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Big Bummer for Stockton Fire

September 6, 2010 By 11 Comments

Long story short……

Stockton City Fire recently lost their paramedic privileges due to circumstances that I still don’t fully understand. So naturally the fire officials are on TV talking about how people are going to start dying left and right because now the only paramedics responding to their calls are on ambulances.

Hmm, paramedics working on ambulances and firemen working on fire trucks. Who would have thought?

The firefighters are going to arrive on scene first, like they do 73% of the time.
-Fire Chief Ron Hittle

There are cities all over the nation that work at this same level. It’s called a tiered response and it works well. The majority of ALS care should be done while en route to the hospital. Sitting around on scene starting IV’s and pushing medications accomplishes nothing.

Don’t get me wrong, I get that there could be SOME occasions where the ambulance service is delayed arriving on scene within their required response times. But how many times is this actually going to negatively affect the patient? Cities and counties spend millions of dollars on services that can be provided at NO COST to the tax payers if it were to be contracted out to private enterprise.

I’m sure that AMR will handle this situation just fine.

http://www.ems1.com/fire-ems/articles/874010-Calif-firefighters-barred-from-ALS-responses/


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  • Lyfeoffire

    Yes smaller citys with a fraction of the call volume work at a lower level of service. Sounds like the service I want for my family. The service Stockton Fire provides costs tax payers a small $1.2 million a year for 60- 100 paramedics. A minumum of 26 Medics a day. The city pays more for some individual beautification projects….statues!

    AMR…No cost to citizens/TAX payers? Give me a break..How much is the AMR bill for a $10 taxi ride to the hospital? $800-1000 to start? How much does one I.V. catheter or non-sterile 4×4 cost and how much does AMR bill for those. Yes, tax payers pay for Firefighters with TAXES. Fire departments are here to serve the citizens and private ambulances are here to make a profit.

    If you work on the streets, your private, for-profit company I’m sure will look out for your best interests as such a valuable employee .If you are on the streets you probably don’t understand this. But you will when your management lays you off for the new graduate medic that doesn’t cost them as much in benefits and hourly pay. You’ll understand this when you are running 20 calls a shift because your company leaders are pulling rigs off the street in non-paying districts to make more money.Why do you think most street medics become firefighters or go to Nursing and PA school. This is a threat to your job! The medical Director in this county is anti-ALS! He stated publically last week that “Paramedics don’t practice medicine..physicians do.” How many times have you seen an PSVT convert on scene, breathing treaments work before care is transferred? How many advanced airways have you secured? If you don’t think a difference is made on scene, try showing up before the fire department. You’ll get it. That is why the Paramedic system was created. To Stablize treat and transport to definitive care.

    To take a system backwards 30 years is criminal. To take a service away from the citizens that is payed for with Taxes is crminal. Why would you want less service? To protect your profit? Hmmm think about it!

    AMR…a For Profit Company. There employees on the streets have no solid representation, are forced to sit in an ambulance for 8-12 hours on street corners with no access to bathrooms, illegally eat meals in those ambulances, sleep in them and who profits? Upper management. For profit companies make millions on cutting costs from the bottom up. This is a political move to increase profit and is directly related to the AMR subsidised dispatch center-Lifecomm. Why would Lifecomm want control of dispatching? For federal funding…Profit! Who is a direct beneficiary of this profit? The EMS Director, also a shareholder with AMR. He has a direct interest in moving the profit to another county. Oh! did I mention The dispatch center for this county is in another county? Oh and did I mention that the fines AMR pays, somewhere in the vicinity of $15,000 a month goes to the county budget. Yes they also are profiting from this. AMR/Lifecomm receives state and federal tax funding by calling their dispatch center a public safety dispatch center. But when run strings/response times are requested they call themselves a private comapny to protect themselves from public destruction and scrutiny. This is about a dollar, not human life. I became a paramedic for human life, not a dollar. More to come…

    • Anonymous

      You offer up some very valid arguments but I must still respectfully disagree.

