Does the Fire Service Have a Dirty Little Secret?

In late July, USA Today published a series of articles on emergency medical services in the United States. Most of three-part series focused on the 50 most populous cities and how cardiac arrest survival rates varied because of the ways in which some EMS systems operate. Some were painted as horrendous, while others were highlighted as model systems.

One of the authors of the USA Today articles, Robert Davis, pointed to a clash between EMS and fire personnel as one of the reasons why some EMS systems have a terrible cardiac arrest survival rate. Davis based most of his comments on his observations of the Washington, D.C. Fire Department.

In the first part of the series, a subheading in the USA Today read "Turf Wars." Davis went on to write, "First aid is part of a Washington, D.C. firefighter's job. A fire engine responds with an ambulance on serious medical calls. But the crews don't always work well together. Over 18 months, a reporter visited Washington, D.C. crews on the front lines. Dozens of times, sometimes scheduled, sometimes unannounced. During those visits, emergency workers were more likely to be at each other's throats than watching each other's backs. Ambulance crews made it clear they view firefighters as lazy; firefighters view ambulance crews as undisciplined. Every day in Washington, firefighters and the paramedics who back their ambulances into the same fire stations are likely to be quarreling over everything from where they park and what they eat to whose job it is to care for the sick and injured."

In response to this series, numerous articles, commentaries and editorials have popped up in a variety of professional trade magazines across the Internet, and in newsletters. Some of these authors who chose to analyze the USA Today articles jumped at the chance to bash the fire service because of the comments in the newspaper about the rancor between EMS and fire.

Many of these authors, who are not members of fire service, wrote with glee statements to the effect that "The fire service's dirty little secret is now out - firefighters hate doing EMS."

With all due respect to Mr. Davis and the newfound experts of the fire service who wrote their opinions in various publications or on the Internet, there is no dirty little secret. Yes, there are some firefighters who do not want to go on EMS calls. There are even some firefighters who do not want to go on fire calls and there are even some EMS people who do not want to go on even EMS calls. There are some paramedics and nurses who do not get along. There are even EMS people who do not get along with each other. Finally, some of these same people may not even get along with members of their own families. It is a fact of human nature.

As for as the EMS and fire conflicts, the reasons for this vary. Sometimes it is work ethics, while other times it is personality, while other times it is just plain acceptance of job responsibilities. But I do not think there is a crisis between EMS and fire.

I travel the country extensively, talk to many in the fire service, and even ride, eat and sleep at many firehouses throughout the United States. Yes, there are sometimes EMS and fire personnel in a firehouse who don't get along with each other. But I can certainly attest that there are no two armies lined up against each other in medieval battle gear inside the firehouse, ready to do battle each morning at shift change.

What I have found is that there are some individuals and what mainly seems to be geographic indifference to EMS. Many East Coast fire departments have been slow to accept EMS, while many departments in the South and on the West Coast, with the exception of one or two fire departments in California, generally accept the practice of performing EMS functions in the fire service.

Many times I am asked, "Will EMS ever be accepted in the fire service?" I believe it is already accepted. But the acceptance can improve and is continuing to improve. For those who have been around awhile, think back to the majority of the attitudes in 1970s and '80s, and where the majority of thinking is today. EMS is far more accepted in the fire service today than it was 20 or 25 years ago. In many fire departments, you cannot even be hired unless you already have a paramedic license.

To illustrate my point, I always tell the story of when fire engines with motors were starting to be introduced into the fire service around 1910. There were probably the old-time firefighters who went through their entire careers working with horse-drawn steam engines. They were close to their horses and the horses were a tremendous source of pride. Firefighters at that time were known to be very attached to their horses and maintained accounts to pay the retirement expenses of their horses. They were even known to parade horses through the streets when one of the horses died, to let the people know of their loss.

Many of their horses had names and there was daily contact. But when their departments bought their first motorized pieces of fire apparatus and the horses and steam engines were slowly removed from the engines houses, there was no doubt outrage. "How can they get rid of the horses? They have been part of the fire service for over 75 years!" "This is crazy - the horses are dependable, they never break down, these motorized contraptions are always breaking down." "The horses are trained - when the bell rings, they are already moving. We just hope that this new engine starts, because if it doesn't, people will die and buildings will burn down."

Eventually, as time passed and the horses were gradually phased out all together, there were those who accepted the new motorized apparatus, but there still remained some who wanted the horses back.

As even more years passed and newer, more dependable and more efficient fire apparatus came into the firehouse, there were even fewer detractors because they saw the value of the motorized apparatus. Today, motorized apparatus is totally accepted in the fire service. Can you imagine the response if a fire chief wanted to remove the motorized fire apparatus and replace it with horse-drawn steam engines?

The same will eventually happen to EMS. As time passes, there will be total acceptance. Those who are opposed from EMS and fire will move on to retirement. Those coming into the fire service today will always have EMS as a part of their career. And those who are too young or not even born yet, but one day will members of the fire service, will always have EMS as a part of their career.

So for those who wish to think the fire service's "dirty little secret" has now been exposed - hold your exhilaration, for it always was there. And to your dismay, EMS will continue to strengthen the vital role the fire service plays in communities throughout the United States, while the fire service continues to strengthen the importance of prompt and quality EMS delivery.