Goodnight, ALCO

On November 1, at 12:01am Pacific time, Paramedics Plus took over 9-1-1 coverage in Alameda County marking the end of a lengthy service by American Medical Response.  I, however, cannot help but feel like AMR got the short end of the stick in the deal.

I have read through both of the bids quite extensively, and I must say that from the perspective of Alameda County, they had a strong grasp of what they were looking for, and released a rather detailed document spelling out what EMS means to the county.  Both replies were lengthy and well put together, and in my opinion far exceeded the expectations that were set.  In the end though, the bid came down to one thing: the all mighty dollar.

The last piece of the bid called for both companies to submit what they planned to charge for their patients for their services.  Paramedics Plus came in lower than AMR giving them the points they needed to push themselves over the top, and ultimately win them the contract.  Kudos to Alameda County for looking out for the wallets of their tax payers, but I feel like there was too much weight put on this stat.  While most services harp on response times, ALCO shifted that focus to financials.  Their response time criteria was still very strict, and they did a lot to further the quality of patient care provided in the county, but a lot of that feels disregarded to me when I see the weight that patient charges, most of which an insured person would never see, are figured into the equation.

It must be understood though that I am a little biased.  I owe a lot to Mike Taigman and his team in Alameda County.  Level Zero was the project that opened my eyes up to EMS on the internet.  A profile of a few of the providers in the county, having seen the movie I was even more excited to hit the streets in ALCO when I had the chance hoping I’d just have the opportunity to run into someone I might already know a bit about.  While I only saw one “cast” member from afar, I met many amazing EMTs and paramedics.  I was impressed by their poise under pressure, and how easily and fluently they worked in such a high volume system.  They were proud to work where they worked, and many of them intended to make working in the operation their career.

As I learned more about the AMR ALCO division, I took a lot of inspiration from them.  I liked how they solved some of the problems that I saw within my own service, and I found myself looking at some of their solutions and simply saying “That seems so simple.  Why didn’t we think of that?”  Mike’s management style brought that division back together.  He inspired people not to stand behind him but to stand with him as part of a unified team.

Above all else, the AMR ALCO Division and Mike Taigman succeeded where many other EMS services failed: they became a community partner.  In order to be successful EMS services must be willing to push the envelope of patient care, and let the community be a part of it.  They need to not only be there when people call, but be there before they do.  They need to have an open and transparent relationship with everyone around them, inviting everyone to be a part of the development of a successful, cutting edge service.  This, and only this, will defeat the ignorance that exists within the public about who we are, and what we do.  This will stop the declarations from patients that we should “just take them to the hospital.”  This will help put the decision making where it belongs: in the hands of the provider.

I was at work driving down the highway when my clock struck 3:01am on the east coast.  Without another car in sight, I lit up my lights and fired off the siren for just a few seconds to pay tribute to my brothers and sisters on the west coast who were finishing their last shift under Mike Taigman in the San Laredo deployment office.  Although many of the providers may stay the same and transition into a new uniform, I don’t think it will feel the same to anyone.  I know it won’t to me.

To everyone at AMR ALCO, thank you.  Thank you for being an inspiration to me, and thank you for opening the door to this new chapter in my life.  Keep doing what you do, because there are few out there that are better at it.

Good night, ALCO.  You’ll be missed.


  1. Scott, this brought a lump to my throat that someone from the East Coast could hold them in such esteem. I know they would appreciate hearing this and I’ll make sure they get it. It was such a sad night last night I couldn’t sleep until 0300 this morning. To think that you thought of them and hit your lights at 0301 gives me that much more appreciation for the man and the paramedic I think so much of. You’ve always been such a team player at FRNtv, and you’re a team player for paramedics everywhere. It shows what a tight family we really are. Here’s my appreciation from a fellow medic, FRNtv advocate and former AMR Alco employee.

  2. Very touching thank you EMS brother. I will mis AMR, was ther for 19.5 yrs and now a new chapter opens up and no it will not be the same, not by a long shot.

    Thank You,
    EMS CO-Worker . It’s a new day for Alco.

  3. Rags2riches75 /

    So crazy… I’ve been in Sac for a while now but my first experience as an EMT in training was in ALCO…and worked a few times while in Richmond with them…wow…pretty sad…

  4. Ckemtp /

    A very nice tribute, Scott. Even as a young medic in the Midwest I had heard of Alameda County and the quality of the EMS there. When I got in to all of the writing and participating and I got to meet people from there through the Chronicles I was only more impressed. The era will be missed.

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