      To compare yourself to a “for profit” enterprise and say that you provide better care is just wrong. As long as you continue to collect a pay check then you are in the same boat. As am I. We all provide our communities with a valuable service. But we do it for some type of reward, as we would with any other job. You show up to work, you run calls, save lives, put out fires, etc. You may love your job and look forward to it, but in order to do what you do there must be one thing that is taken care of first. Money. You gotta bring home the bacon. Your absolutely right, people leave private ambulance jobs to become firefighters, doctors, and nurses…..TO MAKE MORE MONEY. Does this make you or me a bad person? No. Are we putting money before peoples lives? Maybe.

      As long as we can remember, medicine has come at some price. Years ago, if we needed an appendix removed then we might agree to paint the doctors house or give him a few cows. Now we pay in the form of money. EMS is no different. We either pay in the form of taxes or we pay in the form of a bill after being transported. In some areas we do both.

      The evil upper management cutting units to save costs is no different than your county officials taking away paramedics from your fire engines. Politics is politics. No matter what side of the fence you are on, it sucks.

      Your argument in regards to ambulance bills doesn’t hold any water. If the fire service was providing transport services, they would be collecting taxes and billing per transport to provide that service. And yes, their bill would be just as high.

      I’m not sure if you have been watching the news lately, but thousands of government employees are getting laid off everyday. It’s not just a private-sector thing. As a matter of fact, the private ambulances are less likely to do massive layoffs as they have to meet their response time requirements in order to fulfill their contract obligations. They HAVE to have units on the streets or they will be replaced. And sitting on the street corners isn’t that bad. I know lots of cops that make a pretty good living doing the same thing. I would like to see one, just one private ambulance crew that could possibly run 20 calls in a 12 hour shift. Is that even physically possible?

      Taking paramedics off fire engines isn’t going backwards. There are still paramedics providing care in the form of transporting ambulances. Something that is done in the majority of systems around the world. Nothing criminal there. I’m sorry but people aren’t going to start dropping dead.

      If the people of Stockton still want paramedics on their fire engines, then more power to them! I’m all about the freedom of choice. If the majority of citizens in that community are against this move, then I will concede and say “shame on San Joaquin County” for not listening to their constituents. However, I will not argue that the move is going to put people at great risk.

      • Lyfeoffire

        The Fire department provides Faster care…we don’t race from one end of the county to the next to get on scene. We are strategically placed throughout our city to allow fast response to all emergency calls. Maybe this is the better care, remember-Time is muscle…Im not making this a Fire against ambulance blog just putting info out about how managment in a private for-profit company doesnt care about citizens or its street level employees.

        I don’t collect a paycheck. I serve the public. Maybe someday you will know what it is like. If you have been in the business long enough ask the older firefighters about the food stamps they qualified for or two jobs they worked or the cancers, and retiring injuries they have endured. You said it yourself..you’re bringing home the bacon. If youre in this to make a penny, you should reconsider why you do this.I have taken pay cuts, made concessions, have had multiple injuries, and deserve every benefit I have. We are being targeted, blamed and paying for the wasteful spending of the City officials. If you dont believe me come see for yourself. This city has wasted millions trying to make Stockton a destination city..It is not and never will be. Number 2 most miserable city in America, 3rd for homicides in California, 11th busiest engine company, on and on… Yes the pay is good and yes I would do it for less. This boils down to providing the best care for people in need, not money.

        There were F.D. ambulances here, that were payed for with taxes. Those rigs weren’t downstaffed at night, or moved to influential areas and discrminating against the poor. That seems to be the norm with AMR. Cutting ambulances to make money by not paying multiple employees is dangerous and cuts service to those we serve, yes just like the county supervisors taking our licenses and giving less of a service to the city they dont even live in.. Although….the county doesn’t sign my paycheck, the city does and the Paramedic License I hold is a minimal cost to the city.

