All the Wrong Reasons

Orlando Fire Department looks to take over most EMS transports in Orlando.

The money quote:

“A year ago, Dyer proposed laying off 46 firefighters and mothballing the city’s ambulance fleet to save money. An $8.3 million federal grant saved those jobs. The layoff threat was enough to convince firefighters — many of whom opposed the idea of taking on patient transport — that more work means more job security.”

Well, at least they announced their motivation for the change – justifying firefighter jobs – thus saving me the trouble of fisking some bullshit cover story that it’s all about patient care.

It’s no secret that I’m critical of the fire service model of EMS delivery, and this is precisely the reason why. It’s not an inherent bias against the fire service on my part, either. I don’t think the current system I work in is the best model for delivering EMS care, either. But the bottom line is, reluctant medics make for shitty care.

There are departments that do it well. Invariably, those are departments who embraced the EMS mission early on, and realize that providing EMS is 80% of their job, and fighting fires only 20%. They view EMS as a core mission.

There are plenty of others – in some of our biggest cities – whose departmental culture still regards EMS as the bastard stepchild, and work on the ambulance as one step above pulling oars in a galley. They view EMS as a necessary evil, something to be endured if you want to be a firefighter.

I’ve got a friend on the blogroll who works in that system. We’ve chatted and talked in person, and he strikes me as a pretty sharp character, and a good medic. And I have no doubt he has colleagues in his department who are just as good. Are they better than the Rural Metro or AMR medics? Debatable.  Are they any worse? Also debatable.

But we’re not talking about individual medics here, we’re talking about departmental culture. That is something that changes very slowly in any organization. The fire service is no different. There are more than a few grains of truth in the old saying, “The fire service: hundreds of years of tradition, unimpeded by progress.”

And if you really want to stymie progress, force a bunch of reluctant fire medics to take on substantially more job duties, for a pittance of a raise, or none at all. Hold their jobs hostage to ensure their compliance.

Yeah, that oughta work.