A few years ago, while reviewing the competencies needed for each level of EMS officers as defined by the U.S. Fire Administration's fire and emergency services higher education (FESHE) project, an anomaly was discovered. One of the two competencies that didn't pass muster with more than 300 EMS managers was an understanding of international EMS and its relation to American EMS. It really wasn't too much of a surprise that the egocentric view prevalent among U.S. fire and emergency service providers — that we do it best — presented itself in this survey. Yet, tactics that are successful in many other countries are taking hold globally and soon will be coming to a town near you.
What would you think of a company that survived two world wars, during which time it continued to provide its typical services? A company that provided security, roadside assistance, fire protection and training, EMS, employee health services, as well as wellness programs to employers and the public, all for a reasonable price? A company that while doing all of this also provided great pay, benefits and pensions to its employees? As if that wasn't enough, this company also is an innovator in emergency-service operations, employing modern ambulance design, out-of-the-box services and state-of-the-art training to establish a long tradition of outstanding customer service.
The company that I've described is Falck, a Danish multinational that has waded into the American market ready to do business and potentially change the face of emergency services in the U.S. Its activities are focused on preventing accidents and disease; providing assistance during emergency incidents; and helping people move on with their lives after illness or accidents.
Falck bought its first ambulance in 1907, the first automobile ambulance in Scandinavia. Today, Falck provides 85% of all Danish ambulance operations. In the 1990s, Falck ambulances were put into operation in Poland and Sweden, and after the turn of the millennium in Belgium, Finland and Norway. In 2006, Falck became the largest ambulance company in Slovakia. In the last six months of 2010, the company acquired CARE, one of the largest West Coast ambulance services with primary contracts in Los Angeles and Orange County, Calif., and LifeStar ambulance, a major East Coast ambulance operator. As a result of these deals, Falck became one the top-five ambulance operators in the U.S., virtually overnight.
In 1922, Falck became a fire-service provider as well, and soon its brigades fought fires in most of Denmark. Today Falck provides firefighting services in two-thirds of the country's municipalities. Falck set up an independent division, Fire & Safety, in 2007 in Spain, and began offering fire-protection and training services outside of Denmark. Since then, Falck has obtained firefighting contracts in Brazil, the Netherlands, Romania, Slovakia, Spain, Sweden and United Kingdom. The company has plans to expand into southern Europe, South America and Mexico. Falck purchased Alford, a training subsidiary, and announced the opening of its new training facility located in Shreveport, La. This center offers more than 20 courses, as well as personnel services ranging from safety representatives to paramedics. Training centers also have opened in Homa and Lafayette, La., and most recently in Houston.
Both Falck and American private-ambulance companies have received recent infusions of capital from private-equity firms, putting them in position to expand markets and operations. For example, Falck — a company valued at more than 7.5 billion Danish krones (about $13 billion) in 2009 — recently received 2.8 billion krones (about $5 billion) from the Lundbeck Foundation for 36% of the company. In the U.S., EMS-C Corp., the parent of AMR, received $3.2 billion last month from Clayton, Dubliner and Rice in a leveraged buyout.
These are serious competitors to the American fire service. Traditionally, American private-ambulance services have seen a steady stream of employees migrate to the fire service for better pay, benefits and working conditions. Now, however, we are seeing private-ambulance companies that are backed by well-financed corporate parents, and which offer European-style benefits. Can you imagine an ambulance company that pays wages at the European scale, gives a month of vacation and expects you to take it — and embraces a never-say-no model of customer service?
Falck is such an entity. Indeed, it is the Halliburton of emergency services, prepared to service every aspect of a government's first-response needs. A company of this size comes with a cadre of all-star lobbyists and possesses a clear understanding of how big business influences policy decisions. In less than six months, Falck has become one of the largest ambulance operators in the U.S. Within two years the fire service may awaken one day to discover that the environment and structure in which public safety operates has been altered dramatically.
It remains to be seen whether the entrance of this European conglomerate will be the tipping point for municipal fire departments in terms of how they compete with the private ambulance industry. But one thing is certain: If we do not study the global changes that occur in our industry, the American fire and EMS service is going to wake up one day and say "what the Falck happened?"
What do you think? Tell us in the comment box below.
Bruce Evans is the EMS chief for the North Las Vegas (Nev.) Fire Department. He also is an adjunct faculty member for the National Fire Academy's EMS and injury prevention courses.
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