        People leave the ambulance because they get tired of being a slave to upper management, and have hip, knee, and back problems. Or, maybe they leave because the security of their job is not there. Always the threat of being layed off/fired. I hope Cal-Osha see’s the abuse some of my friends are put through. Yes, I came from private ambulance, yes I have some great friends there. Yes there are quality medics on those rigs. The company does not give 2 cents about employees, and few AMR street medics are happy with management in San Joaquin.

        I challenge you to post AMR transport and treatment cost recovery spreadsheets and expenditure reports. There is a difference with paying for great service and ripping off the poor and elderly -most of the demographics we treat. I wish that we could contract with the AMR street employees and allow them peace of mind to work for reason and not fear. I have sat on street corners, this town is not fairy town, it is Stockton. And yes I have run 20 calls in 12 hours, not sitting out of service at a hospital, but going from one call to the hospital to the next, back when there were 5 different ambulance providers in this city. Cops can’t be brought into this. They hate there job. Everyone hates police, they risk their life on every single call and never get a break. Just watch Cop vs. FF j/k.

        Again, the way AMR gets around staffing requirements in this county and avoiding layoffs and cover up their response time requirements is by paying a nice $15,000 a month fine to the county, whom doesn’t mind getting more money. AMR owns Lifecom Dispatch. AMR…a For Profit Company. Upper management. For profit companies make millions on cutting costs from the bottom(streets) up. This is a political move to increase profit and is directly related to the AMR subsidised dispatch center-Lifecom. Why would Lifecom want control of dispatching? For federal funding…Profit! Who is a direct beneficiary of this profit? The EMS Director, also a shareholder with AMR. He has a direct interest in moving the profit to another county. Oh! did I mention The dispatch center for this county is in another county? Yes they also are profiting from this. AMR/Lifecom receives state and federal tax funding by calling their dispatch center a public safety dispatch center. But when run strings/response times are requested they call themselves a private company to protect themselves from public destruction and scrutiny.

        In the news: The Alameda County Board of Supervisors voted 4-0 Tuesday to replace the county’s current ambulance service provider AMR with a company from Texas. Director Alex Briscoe recommended that the new five-year contract be awarded to Paramedics Plus because it submitted a lower bid and scored better in an analysis conducted by outside experts. 10 year contract.

        There were 2 medics on every engine in Stockton, it is quite nice to have three sets of hands working to stablize patients on scene and enroute. In this county, it takes two people just to intubate, so two other medics usually get IV’s and push meds. I have seen, many field saves and well organized codes, MCI’s etc. Run an MCI in this county now. Have two engines with 8 guys show up and all they can do is take bp, o2 and triage, while the medic on scene is MED group sup and hands are tied to radios wating for more units. And here the engines have sometime 3 or more medics on an engine, 1 or 2 that are unassigned medics. If you dont think we make a difference come ride a long. You’ll see first hand. In closing, this move has been about money and politics, not standard of care. About a Dr. whom believes “Medics don’t practice medicine, physcians do.” I have seen first hand how much a minute or two matter and the patient care compromised. Why after 30 years would you take a valuabe tool away, even if it was only one life we saved.

        • Anonymous

          To say that you serve the public and I don’t is absurd. We both do the same job. It doesn’t matter who signs our checks. We signed up for this job for the same reason. Neither of us do this FOR THE MONEY but we have to make a living.

          Making broad statements that private entities don’t care about the citizens simply because they turn a profit is wrong. I’m not advocating for AMR because I don’t work for them and honestly know nothing about how they do business. What I do know is that I work for a private ambulance service that cares very much about the citizens in our community. We provide countless hours of free community service events ranging from ambulance standbys, school events, blood pressure clinics, food drives, etc. Not to mention the large amounts of money that we donate to local charities and programs. We have had employees come in on their days off to volunteer at senior centers and homeless shelters with no direction. So lets not say that all privates are evil.

