NYTimes on Fire based EMS

[p3medic]

There are plenty of "combined" services that are "separate" FNDY for example. They are a fire department ambulance, but they are not firefighters. City of Allentown, is fun by the City of Allentown Police. Their dual medic ambulances are not all cops, and their cops are not all medics. It is possible to be combined and have separate duties.

The International Association of Fire Chiefs recently came out with a postition statement OPPOSED to the merger of fire departments with police departments because they are completetly different jobs and would be impossible to provide the same level of service to both functions. They fail to make the same comparison to EMS oddly enough.

[aussiephil]

So whats wrong with a combined agency? I keep hearing the same complaints but I can't believe that it is a insurmountable problem. Improve training, properly direct funding and find the right personnel that are committed to helping people and not hung up on titles or images and Shazam you have a cost affective all risk emergency response agency.

Whats right with a combined service?

Does your local bank plan on opening a McDonalds franchise in the lobby? Or will the local child care centre become a guns & ammo dealer?

That is how different EMS & fire are as professions. Why combine them. I am yet to hear 1 solid argument showing they are better combined.

When will people agknowledge that EMS is a profession of its own & as such be a seperate agency?

[HERBIE1]

In order to understand why EMS and fire have become "married" in this country(I can't speak for outside the US), you need to understand the history and logistics of providing first responder care. Fire Departments have the established infrastructure to handle emergency response. They have the manpower, the equipment, the locations, and the only thing left is the training. When EMS was absorbed into the fire service, they were and still are in many cases-a necessary evil. The fire service would assist with manpower and basic training but never had to completely assimilate EMS into the fold. As fire calls dropped, in order to maintain their budgets and manpower,the fire service became more intimately involved in prehospital care not by choice, but by necessity. Fire budgets are dictated by tax revenue, and with more demands on that finite amount of cash, they realized that EMS generates revenue. That is the bottom line folks-the almighty dollar- it has nothing to do with providing a "better" quality of care or service to the public.

[joesph]

Whats right with a combined service?

Does your local bank plan on opening a McDonalds franchise in the lobby? Or will the local child care centre become a guns & ammo dealer?

That is how different EMS & fire are as professions. Why combine them. I am yet to hear 1 solid argument showing they are better combined.

When will people agknowledge that EMS is a profession of its own & as such be a seperate agency?

the direction I am proposing is fire and EMS to evolve into a all risk system lets park the agenda's of both entities and rewrite them to benefit the customer best.

[Kiwiology]

the direction I am proposing is fire and EMS to evolve into a all risk system lets park the agenda's of both entities and rewrite them to benefit the customer best.

What benefits the patient best is not being served up medical care by the fire department; if the hospital was run by the telephone company (for example - because that's about how seperate fire and EMS are) would you go there?

[CBEMT]

the direction I am proposing is fire and EMS to evolve into a all risk system lets park the agenda's of both entities and rewrite them to benefit the customer best.

Oh, how cute. He actually thinks its patient/customer care that the fire department is interested in.

[aussiephil]

In order to understand why EMS and fire have become "married" in this country(I can't speak for outside the US), you need to understand the history and logistics of providing first responder care.

There is a difference between First Responders & full ambulatory services, incliding paramedical services. First Responder is fine. Basic EMS. Nothing more. I have no problem with that.

Fire Departments have the established infrastructure to handle emergency response. They have the manpower, the equipment, the locations, and the only thing left is the training. When EMS was absorbed into the fire service, they were and still are in many cases-a necessary evil.

It was initially, from what you describe, a quick fix.

The fire service would assist with manpower and basic training but never had to completely assimilate EMS into the fold. As fire calls dropped, in order to maintain their budgets and manpower,the fire service became more intimately involved in prehospital care not by choice, but by necessity. Fire budgets are dictated by tax revenue, and with more demands on that finite amount of cash, they realized that EMS generates revenue. That is the bottom line folks-the almighty dollar- it has nothing to do with providing a "better" quality of care or service to the public.

This is reality. As I stated earlier, it is about Fire justifying their existance. Nothing more. Now when you say

As fire calls dropped, in order to maintain their budgets and manpower

why have they not been revamped so that EMS takes control & fire is the poor cousin?

I will scream this from every rooftop I have to, PRE HOSPITAL MEDICINE SHOULD BE NOT FOR PROFIT, FREE TO ALL PEOPLE. In some cases, we are all they can get to.

Fire will not allow this to happen because they will continue to push thier hero banner, get themselves on TV looking like heros, when reality is EMS gets in & gets out as fast as possible.

If fire calls are dropping, cut their budgets & chanel the money into EMS. start from the ground up & standarise all training, get rid of the mills that churn out moron medics. Maintain the fire department to the number of calls they attend. Then maintain an EMS service to the number of calls they attend. See who bitches about funding etc then.

the direction I am proposing is fire and EMS to evolve into a all risk system lets park the agenda's of both entities and rewrite them to benefit the customer best.

The only way this can happen is for thenm to be seperate entities. The Ego of fire (hero mentality) is too big & while they believe that they are the be all & end all, the utopia you are deluded about will never & can never occur.

[Kiwiology]

the direction I am proposing is fire and EMS to evolve into a all risk system lets park the agenda's of both entities and rewrite them to benefit the customer best.

If the Fire Service is so bloody fantastic at providing "customer" service; why is it that in as far as I know, every other nation on earth (with the exception of like one department in Canada) is the fire department not involved in EMS?

The New Zealand Fire Service Commission and the NZ Professional Firefighters Union have long refused to get involved in any form of patient care or ambulance response (beyond first response in a few very rural areas) because it's not the mission of thier service or in the interest of the public or thier members!

Edited September 8, 2009 by kiwimedic

[Richard B the EMT]

Would anyone care to respond to my observation that things are smoother when a Fire Department ASKS to have EMS duties included in their overall mission, by the members, as opposed to BEING TOLD, by non members (like the local mayor) that they HAVE to include EMS operations in their overall mission?

[CBEMT]

Would anyone care to respond to my observation that things are smoother when a Fire Department ASKS to have EMS duties included in their overall mission, by the members, as opposed to BEING TOLD, by non members (like the local mayor) that they HAVE to include EMS operations in their overall mission?

Won't last long. The first ones on the bus post-takeover will be the first ones looking for an engine bid when the next new hire group (who were required to be paramedics as a condition of hire, of course) comes in.

There are plenty of "combined" services that are "separate" FNDY for example.

Congratulations, you just used one of the most disastrous Fire-EMS mergers in history as your evidence.