac arrest is different from - but may be caused by - a heart attack. It occurs when the heart suddenly stops beating and the person is no longer breathing. One major cause is disruption of normal heart contractions, such as that caused by ventricular fibrillation. Lead author Dr. Graham Nichol of the University of Washington said the key to saving lives is a quick response by bystanders, who need to perform immediate and continuous CPR until paramedics or firefighters arrive to treat and transport the patient to hospital. In the study, published in this week's Journal of the American Medical Association, researchers looked at more than 20,000 cardiac arrest cases between May 2006 and April 2007. Resuscitation was attempted in less than 12,000 cases - and only 954 of those felled by a cardiac arrest lived to be discharged from hospital.

don't get stats from AHA, or you will get stats that say grandma and grandpa are saved 50% of the time. people we are at a time when 70 million so-called baby boomers are at the age where people start to become weak, ill, and dye. let's go to the preventive side and enchorage these people to seek and get better care. in addition we can recieve beter training through use of meds, matterials, and tools to prevent this when these pts. are at our side! asking for help. bye the way who has the stats that state what i said about cpr, everyone who works in the medical field, especially "911" and er personell. just ask one another this simple question. how many people have you seen or done yourself who were "dead" that you brought back by using cpr. everone knows there are no suprises. lets stop CPR!!!!!

there are a few questions that are being asked these days on and about cpr. questions that are starting to make people worried, like american heart assoc.. companys that make lots of money promoting these procedures through schooling, books, materials, and govt. handouts. why are these questions being asked and by whom?. this is a simple answer, its us, the emt/medics. the reason is simple as well, its because CPR does'nt revive people who are pulseless and non-breathing and never has. now before you become angry and start to scream and think of cuting my manhood off with old trama shears let me point out to you people the stats. on cpr revival. first those few pts. that we get that are in cardiac arrest due to drownings, cold exposure, children, and new borns lets leave out of the equation. CPR success rates are only one tenth of one percent and of pts who are found pulseless and non-breathing only 1 percent of that rate walk out of the hosp without major brain injuries resulting in being on vents, severe disibilitys and living in a n.h. for a few years with severe complications. we all know of these figures but continue to perform cpr, why? and why do we get on scene find a full coded pt. whose been down for several mins. at least if not 15-20 and still told to perform cpr?. its simple, these people who want us to continue this make alot of moola!, knowing cpr is worhtless and doesnt revive the pulseless and non-breathing. the AHA is a large so-called not for profit organization, but these people make millions of dollars every year by selling books, recert cpr cards and receiving grants/funding from govt.( ie, you& i) and all they simply say is "WE NEED CPR", but have yet to prove that it is effective on a pulseless and non-breathing human. in my opion cpr should be done away with for every pt. ( except those i mentioned ), if you arrive on scene and find a pulseless non-breathing pt. you do your normal checks ( breath sounsd, pulse, monitor in all leads) and if they are in assytole you simply call it what it is a dead person who went to be with the lord. the statistics are out there you just have to bring it to your med director, insurance people, and politicians so we can get this to stop us from waisting our valuable time and go to prevention mode, education. think of this, many people believe they will be reseuated when they become pulseless and non-breathing but give them the statistics and they will be surprised and may seek overall prevenative care and not want you to attempt to rescue them from visiting the lord. (i'm not a conspiracy theroist)

I DONT KNOW ABOUT FL. EMS. IM NOT SURE IF I WOULD QUALIFY FOR GOV. AGENCY DUE TO THE FACT I'M NOT GOD LIKE F.F. WITH JUST A "MEDIC" LIC. YOU SEE IM 36 YO MEDIC, NOT A F.F.. I ONLY WORKED ON PRIVATE SIDE AND DID "911" THROUGH CONTRACT WITH F.D.. I HAVE A FEW QUESTIONS?. 1. IN FL. DO YOU NEED TO BE A F.F. WITH MEDIC LIC. TO GET HIRED ON THESE JOBS 2. DO YOU NEED TO NREMT--P TO GET A JOB IN FL. 3. DO THEY TAKE 36 YO MALES WHO WANT CHANGE IN THEIR LIFE AND A DIFFERENT STATE FOR THAT CHANGE 4. WHY IS FLORIDA NEEDING SO MANY MEDICS, IS IT DO TO MEDICS BEING MISTREATED BY THE BIG WIGS. PLEASE LET ME KNOW, IM NEW TO THESE SITES AND ABOUT EMS IN FL.

WANTING TO LEAVE ILLINOIS AND MOVE TO FL. LOOKING AT PRIVATE CO CALLED SUNSTAR. PLEASE GIVE ME INFO FROM THE "CLOSET" NOT WHAT I GET FROM THEIR WEBSITES. ALSO LOOKING AT OTHER PLACES BUT THEY SEEM TO BE MORE GOVT. RUN, I KNOW SUNSTAR IS BUT SEEMS TO BE MORE INDEPENDENT. IN ADDITION IM PLANING ON TAKING THE TEST SO I CAN SWITCH OVER TO A "FLORIDA" MEDIC LICENSE