          If AMR isn’t meeting their response time requirements, then perhaps your county should look into finding another service that can. We sit on street corners and utilize system status in our busy metro areas. Sure it’s not as comfortable as sitting in a recliner but it’s cost efficient and it works. As a result, we arrive on scene the majority of time either before or with the local fire department. Keep in mind that we do this less than half the resources that the fire departments have. I get that fire stations have to be strategically placed in order to fight fires effectively, but you cant put EMS into this category. There are simply too many medical emergencies (or 911 calls rather) to have crews sitting in a station. Adding more crews to match the numbers that the fire department has would simply be a waste of money. Would you be opposed to placing response time requirements on fire responses? Perhaps the service could be contracted out to CDF or a private entity such as Rural Metro if the current fire service fell out of compliance.

          We run single medic on every call for the majority of the county. We do just fine on MCI’s, full arrests, etc. If you have a true MCI, ALS care should be kept strictly to a minimum, if even done at all. If you start an IV, you have done nothing for that patient. Now they are hurt and have a needle in their arm. You can’t sit around a watch a heart monitor because that takes a resource away from the incident that should be used gathering and moving patients. Intubation? Shouldn’t even be considered on an MCI.

          I am interested in how your system requires 2 paramedics to intubate. Is this a policy? If so, is the ambulance service staffing dual medic units to meet this requirement? I’m interested to hear more about that.

          I’m well aware that cities and counties are now paying for the years of wasteful spending and the ones providing essential services are getting caught in the cross hairs. It sucks but thats your government, here to help.

          • Lyfeoffire

            I had a chance to read many of your blogs on this site. I have spent years hoping that doing the right thing, being a preceptor for many successful interns, really having a passion to help people, would be enough to make an impact on the EMS system. After reading your website, I am becoming hungry to find out more about why you hate Fire Departments so much, and why you truly believe that less is better?

            I have personally intubated a patient pinned under a car during a mass casualty/MCI, Why? because there were enough medics on scene and not enough ambulances to transport patients. Our county medical administrator has designed many policies slowly taking pertinent skills away from medics over the last 3 years. He has never worked the streets. Book educated! Our county required a 100% audit on all intubations performed in the field. During this audit they found that SFD was 95% successful during field intubations and private ambulance at 70% succeess. So, the solution was to have two people assigned to all intubations and we have to use a nice little device called a Bougie/ETTI. The stylet is removed from the ET tube and the intubation is performed using bougie/ETTI. Then the second person slides the ET tube over the Bougie and into the trachea.-2 people…I have had 14 intuabtions this year alone, on an engine with continous Interns. All successful. But let me tell you this, the more skilled hands on scene make a difference. I am not going to get into policies, as you know city to city as well as county to county they are different. Our demographics, call volumes response times and funding are all dynamic. Our system in California is broken. I had the oppurtunity to go to a few EMS courses on the east coast over the last few years and the Paramedics there put ours to shame. Their protocols far exceed any treatment modalities in this state. My statements concerning Privates not caring for the citizen refers to the Upper management. I know how much of a difference the street employees make and commend them for working under those circumstances. I think we can improve the system here but when profit is involved, the interest gets taken away from customer service.

            We have response time requirements here at the SFD. We are a Class 1 city and only 1 of 3 on the west coast. This classification is very hard to keep but we do, and have for years. We pride ourselves in performing aggressive interior attack firefighting and rarely loose a structure because of this. Ask around about the reputation of Stockton Fire and you will hear the same. We still fight fire in this town. A lot. I am proud to work here, but ashamed at the direction of our EMS system. AMR used to have stations and 24 hour cars here, along with 4-5 other providers. Ask the employees here how they feel about posting for 12 hours, with no stations or a place to change and was off blood and stink. I would love for our county to hold AMR responsible for response times or find a better provider, but when the political corruption runs alongside of corporate corruption not much will change and those discrepancies in the system will be swept under the rug, as they have been here. Everyone has their hand in each others pockets. What a shame.

            How would you feel if tomorrow morning you went to work and your EMS director told you to put electrical tape over anything with the word Paramedic on it, that no matter what you have, to only due the minimum amount of care with minimum amount of equipment. To remove this equipment and store it. All because he doesn’t think you make a difference. And come to find out, that the real reason has to do with one man wanting and creating control for himself, and nothing to do with the care you provided. Now run a few calls that you know you could make a difference and the outcome of the patient worsens and you can do nothing about it.

