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Open Letter to the Fire Service

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From the NYSAFC site

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Posted on a national EMS management list server June 5, 2007. Becknell is the publisher of EMS Best Practices, a newsletter for EMS managers:

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An Open Letter to the Fire Service

By John Becknell

Dear United States Fire Service:

You are big, strong and the nation's undisputed all-hazard responder.

You have 30,000 departments across the nation and more than 1 million

firefighters. You respond to millions of emergency medical calls each

year in addition to your firefighting responsibilities. You have

widespread respect from the public, a high-level fire administration in

the federal government, the largest caucus in Congress, one of the most

powerful labor unions in the country and envious political clout, as

evidenced by your hosting the first Presidential Forum of the 2008

election earlier this year.

Despite this considerable strength, your recently released paper,

Prehospital 9-1-1 Emergency Medical Response: The Role of the United

States Fire Service in Delivery and Coordination, sounds awfully

defensive. Even worse, in my opinion, the paper fails to meet its

objective of proving that the fire service should be the coordinator and

point agency for EMS in every community in the nation.

You did not need to ransack history to point out that the fire service

has been involved with medical care since the Crusades. No one doubts

that firefighters can provide medical aid. But your paper makes numerous

unsubstantiated assertions that come off as reactive and defensive and

hardly help your cause. Instead of just saying that the fire service is

the nation's EMS champion, why don't you just become that champion? You

can start by becoming truly passionate about EMS. Make EMS a fire

service priority. Tell the world that EMS is mostly what you do. Make

EMS the headliner of your conferences. Grow the IAFC's EMS section from

1,200 members to 12,000. Demand that the fire-service trade journals

dedicate more than a column and an occasional article to EMS.

You applaud Miami Fire Rescue for recognizing the importance of medical

response and changing its name to include the word "rescue." I suggest

all fire departments stop calling themselves fire departments, and

instead embrace EMS in their titles.

If you truly want to be the nation's EMS champion, advocate for EMS at a

national level and for the needs of all EMS providers. Your fire caucus

and lobbying organizations have left EMS out in the cold for too long,

thus resulting in a growing movement among non-fire-based EMS

organizations to organize and advocate for EMS as a distinct and

important part of healthcare, public health and public safety. True EMS

advocates clamor for more attention and dollars for EMS on a federal

level. They want to strengthen EMS' place in the federal government

through the creation of an EMS Congressional caucus and a single,

high-level, federal EMS agency. If this movement worries you - join in

the fight.

As the big and powerful fire service, you can lead the fight for more

recognition for EMS without bullying. Embrace the fact that EMS is

diverse and that no one system design has been proven universally

effective. Everyone will respect your honesty. Use your clout to push

the government to recognize the critical importance of EMS in every

community. As you do, all ships will rise with the tide, but no one will

fail to notice that yours is the largest ship.

If you are serious about the fire service taking the point position on

EMS, why not change the names (and attitudes) of the US Fire

Administration and the Congressional Fire Services Institute to include

EMS? As the nation's EMS champion, why not join with all of the

non-fire-based EMS groups in an effort to bring attention to the flawed

fee-for-transport system and help create something new? Such unity would

be difficult to ignore. And while you're at it, use your clout to help

the nation figure out how to provide quality EMS care in rural areas

where workforce shortages are huge, and there are no union jobs. Such

efforts would make your predecessors, the Maltese Knights, proud.

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I SECOND THAT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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I 100% second that. EMS calls outway fire calls atleast 2:1 in every district I know of yet ems gets absolutely nothing in return. Like the article says no unions, no retirement with the exception on NYC, and no recognition. Its very hard to keep a career in EMS. There is just no money in it. The way the system is set up is the main problem. Think about most municipalities. They have a paid police dept, paid or volunteer municiple fire dept., and a private company for ems. Thats the main problem, until ems is a paid civil service position there will never be a good career in it.

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I read this a couple times before I decided on my exact thoughts. The author is correct and accurate. A number of fire services would have been reduced over the past few years if their numbers were not raised by responding as first responders on EMS jobs. However, to a good many this is a chore and not a service. I am sick and tired of persons who are trained to manage a patient calling for an ETA on the ambulance cause they don't want to wait...why else would there be a first responder system other than to get aid to victims sooner rather than later. The fire service in general has to recognize the importance of the EMS portion of the Emergency Service System and embrace it. It is scary when you break down numbers and see what is really going on. If they were to add ambulances then there would be no need for the first responder system...ambulances would just be there waiting, sort of like fire units do now...

JMO

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I think the fire srvice should definately be supplemental to

EMS, but not be the "champion." I think EMS is too important to be merged with the Fire Service. It would be miss managed, do EMTs and Paramedics need higher salary? Yes, absolutely, but I think its too much for one agency to handle both, JMO.

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I wish that article was on a more public forum...Like the post or daily news might make people more aware of what needs to be done..I have believed and said for years that firefighters need to be cross trained for ems AND vice versa if not at least to know what must be done for the pts because lets face it our jobs is LIFE SAFTEY FIRST NO MATTER WHAT YOUR JOB (and yes i mean that ems and medics know whats goin on @ a fire and the harm and smoke and cyanide poising and numorous other hazards)

I agree with that artice 1000 %

and thats MY 2 CENTS

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Being a FF/Paramedic and being Fire based I agree with many aspects of that letter.

What I do not agree with is how many feel that EMS would be mismanaged if the fire service were the "EMS" champion. There are many great fire/ems leaders in this country today. I like to think I am along those lines. I have one simple rule if your going to do it, do it the correct way and don't treat it as a secondary service. They have to be equal and treated as such. Take much of the northeast out of it. Go down south and out west and you can see the role models of the fire/ems industry is.

It all starts with the proper management and leadership. You have to have both not one or the other. As some departments get managers and leaders whom are dual role and love both, it will improve. Until then it will still be marred. No different then what many private agencies have done to systems and the service as a whole.

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