In my daily search of the news to find articles relating to EMS trends and how things progress in other communities, occasionally I will come across something that starts the wheels turning. 

First, I am in total agreement with Matt Zavadky regarding EMS when it comes to Healthcare vs. Public Safety. What clouds this issue is the delivery aspect and in EMS, one size or system does not fit all. What works in Boston will not work in Kaycee, Wyoming. What works in Los Angeles may not fit the needs of Denver.  Not every community has the tax base or population to support such delivery systems.  In fact most of this country is made up of many small communities, who are dependant at times on their neighbor’s goodwill and concern to provide EMS and sometimes fire protection on a local level.

Now, inject politics in to the arena and watch how things can really get cloudy.

Recently the Boston Globe ran an article regarding response times.  The local fire chief  who’s been putting out fires in the community of Brewster for the last 40 years identified the town’s leaders and budget cuts as to the reason the local department could not affect an improvement as they were still restricted to a single station from which to respond from and only has two full time staff on duty in the evening hours.  The response of the local selectmen was to summon the chief before the Board to face discipline “up to and including termination”.

Taxpayers don’t want their taxes raised.  Politicians, in an attempt to carry out the mandate of those who elect them, the Taxpayers, do their best to keep budgets in line. Otherwise, next election they won’t get elected.  An endless cycle, only the problem that develops is Department heads end up trying to spin gold out of flax, and we all know that’s a fairy tale straight out of Mother Goose.

It is the goal of every government employee, regardless of their level, to become so efficient that they put themselves out of a job.  It has been my observation that the fire service has done just this.  No longer do we have the conflagrations where entire cities are consumed by fire.  In fact, because of building codes, construction materials, fire codes, fire prevention, training and education most departments are tested only rarely on what their potential and ability is.  In an effort to keep budgets, manpower and equipment in tact, respond to medical calls 75% of the time. If perceived necessary, get in to the EMS delivery and transport system and sell it as a revenue generator to the governing bodies.   It helps with the image portrayed to the bean counters that they are still needed, and the community will make money.  What the bean counters fail to understand is the potential factor.  Not every response needs a ladder truck, but when it’s needed, it needs to be available and there needs to be trained people to use it. It’s very similar to the Military.  Not that we are a nation constantly at war, but we need the Stealth Bombers, the satellite systems and the Infantry and Navy ready at an instant because of that ethereal “potential” that may never crop up in our lifetime.  The Military Complex has lobbyists to remind Congress and the Senate of the “potential” on a daily basis and usually over dinners and lunch, and sometimes at the clubhouse at golf course.   Fire and EMS battle for existence on a daily basis because the public is apathetic and concerned about their taxes and the chances of the average person needing either runs about once every twenty years.

Last week the Mayor of San Francisco presented an idea where they could take the fire apparatus out of the stations and park them on the street with staff in high crime areas at night where several shootings have occurred as a deterrant.  As if the local gang bangers will see a truck company and think, “Don’t shoot.  They have a ladder”.  I have to ask, what happened to hiring more policemen or was it spent on adding more vice-mayors or deputy chiefs?

Now I realize that at times San Francisco and the politics have been on the fringe of what most people consider reasonable and normal. Personally I think that’s what makes it a great place, especially when dealing with my own political demons.  I can always share with staff that at least we aren’t having a meeting about deterring crime with unarmed staff on fire trucks and ambulances and we can continue to spin gold from flax.  

As of yet I have not had any follow up on Memphis and their attempt to add more ambulances. Last I heard was the council voted themselves a raise, laid off more employees and had a study done on their EMS system.  The first sentence of the study describes the fire department as “An EMS agency that sometimes responds to fires.” Then why call it a “fire department”?

Mayor Herenton was almost immediately sidetracked when it was revealed he had conceived a child out of wedlock and was focused on dealing with the new parental issues at hand.

Many years ago I was told, “if it’s not in the news, it’s not an issue, so ignore it.”