            Put yourself in our shoes, as I have been in yours. Give me a solution. Please, come ride along up here, see how busy we are, and what really goes on behind the media articles. Then I welcome your input. To convince me that less is better than more when it comes down to human life will change why I do this, and I hope that never happens. I apologize if you were offended by some of my comments but I want to get the truth out to anyone that reads this. My intentions were never to attack you or any other street medic, just to defend our core beliefs. Thanks for discussing this…

  • Lyfeoffire

    Yes smaller citys with a fraction of the call volume work at a lower level of service. Sounds like the service I want for my family. The service Stockton Fire provides costs tax payers a small $1.2 million a year for 60- 100 paramedics. A minumum of 26 Medics a day. The city pays more for some individual beautification projects….statues!

    AMR…No cost to citizens/TAX payers? Give me a break..How much is the AMR bill for a $10 taxi ride to the hospital? $800-1000 to start? How much does one I.V. catheter or non-sterile 4×4 cost and how much does AMR bill for those. Yes, tax payers pay for Firefighters with TAXES. Fire departments are here to serve the citizens and private ambulances are here to make a profit.

    If you work on the streets, your private, for-profit company I’m sure will look out for your best interests as such a valuable employee .If you are on the streets you probably don’t understand this. But you will when your management lays you off for the new graduate medic that doesn’t cost them as much in benefits and hourly pay. You’ll understand this when you are running 20 calls a shift because your company leaders are pulling rigs off the street in non-paying districts to make more money.Why do you think most street medics become firefighters or go to Nursing and PA school. This is a threat to your job! The medical Director in this county is anti-ALS! He stated publically last week that “Paramedics don’t practice medicine..physicians do.” How many times have you seen an PSVT convert on scene, breathing treaments work before care is transferred? How many advanced airways have you secured? If you don’t think a difference is made on scene, try showing up before the fire department. You’ll get it. That is why the Paramedic system was created. To Stablize treat and transport to definitive care.

    To take a system backwards 30 years is criminal. To take a service away from the citizens that is payed for with Taxes is crminal. Why would you want less service? To protect your profit? Hmmm think about it!

    AMR…a For Profit Company. There employees on the streets have no solid representation, are forced to sit in an ambulance for 8-12 hours on street corners with no access to bathrooms, illegally eat meals in those ambulances, sleep in them and who profits? Upper management. For profit companies make millions on cutting costs from the bottom up. This is a political move to increase profit and is directly related to the AMR subsidised dispatch center-Lifecomm. Why would Lifecomm want control of dispatching? For federal funding…Profit! Who is a direct beneficiary of this profit? The EMS Director, also a shareholder with AMR. He has a direct interest in moving the profit to another county. Oh! did I mention The dispatch center for this county is in another county? Oh and did I mention that the fines AMR pays, somewhere in the vicinity of $15,000 a month goes to the county budget. Yes they also are profiting from this. AMR/Lifecomm receives state and federal tax funding by calling their dispatch center a public safety dispatch center. But when run strings/response times are requested they call themselves a private comapny to protect themselves from public destruction and scrutiny. This is about a dollar, not human life. I became a paramedic for human life, not a dollar. More to come…

    • http://www.medicmadness.com Sean Eddy

      You offer up some very valid arguments but I must still respectfully disagree.

      To compare yourself to a “for profit” enterprise and say that you provide better care is just wrong. As long as you continue to collect a pay check then you are in the same boat. As am I. We all provide our communities with a valuable service. But we do it for some type of reward, as we would with any other job. You show up to work, you run calls, save lives, put out fires, etc. You may love your job and look forward to it, but in order to do what you do there must be one thing that is taken care of first. Money. You gotta bring home the bacon. Your absolutely right, people leave private ambulance jobs to become firefighters, doctors, and nurses…..TO MAKE MORE MONEY. Does this make you or me a bad person? No. Are we putting money before peoples lives? Maybe.

