Over the past couple of years I have read a few articles about the importance of living in the community that one serves.  I have seen articles championing volunteer organizations because “people like being cared for by their neighbors” or implying that those who do care for their neighbors would do a better job because of their proximity both physically and emotionally to a patient. Other articles about fire based systems for example talk about how being part of a community can allow one to know the back roads and short cuts that might shave precious seconds off of response times thus saving countless lives.  Further reading will reveal criticism of private EMS departments that come in from outside of the area and know little about the people that they are caring for.  Some feel that not living in the area that one practices medicine in can result in them caring that much less about the people that they are providing medical care for. Based on some personal experiences that I have had, I fail to see any of these as being an absolute that one should lead an argument with.  My first EMS position was in the town that I grew up in.  Island Heights, New Jersey is small, populated by maybe 1,200 people during the summer months.  It was impossible for me to go into a house on a call and not either know the patient or one of their relatives.  From there I moved some 250 miles away for college, and spent the first twelve years of my career in Springfield, Massachusetts.  I was a transplant, and as a white kid from suburbia, I did not fit the cultural makeup of the city that I worked in at all.  Neither did the vast majority of my coworkers.  Much like the majority of the workforce in EMS, we were Caucasian and majority male. Although I was not from the area I was able to learn the streets, and learn a lot about the culture as well.  Working in Springfield pushed me to improve the quality of the Spanish that I spoke, and learn a little bit about the cultures that I was...

The recent resignation of Dr. Juliette Saussy the medical director of Washington DC Fire and EMS has been a boulder dropped in the lake of EMS that is sending ripples far and wide.  After her announcement and the letter accompanying her resignation was made public it seem that just about everyone has had a look at what she had to say, and what it means to specific services as well as our industry.  Not wanting to feel left out, I felt that it was my turn to do the same. There was not much in Dr. Saussy’s letter that surprised me.  Many of the issues that she brought to light were ones that have been there for years, and have been known about for years but commonly were just brushed under the rug.  To expand on that a bit, a lot of the problems pointed out in the letter closely resemble problems pointed out to me by friends working in a number of different surfaces around the country. You cannot blame Dr. Saussy for the decision that she made.  As medical director, the ultimate responsibility of who does and does not practice within her system rests on her.  She is a woman with a long standing reputation as an innovative, aggressive, and involved medical director.  Her capture by DCFEMS was one that should have been seen as a huge step forward for the department.  The only question that fire department leadership should have been asking following the hiring should have been “Tell us what to do next, doctor.”  Instead, Dr. Saussy was met with resistance and the usual “that will not work here.”  She was forced to go head to head with a union that has done so much to hold back its department, not to mention its “sister” union representing the single role providers serving Washington, DC. And then there is the proposed plan involving American Medical Response.  First, let me start out by saying that while some might not like AMR or their business practices, they really are one heck of a company.  I worked with them for 12 years, and although some of the leadership in the division that I worked...

Well, as the title of this post suggests, I am back. I know, I know it has been quite some time since I have posted anything here, and it has been a lot longer since I have posted consistently but with EMS Today coming up this week, I decided to reopen the door to blogging and start writing again. For the last six months I have been focusing on a lot of aspects of both my personal and professional life. I have been teaching more, developing classes more, and just generally enjoying life outside of the blogging world. After writing for five and a half years, I guess that I just needed a break. I have spent the last couple of months writing for Dragons Speak, a blog about Drexel University’s basketball team in Philadelphia. As a present to my dad, a Drexel grad, I got us season tickets. Sports writing has been a good outlet, and has helped me break down some of the more serious setbacks that I have had with writer’s block over the last couple of months. I am sure that most of the other bloggers who are still out there and active will agree that writing is a labor of love. Unlike some, I don’t make any money from doing this. This website is completely self-funded and maintained. I write because I enjoy it, and I write because I am passionate about my chosen career. My main motivation for coming back and writing, however, is two-fold. Moving past my love for it and my field, I am not at all happy with the direction that the online community of bloggers has taken. While there are still the likes of Noonan, Grayson, and Schorr gracing this series of tubes that we call the internet with their thoughts and feelings on this field, there are others who have become more frequent contributors who leave me scratching my head. But enough of the negativity. Let’s get back to writing, right? Lately, EMS Compass has taken up a lot of my time, and with that coming to a close I plan on having more time to spend with a cup of coffee and...

The city council in Washington DC passed an ordinance this past week to contract with private ambulance companies to provide additional ambulance coverage to handle an overflow of lower priority calls.  The response from the paramedic’s union is the usual rhetoric one would expect: “If we don’t show up people are going to die!”  Wrong, folks.  If nobody shows up that might happen.  Does it have to be a DCFEMS ambulance?  Absolutely not. For the life of me I cannot figure out how a system the of Washington, DC’s can operate without a safety net.  How is there nobody there to pick up the overflow?   In Springfield, Massachusetts for example, a city of 150,000 people we had a relief valve for when the volume outpaced the resources.  Other companies signed agreements and participated in the 911 system when we needed them to and guess what?  Because of the structure of our system, and the allowance that we could select who was part of the system in my seven years in management I never heard a complaint about the level of care that was provided in any instances of backup response.  Sure, you ran into the occasional response time issue however much like the proposed DCFEMS changes those units were commonly handling lower priority calls.  It is much easier to get a truck who is making a turnaround at a hospital to pick up a CPR call or a shooting than it is the toe pain or another suicidal person. The key to a partnership like this is structure and oversight.  While some might complain that the hastily made plan by the city council might lack just that, but creating and instituting these measures should not be difficult.  For example, a great place to start is to set standards for who you will let in on the action.  Is it smart to let every mom and pop shop descend into the neighborhoods of DC to provide emergency care?  Absolutely not, but there are plenty of services in the heavily saturated DC area who could more than handle the volume. And let’s not lose sight of the fact that although the patch on one shoulder...

Sep 22, 2015

My trip to Las Vegas for EMS World EXPO 2015 was my eleventh consecutive trip to a major EMS conference.  I feel like I have had a front row seat to see the direction that conferences like EMS World EXPO and EMS Today have taken on a number of different levels.  The crowd certainly has changed.  You still have your big names that show up year after year and those faithful attendees who come year after year and take classes.  Many products stay the same, while many “new and great ideas” are here one year, and gone the next.  Ambulance design shows the continued utter lack of advancement particularly from a provider safety stand point, which I continue to find alarming.  My car today looks nothing like the 1987 Volkswagen Jetta that was my first car in high school, so why does the back of my ambulance look exactly the same as the 1984 box truck that I first road in back in 1993? It is interesting the direction that conferences in general have taken.  For a few years there seemed to be a bevy of new content mixed in with the usual trauma, mass casualty and pediatric classes that always seem to populate the convention schedule.  We used to learn about how ultrasounds were going to be the next big thing, and now Mobile Integrated Healthcare has taken yet another conference by storm.  It’s important information about the future of our industry but come on, folks, it’s time to see something new. To JEMS and EMS World, I beg of you, step outside of your comfort zones.  Let’s move away from the same speakers that present year after year, regardless of how many awards that they have won, or how many articles that they have published.  We need some fresh new ideas and fresh new presenters.  I know that might ruffle the feathers of a few people out there who do not like being turned down, in fact I know of one in particular who has already said he is not submitting to a certain conference anymore because they did not want him this time around, but the time has come.  We are...