Paid vs Volley or Volley vs Patient?

[BushyFromOz]

I think most of you are missing the point of what the original post is about. Is the current system supporting the communities it is supposed to be supporting adequately and appropriatley. The answer is no.

Root cause analysis would say the complexity and the politics of a volunteer system raises issues that are avoided simply by paid providers essentially having a contract to be on duty available to respond, with a minimium level of resources available and not pick and choose what they will and wont attend.

simple.

[ERDoc]

I am in a Linkedin group with the author of the blog. He has pulled the post down due to the amount of pressure put on him by those in power, mostly from the FDs that run EMS. The good thing about the internet is that is has gotten out there and there is no taking it back. It may not change the system but it opens the door. And to clear up any questions about the author, he is a 37 year volunteer in the system.

Politics is a big issue in the system also. We would drop pts off at hospital X, which is in ambulance company Y's district. We would be leaving the hospital to head back to our HQ and hear a call go out in Y's district. We are not allowed to respond since it is not our district and we do not have a operating certificate for that district. So, unless they called us for mutual aid we cannot respond, even though we could be the closest ambulance and already staffed.

[uglyEMT]

The complexity is definatley the issue. What they need is to sit down with all dept heads, oem, dispatch and get it figured out. First is duty crews. You have the man power avaialable 24/7 by assigning shifts, coverages, and times. You sit down and logical look at the coverage area and break it up accordingly. You base you dispatch times from there, if there are longer times second tone and mutal aid times are shortened to get the man power moving sooner.

The Department heads and/or Squad Captains need to sit down and hash it out. If anything get a mediator in there and put the BS to the side and get it done. It can be done and has in many municipalities. I know NJ isn't the bastion for EMS in the country but we do have an extremley large volunteer based system and it works. Usually the cities are paid services because the call volume and the population warrant it. Most of the suburbs and rural (yes folks NJ has rural areas) are soley volunteer based due to the above mentioned reasons.

I know that in my area we sit down at the end of the year and review our logs and make recomendations for the upcoming year. This is usually a few day process of review and discussion with everyone (FD,PD,Dispatch,OEM,EMS) and things get worked out. Then the squads work out their scheduals for the upcoming year to have 24/7 coverage and mutual aid agreements. Then during the year any big events that get planned we work out accordingly for the extra coverage even if we need to bring in outside municipalities to have enough man power. Also every quarter all the Squad Captains in the county have a meeting where we discuss issues and make recomendations that way surrounding municipalities are all on the same page.

[ERDoc]

That has been attempted in the past and the medical director was run out of her position for it. She was pretty much told, "It's our district and we will do as we please." Most of this came from the FDs but there were a few VACs that weren't too keen on it either though.

[paramedicmike]

And therein lies the problem. Everyone has their own little kingdom and they don't want to cede any perceived power they think they might have.

[Happiness]

Sounds like our hospital here, the little kingdom..................................

[Just Plain Ruff]

That has been attempted in the past and the medical director was run out of her position for it. She was pretty much told, "It's our district and we will do as we please." Most of this came from the FDs but there were a few VACs that weren't too keen on it either though.

Then maybe if enough of the medical directors get together and make a stand for patient care and say "enoughs enough" something might get done. If the EMS agencies don't have a medical director then they don't turn a wheel right? The mere threat that they won't have a medical director might be enough to spark some interest in making a change?

Or they just probably would get some lackey physician to sign his name to the dotted line not knowing what he was getting himself into.

[ERDoc]

There is a county EMS director who is a county employee that covers all of the agencies in the county. The position is still vacant but covered by an interim. It is basically, don't piss off the vollies or you will lose your job.

[Happiness]

WOW crappy system

[Just Plain Ruff]

And people wonder why some volly systems have such a crappy repuatation in our sphere.