The pros to fire-based EMS

For those you that have been reading my blog for any amount of time, this title probably comes as a shock to you. As you know, I make it no secret that I prefer a private-based EMS system. Perhaps it’s my conservative, pro private-business background that has molded my opinion on the matter. Regardless, I have yet to publicly acknowledge that other types of systems can be beneficial. Well today the pigs are a go for take-off, because I am going to take some time to talk about the benefits of fire-based EMS.

So here it goes, my list of the “pros” to fire-based EMS.

Training

For the most part, fire crews are running less and less fire calls and more medical calls. This being the case, they typically do a lot of training for medical-related emergencies and drill often to try and keep their knowledge and skills up. This is something that many private providers have lacked for a while.

Funding

Fire departments have done a wonderful job of securing funds at the state, local and federal level for a long time. This allows for high-quality equipment, better salaries and more resources. In areas where the fire service also provides ambulance transport, they are able to bill for their services as well to increase revenue.

Selection

With high pay, good benefits and an unbeatable retirement package, fire departments have qualified applicants lining up for miles for a job opportunity. This of course allows the department to be more selective when they hire personnel.

Health and Fitness

Firefighting can be a very physically demanding line of work. So naturally, fire personnel must work hard to stay healthy and physically fit. Regular exercise is something commonly seen amongst the profession. This leads to better concentration and less chance of injury.

Non-profit

In order to write this section, I must take some time to lock my stubbornness in the other room so it doesn’t interfere….so hang in there a minute.

…..ok still there? Good, here it goes.

I will admit that there is benefit to making decisions concerning equipment purchases, in-field practices and system management when making a return on your investment isn’t a priority. This is why you will commonly see fire services take on new procedures and protocols with open arms. They don’t typically have to worry about reimbursement.

So there you have it. My list of pros to fire-based EMS.


Comments

The pros to fire-based EMS — 4 Comments

  1. These are some very good and interesting points… but I need to play the devil’s advocate just a bit because the pros you have listed are relatively superficial:

    Training- Running more and more medical calls does not equate to more and more training for medical calls. Most FDs still have high expectations of training for fire calls, and the left over time is usually used for medical. Generally it’s a 4:1 fire to medical training hour ratio, and the medical training is rarely given the same priority due to the fact that the responder is less likely to be injured or killed on a medical call, typically forgetting the actual patient.

    Funding- It’s an interesting quagmire and a completely local issue when you consider that most FDs are tax funded, and being tax funded generally means there is no fee for service. If your house catches fire does the FD send you a bill? If you get robbed does the LE send you an invoice for taking a report? Generally speaking, no. So why can FDs charge for ambulance services? There are already a number of court cases in the legal system challenging this very practice, and eventually they will be resolved with either allowing the fee for service which will then cut tax revenue, or disallowing the fee for service which will end up with EMS being under funded once again

    Selection – Sure FDs can be more selective, but they are generally looking for good Firefighters first and good EMTs/Medics second. Just because you can lay a hose or climb a ladder does not necessarily mean that you have the skill to insert a needle or have a good bedside manner.

    Health and Fitness – No arguments here… especially with those kitchens in the firehouse which allows them to actually eat healthy instead of at the fast food joints down the block

    Non-profit – Yet another issue regarding their fee for service model, because a TRUE non-profit does not send you a bill or put you into collections as many FDs do. Now, a NOT-FOR-PROFIT model is a different model entirely, one that is not aiming to make money but bills for services. This of course raises the issue then about why they are not billing for fire suppression services.

    Yes, I am pro stand alone EMS services because I think that to be truly effective an organization needs to focus on one goal, and a stand alone service’s one goal would be patient care. Now I understand this may not be possible in all communities, and there are plenty of places where a combined service is the only way to serve the community for either financial or personnel reasons, but if more and more of the calls being answered are medical calls (which you state under the Training pro) then why is it Fire-based EMS. Why isn’t it an EMS-based Fire service?

    • Oh how it warms my heart to hear you say that……

      I absolutely agree with you. You have to understand that the purpose of this
      post was to set aside my bias and admit that there are some benefits to
      other systems than just a stand-alone EMS service.

  2. These are some very good and interesting points… but I need to play the devil's advocate just a bit because the pros you have listed are relatively superficial:Training- Running more and more medical calls does not equate to more and more training for medical calls. Most FDs still have high expectations of training for fire calls, and the left over time is usually used for medical. Generally it's a 4:1 fire to medical training hour ratio, and the medical training is rarely given the same priority due to the fact that the responder is less likely to be injured or killed on a medical call, typically forgetting the actual patient.Funding- It's an interesting quagmire and a completely local issue when you consider that most FDs are tax funded, and being tax funded generally means there is no fee for service. If your house catches fire does the FD send you a bill? If you get robbed does the LE send you an invoice for taking a report? Generally speaking, no. So why can FDs charge for ambulance services? There are already a number of court cases in the legal system challenging this very practice, and eventually they will be resolved with either allowing the fee for service which will then cut tax revenue, or disallowing the fee for service which will end up with EMS being under funded once againSelection – Sure FDs can be more selective, but they are generally looking for good Firefighters first and good EMTs/Medics second. Just because you can lay a hose or climb a ladder does not necessarily mean that you have the skill to insert a needle or have a good bedside manner.Health and Fitness – No arguments here… especially with those kitchens in the firehouse which allows them to actually eat healthy instead of at the fast food joints down the blockNon-profit – Yet another issue regarding their fee for service model, because a TRUE non-profit does not send you a bill or put you into collections as many FDs do. Now, a NOT-FOR-PROFIT model is a different model entirely, one that is not aiming to make money but bills for services. This of course raises the issue then about why they are not billing for fire suppression services. Yes, I am pro stand alone EMS services because I think that to be truly effective an organization needs to focus on one goal, and a stand alone service's one goal would be patient care. Now I understand this may not be possible in all communities, and there are plenty of places where a combined service is the only way to serve the community for either financial or personnel reasons, but if more and more of the calls being answered are medical calls (which you state under the Training pro) then why is it Fire-based EMS. Why isn't it an EMS-based Fire service?

  3. Oh how it warms my heart to hear you say that……I absolutely agree with you. You have to understand that the purpose of thispost was to set aside my bias and admit that there are some benefits toother systems than just a stand-alone EMS service.

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