Need info on AMR

[1aCe3]

Some things I've heard about AMR over here :

1. They're infamous for having ambulances that are equiped with a black-box type machine that records the daily activities of it's routine. Everything from speed, how hard one were to break, how sharp turns are taken, and if the partner steps out to "back-up" the ambulance by pressing a little black button on the rear. It also records everytime the lights and sirens are used. The little blackbox by the driver's side makes a "tic-tic" noise everytime there is an excess of speed or sharp turn. If you turn hard enough or speed, it'll start screeching like a crazed alarm clock. They also have a point system which ranks their driver's safety/mile. Kind of funny, but I'm sure it ensures safer driving within the company. Although I did hear that the division here is the worst in the nation when it comes to it's driving record.

2. They're stringent with their uniforms. During the winter employees must wear clip on ties, which many of which I've spoken to hate it with a passion. But again, I can see the reasoning for keeping a clean look.

3. They seem to have bouts of suspensions/firing with large hiring classes during the summer.

4. A lot of old-timers around here have worked for or still work at AMR. A lot of them used the place as a starting point. Management over here is held by several big names in the ny EMS field.

5. The pay is significantly lower than private hospitals, FDNY, and such, but I guess it would still be called the average wage.

6. They manage to hold several large contracts with hospitals in the city, so they are kept quite busy - I think their main competitor would be TransCare.

But then again, like others have said, it would depend on how it's managed locally. I wouldn't be able to tell you much about AMR on the national level.

Lastly, I was managed to catch a couple minutes of "the worlds wildest police chases" a while back :roll: and saw police chasing a stolen ambulance which ended up flipping over and crashing. Can you guess what the logo said on the side? :shock:

And yes, I heard they played a big part in the hurricane aftermath, the city division did send some ambulances down there to assist along with some other notable hospital EMS services.

[fwmedic]

That's absolutely correct on the driving. The system is known as fail safe it is capable of recording just about everything that is happening with the ambulance. Some operations (not ours) even have cameras and microphones in the cab and pt compartment to record what's going on in the event of an investigation such as a traffic accident. AMR holds probably one of the most stringent driving policies I've seen. In our region you must maintain a certain driving level, if you fall below two months in a row you are subject to discipline up to and including discharge. You must come to a complete stop at all traffic signals and stop signs even in emergency operations! You may only proceed when all other traffic has stopped for you. The only exception is an intersection controlled by the police and they are waiving you through. If you are caught running a red light it used to be immediate termination but the policy has now been changed to 15 days off for both you and your partner. That includes at fault accidents, and backing without a spotter. Also if you are observed not wearing your seat belt you are also fired. No exceptions! I have seen it happen here on more than one occasion. There is also rumor going around about the possibility of GPS tracking systems being installed soon as well. As for the uniforms, they are strict here but we do not have to wear ties. I've never seen ties at other AMR operations either but that does not mean it doesn't happen. As far as the driving policies go, I won't say I disagree with the policy because I am big on safety, but I'm not sure if the punishment fits the crime.

[sdiener]

"The whole PUM concept is a joke. It has not worked out anywhere it has been implemented. The dickwads that sell it (Fitch and Associates and some other idiot) make all sorts of promises about how it will save the area huge money and will pay for itself within so many years. It never has. It never will. They always end up spending more money than they ever have had to before. Subsidies go up, not down. Response times go up, not down. None of the promises are ever fulfilled. "

Dustdevil,

Please excuse me for I am sure I do not have the backing of your experience, and I definately don't proclaim to be an expert... but in persuit of an academic debate:

Where is the proof that the PUM concept is a joke? SSM and Dynamic deployment, response time reliability, a dedicated medical control board, oversight by an authority - if practiced correctly, these will make for an excellent EMS system for the PATIENT. Obviously in terms of the provider, the PUM system sucks balls... but then again, do we forget that we are here for other reasons than to play with loud boxes that have flashy red lights on them?

In my examination of the Tulsa, KCMO, Pinellas County systems, these all appear to be well run systems with the PATIENT in the forefront of the decisisons. Paramedics plus has replaced AMR in several cases with great success. Providers are somewhat happy, they get great experience, and they get out and go to the fire department, or a cushy third service (godwilling). Yes, you sit in an ambulance for 12 hours, your unit is probably run ragged, benefits are crap, pay is crap, you eventually hate your job, and like I said want to get out. But the system in theory works; for cheaper than what you would pay for a huge fire department based system

Lets take Baltimore City for example. Population close to a million, high density, hospitals close together, two 8 hour day shifts, two 14 hour night shifts. All 22 medics are on 24 hours a day. Taking computer records, and my memory may be a little hazy, The biggest call volume of the day is at 3:00 in the afternoon and the evening hours of friday, saturday, and sunday. The computers can show you this. There are NEVER 22 calls at 3:00 in the morning. In fact the most at that time of night might have been maybe 7 going at any one time. Yet the city is still paying 44 providers (sometimes 2 medics per ambulance, sometimes 1), 24 hours a day, 365 days a year. This is a tremendous disallocation of resources. In addition, ambulances are pretty much randomly dispatched wherever they are needed. When I was riding, in the city, a 20 minute response time was NOTHING. And this is because they didn't know where the units where. Oh, and medical accountibility, hah! There are great paramedics, but there are some downright AWFUL providers in there as well.

However, lets say you had 22 ambulances on dynamic deployment shifts, with SSM, and geolocation. Same pay, same benefts. However, now you added non emergency transports, and interfacility transports to the mix. Well, now you make more money because the non emergency transports actually pay - as opposed to those citydwellers that we all love. You can actually operate off of less a budget than before because the non emergency transports subsidize your emergency transports. Or keep the same budget, and you can now afford new ambulances, or god for bid, other benefits for your providers.

PUMS will only work though if certain conditions are met, including a dense population, about 1 million people, the monopoly of a provider, and if old data has been kept.

As I said, the providers hate PUMS, because they stay busy as all hell. However, the patient and the taxpayer benefit in the end.

What do ya think?

BTW, from what I can tell, AMR does suck at PUMS

Sam

[Rescue0ne]

Here's what Dr. Bledsoe said in Dec. 2003 concerning PUM.

http://www.emsmagazine.com/publication/art...d=1&id=2031

Here's a response to Dr. Bledsoe's article, as well as Bledsoe's response to the reponse. I'm sure many of you have read this, but for those that haven't...

http://emsmagazine.com/publication/article...d=1&id=2201

In my own experience, the Public Utility Model sucks. Hey, wat dew eye no?

[MAGICFITZPATRICK]

In nyc I see them in the EDs all the time.They seem friendly and well groomed.....and they have those snazzy EZ-PROs Stryker Stretchers.

[EMTgirl84]

You have to work for AMR because you want to work in EMS and you like the job. AMR is greedy when it comes to their money. It is all that they care about...so if that means screwing everyone else over....then they will do it! High turn-over rate....very high...I have been around two years and seen one too many come and go. They make a lot of promises...that never come true. You can't believe anything that they say....until you actually see it for yourself.