In Other News: Water Is Wet, Sky Is Blue

A Santa Clara County civil grand jury finds fire department response to medical calls incredibly wasteful:

A report by the watchdog panel found that 70 percent of fire department calls are medical emergencies, and just 4 percent are fire-related. But even so, firefighters respond as if they are heading to a fire, sending a crew of three or more on a truck or engine costing an average of $500,000 — five times the cost of an ambulance.

Typically only one of the three arriving firefighters has medical training, the report said. That creates a "mismatch between service needed and service provided," with fire departments deploying "personnel who are overtrained to meet the need" — that is, paramedics also trained as firefighters.

Hang on a moment while I try to remember where I put my shocked face. Read the whole article, since it may take me a moment to find it…



Ah, there it is!

Seriously, the only thing shocking about this news article is that it took the media so long to realize what most of us (outside fire departments anyway) have known for years: this isn't about providing medical care, it's about justifying staffing levels and shiny new fire engines.

I'm sure this will cue a nasty fight in comments, including the requisite number of "Ambulance Driver hates fire department EMS" opinions.

Which isn't true, by the way.

I've spent my career working in private EMS, and I do a fair amount of teaching and consulting for fire departments that provide EMS first response and/or transport, yet my personal belief is that municipal third-service EMS is the superior system model. It's not the best fit for everywhere, but in those places with sufficient call volume to support a full-time paid EMS system, I think the best way to provide it is through an EMS system that is separate from police and fire.

I guess my biggest beef is that the attitude I see fostered in so many fire department EMS systems is that EMS is not their core mission, but rather a means to an end.

And as long as 80% of their call volume is EMS, yet 80% of their funding, promotional pathways, and training are devoted to fire suppression, that opinion is not going to change.

Chime in with your comments, but keep them civil or you'll eat Ban Hammer. If the most constructive statement you have to offer is calling someone a hose monkey or a stretcher fetcher, or yet another tired iteration of "private EMS cares more about money than people" or "firefighters are a bunch of testoterone addicts who suck at medical care," find another forum, please.

Chris Kaiser does a nice, even-handed job of summing up my major beefs with fire department EMS here.

Happy Medic's eminently reasonable take on the issue.

My series about fire department EMS, with some excellent comments from both sides:

Marriage Counseling Part I: The Dysfunctional Fire/EMS Relationship

Marriage Counseling Part II: The Dysfunctional Fire/EMS Relationship

Marriage Counseling Part III: Detente in the Dysfunctional Fire/EMS Relationship