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Private-sector proponents describe their system of delivery as being more economical and high performance. But in the same breath, they chastise fire departments for expanding their roles and services to the community by using an existing and trained workforce with a marginal cost to the department. By being economical and high performance with existing human and material resources and by advancing their EMS programs, fire departments are being castigated by their private-sector counterparts for the same thing they claim to be.
MYTH 3: Firefighter/paramedics cannot do two different jobs well.
FACT: There is proof that paramedics and EMTs in the fire service deliver high levels of quality care. Annals of Emergency Medicine published an independent study in February 1990 comparing "Survivability Rates for Non-Fire Based Single Role and Fire-Based Cross-Trained Dual-Role Paramedic EMS Systems." The study compared post-resuscitation hospital discharge rates. This non-partisan, independent study showed that non fire-based EMS systems had a patient discharge rate of 11.4% and fire-based systems had a hospital discharge rate of 17.1%.
There is another objective measurement. Every year, an extensive and comprehensive tournament between EMS agencies occurs at the Clincon competitions in Florida. This past year, not only did a fire department take first place in the ALS competition, but four of the five top EMS agencies were fire departments.
MYTH 4: By getting involved in EMS transport, the fire service is unfairly competing with the private sector for business.
FACT: Using this logic, the U.S. Postal Service must be shut down since it competes with Federal Express and UPS. We might as well close all public schools since they infringe on private schools seeking students. We might as well get rid of police departments since there are private security firms out there that are large enough to handle a municipal contract. Additionally, we need to close every county- or city-operated hospital or health clinic since they can be considered competition for private health institutions.
Bottom line - the fire service is no different from any other government-run operation which may overlap into the private sector. The EMS industry in this country is estimated to be worth $10 billion to those services that transport. Whatever the argument, the fact remains that the fire service is the major deliverer and provider of emergency medical service in the U.S. and has been for considerable amount of time.
Gary Ludwig will discuss "Don't Just Sit There - EMS During Fireground Operations" and "The State of Fire Service EMS" at Firehouse Emergency Services Expo '98 July 15-19 in Baltimore.
Gary Ludwig is the Chief Paramedic/ EMS Bureau Chief for the St. Louis Fire Department. He is currently serving his third term as an elected executive board member to the EMS Section for the International Association of Fire Chiefs and is a frequent lecturer at fire and EMS conferences. Ludwig has a master's degree in management and is a licensed paramedic. He can be contacted at GaryLudwig@aol.com.