      As long as we can remember, medicine has come at some price. Years ago, if we needed an appendix removed then we might agree to paint the doctors house or give him a few cows. Now we pay in the form of money. EMS is no different. We either pay in the form of taxes or we pay in the form of a bill after being transported. In some areas we do both.

      The evil upper management cutting units to save costs is no different than your county officials taking away paramedics from your fire engines. Politics is politics. No matter what side of the fence you are on, it sucks.

      Your argument in regards to ambulance bills doesn’t hold any water. If the fire service was providing transport services, they would be collecting taxes and billing per transport to provide that service. And yes, their bill would be just as high.

      I’m not sure if you have been watching the news lately, but thousands of government employees are getting laid off everyday. It’s not just a private-sector thing. As a matter of fact, the private ambulances are less likely to do massive layoffs as they have to meet their response time requirements in order to fulfill their contract obligations. They HAVE to have units on the streets or they will be replaced. And sitting on the street corners isn’t that bad. I know lots of cops that make a pretty good living doing the same thing. I would like to see one, just one private ambulance crew that could possibly run 20 calls in a 12 hour shift. Is that even physically possible?

      Taking paramedics off fire engines isn’t going backwards. There are still paramedics providing care in the form of transporting ambulances. Something that is done in the majority of systems around the world. Nothing criminal there. I’m sorry but people aren’t going to start dropping dead.

      If the people of Stockton still want paramedics on their fire engines, then more power to them! I’m all about the freedom of choice. If the majority of citizens in that community are against this move, then I will concede and say “shame on San Joaquin County” for not listening to their constituents. However, I will not argue that the move is going to put people at great risk.

      • Lyfeoffire

        The Fire department provides Faster care…we don’t race from one end of the county to the next to get on scene. We are strategically placed throughout our city to allow fast response to all emergency calls. Maybe this is the better care, remember-Time is muscle…Im not making this a Fire against ambulance blog just putting info out about how managment in a private for-profit company doesnt care about citizens or its street level employees.

        I don’t collect a paycheck. I serve the public. Maybe someday you will know what it is like. If you have been in the business long enough ask the older firefighters about the food stamps they qualified for or two jobs they worked or the cancers, and retiring injuries they have endured. You said it yourself..you’re bringing home the bacon. If youre in this to make a penny, you should reconsider why you do this.I have taken pay cuts, made concessions, have had multiple injuries, and deserve every benefit I have. We are being targeted, blamed and paying for the wasteful spending of the City officials. If you dont believe me come see for yourself. This city has wasted millions trying to make Stockton a destination city..It is not and never will be. Number 2 most miserable city in America, 3rd for homicides in California, 11th busiest engine company, on and on… Yes the pay is good and yes I would do it for less. This boils down to providing the best care for people in need, not money.

        There were F.D. ambulances here, that were payed for with taxes. Those rigs weren’t downstaffed at night, or moved to influential areas and discrminating against the poor. That seems to be the norm with AMR. Cutting ambulances to make money by not paying multiple employees is dangerous and cuts service to those we serve, yes just like the county supervisors taking our licenses and giving less of a service to the city they dont even live in.. Although….the county doesn’t sign my paycheck, the city does and the Paramedic License I hold is a minimal cost to the city.

        People leave the ambulance because they get tired of being a slave to upper management, and have hip, knee, and back problems. Or, maybe they leave because the security of their job is not there. Always the threat of being layed off/fired. I hope Cal-Osha see’s the abuse some of my friends are put through. Yes, I came from private ambulance, yes I have some great friends there. Yes there are quality medics on those rigs. The company does not give 2 cents about employees, and few AMR street medics are happy with management in San Joaquin.

        I challenge you to post AMR transport and treatment cost recovery spreadsheets and expenditure reports. There is a difference with paying for great service and ripping off the poor and elderly -most of the demographics we treat. I wish that we could contract with the AMR street employees and allow them peace of mind to work for reason and not fear. I have sat on street corners, this town is not fairy town, it is Stockton. And yes I have run 20 calls in 12 hours, not sitting out of service at a hospital, but going from one call to the hospital to the next, back when there were 5 different ambulance providers in this city. Cops can’t be brought into this. They hate there job. Everyone hates police, they risk their life on every single call and never get a break. Just watch Cop vs. FF j/k.

