Paid vs Volley or Volley vs Patient?

[Happiness]

I have thought long and hard on the topic. First of all there are idiots on both sides of the fence in this profession, and to tell you the truth at some point and time you are the idiot regardless of what side your on, and regardless of the mistake you may have made.

It would be nice in a perfect word to have an ambulance attend to you within minutes but that is never the case anywhere. The problem I would like to focus on is the financial one. We need to think about the following (I will speak in Canadian)

1. Which system works better, Provincial or Private.

[uglyEMT]

Im not going to comment on the paid vs volley. horse meet stick. But I do want to comment on something I noticed in the blog and with my own eyes in my area.

Could it be more of a procedural issue moreso then a paid vs volly issue? What i am getting at is the way in which calls are handled not who handles them. The area I am in is fairly large 85 sq miles covered by two squads that are not fire based. The local procedure is night duty crews responding from home (one crew for each service rig) then any aditional help would be called up as necessary. Dispatch tones out the crew and if not 10-23ed within 5 minutes are retoned. 2 minutes later if no 10-23 recived the other squad gets toned and usually by that time the other squads crew is ready because they heard the retone and started getting ready. So we usually have a rig rolling within 7 minutes most times alot sooner. Some crews with far travel times usually stay at the station for their shift so response time is immediate. During the day we are most general calls, no dedicated duty crews, and I would say 99% of the time a rig gets rolling within a few minutes, usually the retone is to notify responding parties that the crew is filled or if additional support needs to call in. Very rarely has a mutual aid gone out. If it does it usually means all rigs are out on other calls or we are dealing with something big.

The dispatchers procedure is cut and dry as to how EMS calls are handled and coverage is good. They dont keep punching out time after time hoping someone calls in. I would think thats how it should be once twice mutual aid and depending on travel times for mutual time limits for the call up should be looked at.

I think from reading that blog it seems like the procedure is flawed. The dispatcher keeps trying for far to long, then on the other end the mutual aid seems flawed by not making it a priority to respond. I think the fire based issue here isnt so much of an issue as is the procedures put in place is.

I think it is time to sit down with department heads, oem, and dispatchers and work out a new set of procedures and response time variables.

As to the side issue brought up about the "good calls" vs "ugg calls" getting man power I think every service has that problem. Tone out a stomach pain at 3am vs an MVA and see which gets the ants crawling. Same goes for a fire based service. Its the nature of the beast I guess. A fire fighter I know once said their version is call out for a possible smoke condition vs full envolved structure fire and see which gets more guys to turn up.

[ERDoc]

As to the side issue brought up about the "good calls" vs "ugg calls" getting man power I think every service has that problem. Tone out a stomach pain at 3am vs an MVA and see which gets the ants crawling. Same goes for a fire based service. Its the nature of the beast I guess. A fire fighter I know once said their version is call out for a possible smoke condition vs full envolved structure fire and see which gets more guys to turn up.

But wouldn't that be a huge reason to go paid? If you are paid, you don't get to pick and choose. If someone calls 911, they get an ambulance.

[uglyEMT]

Doc I wil agree that a paid service doesn't get to pick and choose. You show up for your shift and answer the call what ever it may be.

I will say though that from my experience even in a volly squad once you set up duty crews the coverage is the same as a paid. Basically its your shift you work it. I paint with a broad brush with my 3am example but we still get the man power, it just seems that the MVA will get everyone calling in vs the stomach pain which will get just the dedicated people calling in. The duty crew responds no matter what unless they are already on a call.

I think if the proper procedures are in place and everyone is on the same page volly does work well.

[Just Plain Ruff]

I still cant get it out of my head that some people realy believe that of you recieve a paychek your somehow less dedicated than someone who does it for free.

Bushy, I have never been one to argue that Vollies are less than paid. I worked my entire career up till I semi retired with mainly volunteer fire fighters and some vol ems. I never met a more dedicated group and found that sometimes the volunteers were more motivated than my lazy ass partners and co-workers at my paid job.

[Happiness]

Im with Ugly and not going to comment on the Volley vrs Paid, it just an argument that is not going to go away.

Here is my analysis on the financial side of running a station. The wages I am going to use are an average and probably low and as a full time station. Now being a bean counter I hope this makes sense.

The population I'm using is of my community is approx. 1500.00 and I will use the amount of calls my station had last year which is 299. All the calculations will be for a 12 month period and for one car.

2 crew per shift x 2 shifts (one 24 hr period) 960.00 per day x 365 days = Annual amount of $350,400.00

1 unit chief lets say 25 per hour as a part timer 26,000.00

Benefits employers expense lets say approx. 30% (EI, CCP, Medical Pension) 112,920.00

Facility rental ambulance station 14,400.00

Insurance both station and Ambulance 3,000.00

Medical supplies and other supplies 7,200.00

Fuel (Remember Im comparing my Station and we have short runs) 1,500.00

For an annual total (estimated) of $ 501,020.00

I had 299 calls in my station last year which means the cost per patient is: $1,675.65

So my question is can a community sustain half a million through taxes or should patients have to pay this. I have left out a lot of things I'm sure, but everyone gets the idea, not every community can sustain a full time station and have to rely on Volley's. It may not be a perfect system but it is an affordable one. Just my 3 cents worth.

Edited June 25, 2013 by Happiness

[paramedicmike]

Setting aside economics for a moment I want to ask why volunteer?

Please don't say, "Because I want to give back to my community". You can do that picking up trash, serving meals at the soup kitchen, putting time in with Meals on Wheels, be a Big Brother/Big Sister volunteer and more.

Why do people so insist on volunteer EMS?

[BushyFromOz]

Setting aside economics for a moment I want to ask why volunteer?

Please don't say, "Because I want to give back to my community". You can do that picking up trash, serving meals at the soup kitchen, putting time in with Meals on Wheels, be a Big Brother/Big Sister volunteer and more.

Why do people so insist on volunteer EMS?

Same reason i volunteered for fire for a few years

Its a selfish motivation. Yeah, i helped the community, but thats not why i went there. I went there for someting to to do an meet new people. Riding a red truck was pretty cool and i learned new things.

It was all about what i could get out of it, not what i gave.

[Happiness]

Setting aside economics for a moment I want to ask why volunteer?Please don't say, "Because I want to give back to my community". You can do that picking up trash, serving meals at the soup kitchen, putting time in with Meals on Wheels, be a Big Brother/Big Sister volunteer and more.Why do people so insist on volunteer EMS?

Plain and simple answer because that's all there is, and to tell you the truth, there are a lot of grateful they are there.

[Richard B the EMT]

I started out Volunteer, continued there when I started out in non-9-1-1 system IFT (Inter Facility Transfer) ambulance service, and still continued the Volunteer when I finally got Municipal (I guess that qualifies as "provincial"?).

Some areas of the country, state/province, or county/parrish have had "organized" volunteer ambulance services for decades. Some have had contracts with private EMS operators, meaning "F&B Ambulance" was, and is, the 9-1-1 EMS responder. In yet others, 9-1-1 EMS is a service provided by either uniformed officers of the Police, Sheriff's Office, or Fire Department, or uniformed EMS members of those agencies, like the FDNY, or it is Hospital based. Everyone jokes at the expense of someone else's system, as that is just human nature: It ain't right, but it is what it is.
OK, I'm boring even myself by saying all that, yet again, but admittedly, I hope all involved, no matter what "base system" they're from, try to do some good.

Yes, some of the way EMS operates is flawed. I posit that no matter how good a local system is, there is always going to be room for improvement.