Wednesday, July 11, 2007
Fire Service and EMS...again!
A document which has been referred to as the "Fire Service EMS White Paper" recently entered my email box.
My first observation from this paper is that 4 well known and talented fire service docs got together and published this paper. The fire service (IAFF, NFPA) quickly flew the white paper "flag" yet there are no logos or indications of endorsement on the paper itself.
It isn't really news that the fire service wants to do more EMS, and in some cases--but clearly not all cases--should. I guess I'm left wondering how a history lesson, a few examples and some muscle flexing gets billing as a white paper. I'm not sure it does the fire service justice and may even sell it a bit short.
John Becknell authored an opinion piece published on the Missouri EMS Association web site in response to the white paper. He brings up some good points.
For EMS to thrive in the fire service deep cultural changes will be required. These changes are the most difficult to make. Many city fire departments have merged fire and EMS and have stumbled (in some cases fallen flat) over these cultural differences. I have blogged about this previously.
In my small part of the world, firefighters are "stuck" on the rescue until they can bid off to a secondary, lower-volume rescue and eventually an engine. Why? Engine companies have a dramatically smaller call volume than the rescue. The least experienced people are always on the rescue. Don't get me wrong, they have the right to bid off. It just isn't good for the system.
In many cases there are no organizational benefits to working more as far as pay or promotion and in many cases it is cultural and career suicide to be a band-aid in a nozzle-head world.
With this paper the fire service has essentially lifted its leg and "marked" EMS as its own. The true test will be whether they have the commitment and institutional flexibility to be the EMS that patients need.