Tuesday, June 5, 2007

While I tread on dangerous ground...how about the fire - EMS issue?

This thread began with a post about Senator Allard's really bad day, then lurched into some of the political issues and how EMS is lagging behind its public safety counterparts. Might just as well bring up the whole fire/EMS issue: just where does EMS belong?

It seems the city of Pittsburgh is asking the same question as evidenced in this article in the Pittsburgh Tribune Review.

The EMS union actually has it in their contract that they can't merge with fire unless there is a renegotiation of the contract terms (a smart bargaining team when that contract was negotiated). The fire union president wants EMS and blames the EMS union for holding up a merger.

Dropping back to a local example, the Kennebunk, Maine Police have been talking about merging with other local police forces. The issues, whether in the smaller police merger or the large Pittsburgh situation, generally aren't equipment or stations or budgets--people and cultures will make or break the merger. Issues like seniority, working environment and perception of equality within the ranks are the big issues.

There are a few big cities out there that may be wishing they could turn the clock back pre-merger for just these reasons.

The leaders who will institute the mergers also make a significant difference. How the merger is introduced, instituted and fed to the rank and file sets a foundation. Early, equitable decisions on controversial issues combined with a consistent message and expectation are vital.

I have seen spectacular fire medics that could treat my family any day. I've also seen fire medics treat people like shit because they got pulled from an engine company to work the rescue. Likewise there are some medics in third service agencies who are true clinicians and others who are many years past their prime.

To me, the issue isn't a blanket decision whether fire or EMS is better. It is about the agency which considers it its mission to provide high quality, clinically competent, patient-centered care to the people it serves--be it fire or EMS.

Wouldn't it be a wonderful world if we had two agencies in one municipality whose true mission it was to provide that type of care...but if that were the case mergers wouldn't be an issue after all, would they?

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