Inside EMS Podcast: Fire-Based EMS Smackdown!*

Special treat for you on this week’s episode of Inside EMS: Co-host Chris Cebollero and I square off against our sister podcast, those hose monkeys hydrant humpers smoke eaters knuckle draggers professional firefighters** over at The Command Post.

Our topic: is fire-based EMS really a viable system model, compared to private or municipal third service?

My position on this has always been clear: I believe that both professions have matured to such a level of specialization and sophistication that each is deserving of a single role in public safety. I believe that, while it may be possible to achieve competency in both fire suppression and EMS, it is nigh impossible to achieve mastery of both for anyone but the most exceptional providers.

I believe that EMS has more in common with law enforcement than fire suppression.

I believe that far too many fire departments view EMS as a means to an end, ie a way to justify current staffing levels in an era of dwindling fire calls. This makes for rather uninspired patient care if you look at EMS as a necessary evil in order to be able to ride the big red truck.

I believe that it smacks of hypocrisy to tout a department’s commitment to EMS when 80% of funding goes to the suppression side of the house, when the medics on the ambulance are running 80% of the calls, and when most of the rungs on the career ladder favor the suppression side of the department.

I also acknowledge that fire-based EMS can work, if done right. The problem is, it is rarely done right, and the largest, most visible fire-based EMS systems in our country could serve as case studies on how to do it wrong.

And I pretty much said all that in the podcast, but our guests Chief Rob Wylie and Lt. Rommie Duckworth gave as good as they got. They confirmed a few of my biases, poked a few holes in some of my assumptions, and generally acquitted themselves well in advocating the effectiveness of fire-based EMS systems. They’re a couple of exceptional providers and fire service leaders, and if more fire command staff had their horse sense and leadership ability, we wouldn’t even be having this debate.

Go listen to the podcast and hear what they said. Good stuff there.

*Not really a smackdown. Actually a very civil debate.

** Most of those firefighter perjoratives, I learned from firefighters. “Hydrant humper” was a new one, though. 😉