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The Redheaded Stepchild: Does EMS Belong in the Fire Ser

Posted: Tue Oct 25, 2005 8:28 pm
by allbutashy1
The leader says this was to long to print in the news paper. I feel it is worth the extra 250 words.

After listening to the forum on a local radio station in the Tomahawk Area where the Merrill Fire Department spoke upon budget issue and emergency medical care in the Merrill area I was moved to respond to such garbage I needed to put my thoughts down on paper

In case someone forgot the "M" in EMS, it stands for medical. EMTs and paramedics are technically classified as allied health professionals, which is a whole different field of endeavor than firefighting. Our true brethren are respiratory therapists, nurses, physicians' assistants and the like. This means we operate in conjunction with other healthcare agencies, be there doctors' offices, clinics, hospitals or health departments.
The fire department is not a healthcare agency. It is a protection agency, no more dedicated to actual healthcare than a police department. Just because we work with fire departments on a daily basis in no way establishes ownership of EMS by fire or changes their job to healthcare.
Since we are part of the healthcare team, and patient care and transportation are our primary objectives, why be stationed at firehouses? Ambulances should be stationed near or in hospitals or medical offices in order to maximize downtime and resources. The end result of taking EMS away from the healthcare team is that patient care suffers.

No matter what unions, national groups or fire service lobbyists say, public safety is made up of three legs, not two. In many agencies, paramedicine is often seen only as a notch in the advancement of a career firefighter. How many administrative or white-collar personnel do you know who made it in a fire-EMS system without requisite fire training? I don't know of any, but I can tell you that a paramedic patch sure looks good on the chief's uniform.

Due to the resounding success of their fire-prevention efforts, Merrill fire department is handling fewer and fewer fire calls. Fewer calls means the normal budget will shrink, because the money isn't needed. Meanwhile, EMS calls are increasing and so are their budgets. In order to grow their budgets, Merrill fire department is running three paramedics /EMT on medical calls. This justifies a little more money, but the other ambulance service in the county provides paramedic level service with only two personnel. Merrill FD has an even larger goal in mind.
On top of the standing budget of EMS, ambulances are somewhat self-supporting. We bill for transport and therefore provide some of our own money in addition to our outside funding. More money for the fire department.
The truth is that while some EMS services were born from fire agencies, the fire service was not the originator of prehospital medicine. We can credit the military with that. In modern history, most of the first units were operated out of funeral homes or hospitals, while the military was operating field ambulances, medevac choppers and field medics—all without the help of the fire department As long as EMS is treated as second-class, patient care will suffer.

Don't get me wrong, Merrill firefighters do a great job fulfilling their primary missions: preventing and extinguishing fires. They already help protect lives and property. They do not need to own EMS to do this job.
All fire departments do need medical support, however, to enable them to do their jobs more effectively. Besides their own risk for injury, they frequently encounter sick or injured people prior to EMS arrival. It behooves them, then, to have some of their personnel trained to the basic EMT level. By carrying a first responder bag and an AED, an EMT can hold down the fort until ambulances arrive with advanced life support.
By fire departments providing basic medical care until EMS can take over, patient care will get better.

Merrill firefighters have a job to do. So do paramedics. The jobs are not the same and efforts to combine them together will not only affect patient care but also deepen the bitterness between the two career fields.
For patient care and public safety to be a success, the best system is a public safety triad in which police, fire and EMS work and even train together, but have careers specific to their professions. From a paramedic's perspective, that means increasing the professionalism of EMS, increasing career options within EMS, and most of all, increasing the chances my patients will live another day. Helping Merrill firefighters get promoted or pad their department budgets is not part of it. For EMS to advance and progress, we need to step away from the shadow of groups or agencies that would freeload off our budgets and impede our progress.

Re: The Redheaded Stepchild: Does EMS Belong in the Fire Ser

Posted: Wed Oct 26, 2005 8:19 am
by Dave
I certainly don't disagree with anything that you have said, but there is a very real problem with placing EMS at hospitols. Most, if not all, of these institutions are run on a for-profit basis by companies and corporations while EMS is operated at the expense, and hopefully for the benefit of, the taxpayers. How would we incorporate the EMS structure into this matrix without making things worse instead of better?

Re: The Redheaded Stepchild: Does EMS Belong in the Fire Ser

Posted: Wed Oct 26, 2005 9:01 am
by allbutashy1
Most of the ambulance services that are run out of a hospital atleast in northern Wisconsin have there ambulance at the hospitals. Including Sacred Heart , Saint Mary's Hospital, Howard Young and Eagle River. What you may not know is that the ambulance are stationed there. The ambulances and equipment are owned by the county. The staff are employees of each hospital and managed by the hospitals. The money collected goes to the county. So the hospitals get paid from the county to run the ambulance.

<small>[ October 26, 2005, 11:34 AM: Message edited by: allbutashy1 ]</small>