SF Chronicle slams SFFD slow response times

[Amhet1]

OK son, do you really want to have a pissing match in a forum, or would prefer to actually add something to the discussion?

#1. The discussion in about SFFD. My point (in case you missed it previously) is the comparison of SF FD to the King County program is not comparable.

#2. King County Medic One program is NOT a 3rd service or Fire model. It is overseen by the Health Department with strong medical oversight which is more closely associated with a PUM.

#3. Though some of the Fire Departments are directly involved in the Medic One program, it is NOT an FD-run program. It is run by KC Public Health.

As to your other points....

"Hell, most fire departments meet 3 or more (mostly more) of your standards and then some. (do you really think that's all it takes to make a good EMS service...wow...that's pathetic)"

No son, MOST Fire Department EMS programs do NOT meet those simple standards. You may be lucky to have so many sterling departments in your area, but when you get the opportunity to see the real world, you will find that there are problems. When you grow up you may come to realize that providing EMS is far different than providing fire protection.

And as far as I know and have read, King county meets goal number 4. They have a complete, dedicated SYSTEM providing EMS. Ill give you number 1, since I dont know the minuscia of your interpersonal relationships. I have seen reports of inadequate numbers of ambulances on occasion, but doesnt look to be a systemic problem. Number 5 is questionable but since KCEMS is not a fire-run system, Im sure Mr Kearne is adequately compensated and has equivelent authority.

here's a quick question for you: can you show me a third-service EMS agency (or any agency that is primarily 911 responses) that is of equal size to those agencies that does not have problems?

Wow, what a tough challenge.... a third service EMS agency that isnt screwed up. I guess the first thing we need to know is what measurement we are going to use? Population? Coverage area? Staffing? Population density? You're the one wanting "equal size".

How about a few PUMs that work? Sunstar, EMSA (Kansas City/Tulsa), NEMSA

Hospital-based? Wishard, (Denver Health 15 years ago before the FD influence)

Private? Pridemark

"And, in case you haven't noticed, most city budgets are not doing so good these days, so if you rely on public funding...ouch."

You're right. When people become dependent on government, the money has to come from taxes. (Or in Medic Ones case, solicit donations). Thats why when you calculate subsidy, you have to also take into account reimbursement, payor mix, and community standards.

"that the bigger you get the harder it is to run a problem-free workplace."

And the problems are; (No, this in not an exhaustive list)

1. Failure to adequately fund EMS

2. Failure to maintain adequate oversight

3. Failure to provide adequate numbers of ambulances

4. Failure to ensure adequate staffing, adequate training, adequate supervision

5. Failure to maintain parity in pay between EMS and Fire

I do have one sincere question for you since you're living up there. A $0.30 levy was proposed last year for the Medic One program. Is that with property tax, sales tax, fuel, or something else? I dont understand how that is calculated. Locally, we pay like .3 mills that go to EMS, which works out to about $35/yr for our property.

Now, on a more personal note..... You may be "god" in your real life, but when you're on this website, you may want to use a bit more humility. Attempting to call someone "Gomer Pyle" is a tad immature, especially when you've only seen him in reruns. It may also suite you well to remember that as smart as you think you are, when you're here, there are FAR more knowledgable people that WILL slap you down far worse than I may have.

[akroeze]

From what EMSA has on their website, I am very impressed by them!

[triemal04]

Oh baby...I love internet balls. It's great. It's better when the person sporting them really has a good, fundamental knowledge of what they're talking about, beyond crunching numbers for one service, but I suppose that's a start. It's nice that you've got a...masters?, it's nice that you were an Air Force medic, and it's nice that you work in the office of an ambulance service, but all that still doesn't make you an authority. Doesn't make me one either, but then, I know that I don't know it all. Somehow I don't think you know that.

Actually, most of the ambulances in King County are FD run; that's part of why King County Medic One can be somewhat hard to understand. Seattle runs it's ambulance along with several other Fire Departments. Each hires the personnel, is responsible for getting them to their initial training at Harborview and then ensuring their continued education, as well as medical oversight, QA/QI, supervision, pay, benefits, yadda yadda yadda. So no, while medic one is not run by the fire department per se (didn't say it was), the majority of it, (outside the actual King County Medic One ambulance service) is administered by the individual fire departments that operate it. As I said, each service, in this case fire departments, runs itself as they see fit. That's not the best description, but, looking at it from the outside (way outside in your case) it's a different way to run things.

Actually, yes, I'm sorry (again) to rain on your parade, but most fire departments do meet at least 3 (usually more) of the requirements you listed. And yes, I'm talking well beyond just my state; see, I don't base everything I think on what gets broadcast in the TV news. On a side note, do you really think that's all it takes to make a good EMS system? Oh my...

As long as the system is the size of the departments I already listed, I'd love to hear about it; seriously, I would (the ones you listed are to small, sorry). As I said, while not exscusing anything those places have done, when a service gets that big it will get harder and harder to ensure good hiring practices, good continuing education for all employees, a good QA/QI program, if publicly funded, good pay/benefits, etc etc. The smaller you are, the easier it is. The bigger you get, the harder it is. That'll hold true for almost every public service agency, and many businesses. So, if there is a place that size out there that's problem free, I'd like to know.

Unfortunately, or fortunately I suppose, I don't live near Seattle, so I have no clue about the levy. See? I don't just go off what I see in the news or what I personally experience. I'm well aware of the faults of many fire-based EMS services, just like I'm well aware of the faults of many private-based, third-service based, and even your own precious Denver Health. That was the point of the first sentence in the last post; you need to be damn sure you know what you are talking about when it comes to this topic; hell, any topic in EMS really. Don't just read a quick headline or go on the belief that you've seen it all and all is the same; you haven't, and it isn't.

I'm still waiting for the slap Mr. Pyle.

Edit: Far as the parity in pay goes...when it comes to fire based EMS, excluding the minority (vast minority) of departments that have civillian medics, you do know that most paramedics working for a fire department, especially one that transports get paid more, right? Just checking.