Back in “the day” (more commonly referred to as the 90’s) I spent a few summers in a little corner of Rhode Island called Yawgoog Scout Reservation. I camped at the Abe Lincoln campsite in the Sandy Beach camp with my troop, where the dining hall was an expansive concrete base with just a roof over it on top of a hill. During the week, we rotated through a variety of camp assignments, including being a waiter for our assigned table in the dining hall.
The dining hall worked on what was called “The One Way System“. All waiters would go to the outermost part of the dining hall platform when their color-coded section was slid to the “serve” position and would proceed in one direction towards the front from wherever in the dining hall they were. Those who failed to adhere to the direction and flow would be on the receiving end of the entire dining hall chanting:
“The One Way System! The mighty One Way System! And if you do not use it, we’ll shout a little louder! The One Way System!”
Too often I think EMS systems devolve into a similar “One Way System“. We find ourselves with EMS systems that may work for some communities being deemed as the “One Way System” for all communities. Communities, like patients, are individualistic in both composition and need. Sure there may be similarities between communities, but no two communities are truly identical… just like patients.
I touch briefly on the possibility of different models in EMS Garage Episode 139: Scott Kier v. The World when I talk about breaking the mold with an EMS Based Fire Service. The concept is relatively simple, have your Paramedic trained firefighters on an ambulance responding to the medical calls that make up the majority of most systems call volume. When there is a fire, have the ambulances respond to the scene while a chauffeur drives the fire apparatus. Then the Paramedics can don their bunker gear, and go fight the fire. It could be a system that is both efficient and revenue generating, two things the public seems to be focusing on for all their services.
Now I’m sure that there will be plenty of people who say, “That’s not the way the fire service works!” or “You can’t do that!“, including both Fire Critic and Happy Medic. Heck, the very idea might be enough to cause a cerebrovascular accident in Fire Geezer and Scott Kier himself may question the sanity. While I’m sure there are very legitimate arguments against the idea, there are two arguments that are invalidated before the discussion even begins:
- It can’t be done – We’ll actually never know if it can’t be done unless it is tried and, to my knowledge, no one has yet tried an EMS based fire service
- Tradition – While I am a big fan of tradition and the spirit it helps to foster in any and all organizations, traditionally firefighters have fought fires. Now fire departments are responding to medical calls for 80% of their call volume, so where is the tradition in that?
Just because its always been one way, doesn’t mean it has to stay that way.
With communities demanding efficiency and more services for a lower cost, what system models do you think could possibly offer a solution?