Comments on: EMS Losing Ground In Turf War?

By: Jim Lemieux

Jim Lemieux — Sun, 31 Dec 2006 23:22:59 +0000

Folks, how about knocking off the personal slams and emotion charged retoric. It will never improve or fix anything.

I think this whole thing unfortunately is in large partdue to prior Ada County administration…not just the EMS portion, by the way…..who failed to plan/staff EMS appropriately for adequate response times. There have indeed been poor response times, with staffing dictated by numbers of calls more than the potential. Too late to go back now, just go ahead.

I have seen many EMS systems, from coast to coast, over the years. I truly believe it matters less who (read agency)provides the service than the system design, which should incorporate not only staffing levels, response times, etc, but training, oversight,AND FUNDING etc.

It seems logical to me that something like the Sheriff’s office does in Eagle, Star, and Kuna could work. The local entity…..could even work in Boise…would provide either some additional funding, or maybe ambulances and 1 person, with the county providing the paramedic. That would help the funding issue, and keep the medics to one set of standards, training, oversight, etc. Has anyone ever seriously looked at this as an option?

By the way, a single, county wide fire agency would seem to make a lot of sense. Please tell me the real reason why this can’t be done?

Editor note–Jim, the problem with a county-wide district is that so much of the county has NO PROPERTY TAX BASE. If we had county-wide fire then Boise Stage Stop for example would be entitled to the same fire service as Flying J on Federal way, but there are no neighbors to share the tax burden. This will change with “planned communities” populating every inch of the county.

By: Just Me

Just Me — Mon, 25 Dec 2006 00:11:32 +0000

Boise Fire Medics usually NEVER ride in to the hospital with ACEMS. Most are not good medics and we don’t want them touching our patients with a 20 foot pole. If there is an EMT and a Paramedic on the ambulance and it’s a critical call the fire department will drive ACEMS in.

The firemedics just don’t have enough experience to be trusted with patient care. I would not let a Boise Fire Medic provide Advanced Life Support to my family members. There are however 2 Meridian Fire Medics I would trust to take care of my family…and they both worked for ACEMS.

By: William

William — Tue, 19 Dec 2006 07:58:42 +0000

How often do Boise Fire Medics ride in on ALS transports? I am looking for a rough percentage here. If ACEMS has a EMT/Medic staffing on an ALS call, assuming the EMT is driving the AC medic and a Boise Fire medic in the back does not seem at all like overkill. I don’t know if this is standard procedure or not. Many Fire Depts staff two medics per engine. Also I am not factoring in supervisor response/assistance.

By: Thomas the tank

Thomas the tank — Sun, 17 Dec 2006 23:58:05 +0000

Fire departments helping and commenting on the direction of Emergency MEDICAL services makes as much sense as Emergency MEDICAL services giving input on how to put out fires or run Fire Departments. Oh wait that makes no sense.

By: Tam

Tam — Sun, 17 Dec 2006 21:45:49 +0000

Croaker hit the nail on the head.

By: Dorothy

Dorothy — Sun, 17 Dec 2006 20:52:20 +0000

It’s called passion for something one believes in…JACK…something all of the thinking parties on this blog do in fact have in common. If you don’t have the courage to state and defend an opinion you are of no use to the world.

By: steve

steve — Sun, 17 Dec 2006 19:56:28 +0000

“The GUARDIAN suggests that if Kuna and Star wish to pay extra for their own service it would save the Ada EMS a lot of manpower and and expense while providing an increased level of service to residents of those fire districts”.

This reader suggest that the “Boise Guardian” focus on Boise and not, Kuna and Star.

EDITOR NOTE–Those districts obviously wish EMS would do the same. Don’t know your point, but brass at both those districts are eager to be heard on the GUARDIAN.

By: Jason

Jason — Sun, 17 Dec 2006 19:33:53 +0000

Dot: While Meridian does have some very talented medics at one time all of the present FTO’s were ACP medics except for Omid, but his credentials certainly hold their own without that. I have no issues with THEIR abilities. Precepting a new medic on an Engine however with limited patient exposures and time with each patient (10-15 minutes on average)doesn’t lend itself to much more than a snapshot of time. You would nearly have to precept someone for a year if they were brand new to get any sort of feel for what they would do medically. My opinion only. As for ACP’s precepting program, I stand behind our FTO’s and the FTO process. The rest of that equation is admin. The medical directorate, regardless of the language of the ordinance, when physicians get together (at least with ER docs anyway) they treat one another with a fair amount of respect and allow for input. They’ll take the time to educate one another where something needs to be debated. I don’t see them not being able to reach a consensus on such issues and then having to pull the “Power Card” so ACP could get it’s figurative way. They’ve done that on some issues already. I think that oversight on all bases is a good thing for fire and ACP alike. Anytime there is more physician involvement EMS systems only benefit from this. KCM1 – Dr. Copass is proof of that and the system he has created is where I would hope we would be someday. None of the physician medical directors presently on either side of the ball is going to go after someones’ livelihood because of the agency they work for. The ordinance suggests annual competency standards and testing with physician oversight for ALL paramedics practicing withing Ada County. I would take that to mean ACP medics too. Everyone gets sharper if they know a test is coming related to a paycheck.

By: Jack

Jack — Sun, 17 Dec 2006 17:57:06 +0000

What a bunch of whiners!

By: Croaker

Croaker — Sun, 17 Dec 2006 15:14:59 +0000

“…Instead of one agency’s physician medical director having the ultimate authority over someone’s career. Which I feel is one of the proposed ordinances main objectives and flaws. Unfortunately the crews in the street have little chance of influencing such decisions, which frustrates and saddens me….”

Well, Dot, I can see your concerns..however this is mine on the same topic….remember I am not part of the inner circle but definitely an interested party.

I have a huge beef with IAFF influenced physicians being able to vote down the one doc who is not influenced by labor/union politics to keep a crappy medic on the streets…and that is what I would be afraid of. I am not talking individuals here, but I really think safeguards need to be in place that prevent union politics and policy out of the medical arena…period.
I can easily see the Fire Docs..with the pressure of the IAFF behind them, ganging up on the ACP doc just like the For departments with the IAFF pressure are ganging up on ACP today…on all matter of medical issues, including keeping bad medics who happen to be good firefighters and good union members …on the street.

this same concern is true of all sorts of medical issues, and how the IAFF may use the “medical directorate” to reduce ACP to a taxi service while they expand.

If you can think of a better safe guard for quality medical care, and making sure ACP remains a stake holder….than having a non union affiliated doc have the final vote, then please speak up.