        Again, the way AMR gets around staffing requirements in this county and avoiding layoffs and cover up their response time requirements is by paying a nice $15,000 a month fine to the county, whom doesn’t mind getting more money. AMR owns Lifecom Dispatch. AMR…a For Profit Company. Upper management. For profit companies make millions on cutting costs from the bottom(streets) up. This is a political move to increase profit and is directly related to the AMR subsidised dispatch center-Lifecom. Why would Lifecom want control of dispatching? For federal funding…Profit! Who is a direct beneficiary of this profit? The EMS Director, also a shareholder with AMR. He has a direct interest in moving the profit to another county. Oh! did I mention The dispatch center for this county is in another county? Yes they also are profiting from this. AMR/Lifecom receives state and federal tax funding by calling their dispatch center a public safety dispatch center. But when run strings/response times are requested they call themselves a private company to protect themselves from public destruction and scrutiny.

        In the news: The Alameda County Board of Supervisors voted 4-0 Tuesday to replace the county’s current ambulance service provider AMR with a company from Texas. Director Alex Briscoe recommended that the new five-year contract be awarded to Paramedics Plus because it submitted a lower bid and scored better in an analysis conducted by outside experts. 10 year contract.

        There were 2 medics on every engine in Stockton, it is quite nice to have three sets of hands working to stablize patients on scene and enroute. In this county, it takes two people just to intubate, so two other medics usually get IV’s and push meds. I have seen, many field saves and well organized codes, MCI’s etc. Run an MCI in this county now. Have two engines with 8 guys show up and all they can do is take bp, o2 and triage, while the medic on scene is MED group sup and hands are tied to radios wating for more units. And here the engines have sometime 3 or more medics on an engine, 1 or 2 that are unassigned medics. If you dont think we make a difference come ride a long. You’ll see first hand. In closing, this move has been about money and politics, not standard of care. About a Dr. whom believes “Medics don’t practice medicine, physcians do.” I have seen first hand how much a minute or two matter and the patient care compromised. Why after 30 years would you take a valuabe tool away, even if it was only one life we saved.

        • http://www.medicmadness.com Sean Eddy

          To say that you serve the public and I don’t is absurd. We both do the same job. It doesn’t matter who signs our checks. We signed up for this job for the same reason. Neither of us do this FOR THE MONEY but we have to make a living.

          Making broad statements that private entities don’t care about the citizens simply because they turn a profit is wrong. I’m not advocating for AMR because I don’t work for them and honestly know nothing about how they do business. What I do know is that I work for a private ambulance service that cares very much about the citizens in our community. We provide countless hours of free community service events ranging from ambulance standbys, school events, blood pressure clinics, food drives, etc. Not to mention the large amounts of money that we donate to local charities and programs. We have had employees come in on their days off to volunteer at senior centers and homeless shelters with no direction. So lets not say that all privates are evil.

          If AMR isn’t meeting their response time requirements, then perhaps your county should look into finding another service that can. We sit on street corners and utilize system status in our busy metro areas. Sure it’s not as comfortable as sitting in a recliner but it’s cost efficient and it works. As a result, we arrive on scene the majority of time either before or with the local fire department. Keep in mind that we do this less than half the resources that the fire departments have. I get that fire stations have to be strategically placed in order to fight fires effectively, but you cant put EMS into this category. There are simply too many medical emergencies (or 911 calls rather) to have crews sitting in a station. Adding more crews to match the numbers that the fire department has would simply be a waste of money. Would you be opposed to placing response time requirements on fire responses? Perhaps the service could be contracted out to CDF or a private entity such as Rural Metro if the current fire service fell out of compliance.

