private based ems | Medic Madness

Posts Tagged ‘private based ems’

The pros to private-based EMS

June 7th, 2010

Sean

After my last post in regards to “fire-based EMS“, I got a few e-mails starting with “what the hell dude?” So I decided to make a post defending my real position on private-based EMS. As most of you know, I work in and favor a private-based single-medic EMS system. My last post was written to make a point that other systems do have their benefits. So here is my rundown on why I prefer a private-based EMS system.

Cost

Private-based EMS is the most cost-effective solution for any municipality. Ambulance companies operate at no cost to the tax-payers unless they actually use the service. In times of financial hardship, it just makes sense.

Contracts

Exclusive operating contracts comes with requirements that must be met in order to continue providing service. These include response time compliance, complaint resolution, QA programs, community service programs and in some cases, minimum staffing. There is a good argument that there is actually more oversight for private companies than public services.

Single Medic

Private ambulances typically run 1 medic per ambulance. This means that each medic does more skills, has more responsibility and runs more calls on their own. For skills like intubation, paramedics need to be performing it as frequently as they can. I do realize that single-medic systems are not unique to private-based EMS, but it is more common amongst those types of systems.

Single Function

One of the biggest reasons that I prefer a private-based ambulance service, is that paramedics employed by these companies are only working as medics. Their roles are not split up by other jobs like firefighting or law enforcement. On top of that, I don’t think that being a firefighter should be a prerequisite to being a paramedic in a 911 system.

I have a few articles out there arguing for private-based EMS systems. If you are interested, check them out.

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Private EMS – The Stepchildren of public safety

Posted in Opinion

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Don’t get your hoses in a knot

February 1st, 2010

Sean

Lately I have participated in many discussions regarding fire-based EMS. As we all know, there are very good arguments to both sides as to whether EMS should be run exclusively by the fire department. So rather than argue about whether or not it should be done, I am going to express my opinion on how fire-based EMS should be run.

Having worked in a single-medic service for my entire career, I tend to favor that type of system. I truly believe that 1-2 paramedics for each call is really all you need. Any more than that and you are just wasting resources. At minimum 1 paramedic on the ambulance would be sufficient. Depending on ambulance availability I suppose having a medic on the engine would be beneficial too. You can refer to my article “Two paramedics are not always better than one” for more on that subject.

I believe that the paramedics assigned to ambulance duty should play a single-function roll. It is very difficult to keep up your skills as a paramedic if your job responsibilities are split between patient care and firefighting. I also say this because I don’t believe that paramedics should have to become firefighters in order to practice in a 911 system.

One big problem with having multiple paramedics on scene is establishing who is in charge. It needs to be made very clear in writing who runs the show. I feel that this responsibility should be given to the transporting paramedic. If they are going to care for this patient all the way to the hospital and have to answer to the doctors and nursing staff, then they should have the final say in how the patient will be cared for.

Being the conservative that I am, I don’t really believe in “special taxes”. Having said that, I do believe that if a community wants to vote to impose such taxes to provide fire-based EMS services, then more power to them. If a special tax is imposed to provide the service, then the department should not be billing the patients. Departments that tax and bill their patients are just asking to be shut down and replaced by a private ambulance service who collects no tax dollars.

I truly do believe that efficient and effective service can be provide by fire-based, third service or private-based EMS, it’s just a matter of doing it right.