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I have to say that I can't answer any of those questions. Barry may be able to jump in with some specifics on this. I would look it up, but I really don't want to disturb the dalmation sleeping on my lap while I am kicked back here in the recliner with the other firemonkeys. I realize that the above references did not come from you, but I would be willing to bet that they are what got Kramer fired up. As you said, I have tried to keep this discussion rational and on topic by presenting facts, but I must admit also that those comments are getting old. I will let you know if I can find out the answer to those questions.

One other thing: I too want to thank DustDevil for what he is doing. Whatever anyone's opinion is of why he has been to Iraq, we should all be grateful that he is there. Although we don't agree on much on this topic, I truly respect you and appreciate you for what you do.

Wow! I take the kids to the grandparents for the weekend and this thing blows up even bigger. First, thanks for the compliment about bringing intelligent conversation and facts into the discussion earlier. Second, I couldn't keep up with all of the posts, but here are a few random comments that I have in mind: I am like Barry in that I no longer ride the units regularly as I was promoted into a new spot. Again, promotion is something that is, or should be, available in all services whether they be fire, private, or hospital so please do not use that against the FD. However, I do still participate by making EMS calls on the truck and teaching ACLS, PALS, and ITLS. Barry and I are part of a growing trend in the department that has helped to decrease, if not eliminate, any bias by the "old" fire guys toward EMS. I have a friend who is a paramedic with FDNY. I understand that there is still a great bias in NYC and often times the fire companies do not even get out on an EMS call. That's their system. It isn't right, but we can't control it. Many of you got on Kramer's back because of some of his comments. As Barry said, he's very intelligent, but doesn't always present his arguments in a tactful manner. One thing you should know about him is that he is a good EMT and by being in charge of that engine company, he will tear you a new one if you even consider not making pt. contact while riding on the engine company and, again, he will wade in up to his elbows if he needs to. Someone asked about BC's and ALS companies. As Kramer said, he is in charge of the scene, not patient care, and he knows that and doesn't try to interfere. There are EMS Lt.'s and Battalion Chief's in the field to supervise pt. care. Each house with a unit has an ALS company. I have heard a lot about LA and the west coast also. I don't know why, but they seem to have (in general, I cannot speak to individual medics or systems) a lot of problems with some skills. I know an ER doc from southern California that says a lot of that has to do with how tightly they control what the medics do in that area and he actually pointed to the nurses unions as fighting anything to do with helping EMS in the region. Again, second hand information, but the only info that I have. As Barry said, we have a very progressive medical director and chief of EMS. We are taught to think and given latitude in our decisions and not required to call for orders for every patient or simply follow protocol XYZ to the letter. Someone spoke of the FD's wanting EMS to get the money. I'm not sure about your area, but money is not to be made by providing EMS in a urban area here. Most of the calls go unpaid because the pt. doesn't have money, insurance, etc. I understand that many of you are on your side of the street and we are on ours, but I too have worked for every kind of EMS service and I think that this is the best model that I have worked for. Is that true of every FD based service? No, but there are knuckleheads that merely passed the test in every kind of service. As I stated a few days ago, we have a QI system in place to correct or weed out those people. Just a few random thoughts............let the bashing begin.

Again, I understand some of the concerns, but you are making generalizations and comparisons that aren't fair. 1) No class or clinical time is done on duty. 2)How many of these people wanted to go to paramedic school, but couldn't afford it or couldn't find the time while working a "regular" job. 3)There is no rotation to a "suburban" engine. You can promote up after a few years and not ride the ambulance anymore, but that is the same with any service. 4) I understand your frustration with the "medic mills". We have seen it too, and hopefully this program will help to eliminate it. These people will reflect on our instructors and our department. Do you think that the instructors will want to put a piece of **** on the street? I don't want to argue over this thing, I'm just trying to make a few points.

Let me address a few of the comments: There is a solid QI program in place that addresses areas of concern with training by the training staff and medical director. All medical in-service training, whether ALS or BLS, is done by paramedics and all training has received CEU's accepted by the state and National Registry. There is and has been a shortage of paramedics across the country for quite some time. You may live in one of the few places that has a bunch of medics, but that is not the national trend. This is the trend: They attend class 16 hours per week, off duty, and the clinical rotations will be in addition to that time. You are required to be cross-trained with the MFD. Is that for everyone? No. I have worked for a fire service that did not do EMS, private EMS running 911 call, and cross-trained fire and EMS. I love the dual role. I go to work and perform both functions that I love, but it is not for everyone and that is O.K. We could debate the single vs. dual role EMS systems all day and each of us would think that we had the most valid points. As you said, you get told about it up front. If it isn't for you, no problem. As for some of the requirements, city Human Resources is responsible for that and not MFD. We don't agree with all of the requirements either, but it is what it is. Every job in every discipline in every community has some quirk attached to it that someone doesn't agree with. Read this as "We get to train them to be paramedics and understand the pathophysiology of what they are dealing with instead of just training them to pass the test" We all know programs that just teach to the test in order to make their numbers look good. Basically what I am saying is that our system may not be perfect, but I don't know of any that are. Please don't bash a program that you don't know anything about. Allow us time to screw it up first (which I do not see happening) before you tear it apart. And no, I am not one of the instructors.