          We run single medic on every call for the majority of the county. We do just fine on MCI’s, full arrests, etc. If you have a true MCI, ALS care should be kept strictly to a minimum, if even done at all. If you start an IV, you have done nothing for that patient. Now they are hurt and have a needle in their arm. You can’t sit around a watch a heart monitor because that takes a resource away from the incident that should be used gathering and moving patients. Intubation? Shouldn’t even be considered on an MCI.

          I am interested in how your system requires 2 paramedics to intubate. Is this a policy? If so, is the ambulance service staffing dual medic units to meet this requirement? I’m interested to hear more about that.

          I’m well aware that cities and counties are now paying for the years of wasteful spending and the ones providing essential services are getting caught in the cross hairs. It sucks but thats your government, here to help.

          • Lyfeoffire

            I had a chance to read many of your blogs on this site. I have spent years hoping that doing the right thing, being a preceptor for many successful interns, really having a passion to help people, would be enough to make an impact on the EMS system. After reading your website, I am becoming hungry to find out more about why you hate Fire Departments so much, and why you truly believe that less is better?

            I have personally intubated a patient pinned under a car during a mass casualty/MCI, Why? because there were enough medics on scene and not enough ambulances to transport patients. Our county medical administrator has designed many policies slowly taking pertinent skills away from medics over the last 3 years. He has never worked the streets. Book educated! Our county required a 100% audit on all intubations performed in the field. During this audit they found that SFD was 95% successful during field intubations and private ambulance at 70% succeess. So, the solution was to have two people assigned to all intubations and we have to use a nice little device called a Bougie/ETTI. The stylet is removed from the ET tube and the intubation is performed using bougie/ETTI. Then the second person slides the ET tube over the Bougie and into the trachea.-2 people…I have had 14 intuabtions this year alone, on an engine with continous Interns. All successful. But let me tell you this, the more skilled hands on scene make a difference. I am not going to get into policies, as you know city to city as well as county to county they are different. Our demographics, call volumes response times and funding are all dynamic. Our system in California is broken. I had the oppurtunity to go to a few EMS courses on the east coast over the last few years and the Paramedics there put ours to shame. Their protocols far exceed any treatment modalities in this state. My statements concerning Privates not caring for the citizen refers to the Upper management. I know how much of a difference the street employees make and commend them for working under those circumstances. I think we can improve the system here but when profit is involved, the interest gets taken away from customer service.

            We have response time requirements here at the SFD. We are a Class 1 city and only 1 of 3 on the west coast. This classification is very hard to keep but we do, and have for years. We pride ourselves in performing aggressive interior attack firefighting and rarely loose a structure because of this. Ask around about the reputation of Stockton Fire and you will hear the same. We still fight fire in this town. A lot. I am proud to work here, but ashamed at the direction of our EMS system. AMR used to have stations and 24 hour cars here, along with 4-5 other providers. Ask the employees here how they feel about posting for 12 hours, with no stations or a place to change and was off blood and stink. I would love for our county to hold AMR responsible for response times or find a better provider, but when the political corruption runs alongside of corporate corruption not much will change and those discrepancies in the system will be swept under the rug, as they have been here. Everyone has their hand in each others pockets. What a shame.

            How would you feel if tomorrow morning you went to work and your EMS director told you to put electrical tape over anything with the word Paramedic on it, that no matter what you have, to only due the minimum amount of care with minimum amount of equipment. To remove this equipment and store it. All because he doesn’t think you make a difference. And come to find out, that the real reason has to do with one man wanting and creating control for himself, and nothing to do with the care you provided. Now run a few calls that you know you could make a difference and the outcome of the patient worsens and you can do nothing about it.

            Put yourself in our shoes, as I have been in yours. Give me a solution. Please, come ride along up here, see how busy we are, and what really goes on behind the media articles. Then I welcome your input. To convince me that less is better than more when it comes down to human life will change why I do this, and I hope that never happens. I apologize if you were offended by some of my comments but I want to get the truth out to anyone that reads this. My intentions were never to attack you or any other street medic, just to defend our core beliefs. Thanks for discussing this…