Fire-based EMS currently is facing a perfect storm, according to Gary Ludwig, chairman of the Fire-Rescue Med conference in Las Vegas in a few weeks, so I asked Ludwig what he thought was the biggest issue facing fire-based EMS today, and his reply was a three-prong attack: money, money, money.’ EMS Section. The organization is hosting its
“You have the major recession and even though they say we’re coming back, it’s still two to three years out," he said. "Governments are cash-strapped and stimulus money is running out. Most fire departments [take up] a major part of municipal budgets, and city managers are looking for cash. … The budget crisis goes on, and two large private-ambulance companies were bought out by private-equity companies looking to expand into the U.S. markets or expand their current markets.”
Large-equity firms with vast resources have invested heavily in private-ambulance companies, which are targeting metro areas to increase their share of EMS response. “We’re going to find ourselves in contested races with private ambulances saying they can do it better and cheaper," Ludwig said. "But what happens when the dust settles in five years? This is our challenge.”
Playing devil’s advocate, I asked Ludwig why shouldn't fire departments let private ambulances take over EMS. With increasing call volumes, potential health and liability risks, and response-coverage issues when staffers are tied up at hospitals for hours, maybe such a strategy would reduce fire departments' hassle.
“The fire service is best suited to give emergency medical services," he answered. "Rural Metro [for example] only provides transport, so fire departments would still need to respond.
"Besides, fire departments offer a multitude of functions — first response, firefighting, rescue, hazmat and inspections," Ludwig continued. "It may cost more, but you don’t have to hire five different people to do our five jobs for one salary. No, it’s an added-value function of a firefighter and the fire department. … The question should be, 'Should we give up the transport?’”
Private ambulances are sure to be a hot topic at Fire-Rescue Med, but there are several pressing issues that also will be addressed in depth this year.
Brad Bradley of the Northwest Fire Protection District in Arizona will give a presentation on EMS in a crisis situation based on the Jan. 8 shooting in Tucson, Ariz.
Aimin Alton of the Ventura County (Calif.) Fire Protection District will discuss EMS personnel and narcotics tampering, which is a growing problem in fire stations. Alton will offer insight on how to discover tampered-with narcotics, known methods of tampering and new techniques for checking narcotics before patient administration.
A presentation on the National Ambulance Contract and Intra-State Mutual Aid Systems will offer details on the two different systems for providing resources during disasters. The Federal National Ground and Air Ambulance and Para-transit Support Services Contract has been activated four times since its inception in 2007, while the Illinois Mutual Aid Box Alarm System is a statewide, nondiscriminatory mutual-aid response system for fire, EMS and specialized incident operation teams. Speakers will include MABAS President Jay Reardon,'s Mark Snyder and American Medical Response's Steve Delahousey.
Chief Randy Corbin of the Wylie (Texas) Fire Department will present a program on servant leadership, a practice which Ludwig supports. “I completely believe I’m here to serve,” Ludwig said. “I really subscribe to that and when I see my medics in the field, I ask them, ‘Is there anything I can do for you and is there anything I can fix for you?’”
Are you finding educational and networking opportunities to help calm the perfect storm?