As someone who spent (far too much) time in EMS in a major city, I’m afraid you have wildly simplified what would be involved with a transition to this both logistically and financially. I also want to call out that you referred to to EMS as “ambulance drivers”. This is a long-outdated term for back when EMS had no medical training and using it now diminishes what they can do on an ambulance.
I think you are also not separating EMT basics (EMT-B) and paramedics (EMT-B). EMTs that PF&R have the same certification as those that work for AMR. In reality, the vast majority of 911 calls don’t need a paramedic. Yes, paramedics and EMT-Bs in a system that isn’t fire-department based aren’t paid well, but this is a national issue. Also, you can have great paramedics working for non-fire department ambulance services and you can have incompetent paramedics working for fire-based EMS.
I could delve into more nuances of the way ambulances are staffed or response times but for the sake of retaining some sense of brevity I’ll move on from this part. When it comes to major things that PF&R would have to take on, it is billing, medical direction, pharmaceutical supplies, fleet (including maintenance), a constant hiring and training process due to the high burnout rate in EMS…this is just a start of the major list.
There are some cities that have what is called third service EMS. In cities like those there is an ongoing debate about just having more ambulances and more staff due to the financial and time waste of having a fire engine or truck show up on every call. I mention this to illustrate that some cities are not finding it makes sense financially to have the fire department more involved, but the these conversations have been going on for probably two decades.
At the end of the day this all requires far more money than the city has, not to mention a lot of patience as this would take a long time to transition. So while I think you bring some interesting ideas to the table through your publication I’m afraid this misses the mark.
Big institutions are complicated, and they fight for their survival. Many cities, including Portland, have considered merging with their counties, for instance, but few have done it. The status quo usually prevails in such cases, even when the longterm benefits of change could outweigh the short-term pain. It is impossible to know at the outset how the feasibility will balance out.
As someone who spent (far too much) time in EMS in a major city, I’m afraid you have wildly simplified what would be involved with a transition to this both logistically and financially. I also want to call out that you referred to to EMS as “ambulance drivers”. This is a long-outdated term for back when EMS had no medical training and using it now diminishes what they can do on an ambulance.
I think you are also not separating EMT basics (EMT-B) and paramedics (EMT-B). EMTs that PF&R have the same certification as those that work for AMR. In reality, the vast majority of 911 calls don’t need a paramedic. Yes, paramedics and EMT-Bs in a system that isn’t fire-department based aren’t paid well, but this is a national issue. Also, you can have great paramedics working for non-fire department ambulance services and you can have incompetent paramedics working for fire-based EMS.
I could delve into more nuances of the way ambulances are staffed or response times but for the sake of retaining some sense of brevity I’ll move on from this part. When it comes to major things that PF&R would have to take on, it is billing, medical direction, pharmaceutical supplies, fleet (including maintenance), a constant hiring and training process due to the high burnout rate in EMS…this is just a start of the major list.
There are some cities that have what is called third service EMS. In cities like those there is an ongoing debate about just having more ambulances and more staff due to the financial and time waste of having a fire engine or truck show up on every call. I mention this to illustrate that some cities are not finding it makes sense financially to have the fire department more involved, but the these conversations have been going on for probably two decades.
At the end of the day this all requires far more money than the city has, not to mention a lot of patience as this would take a long time to transition. So while I think you bring some interesting ideas to the table through your publication I’m afraid this misses the mark.
Big institutions are complicated, and they fight for their survival. Many cities, including Portland, have considered merging with their counties, for instance, but few have done it. The status quo usually prevails in such cases, even when the longterm benefits of change could outweigh the short-term pain. It is impossible to know at the outset how the feasibility will balance out.