He doesn't mean at their level, he means at the EMS level it is simple. And that I will say to a Trauma Surgeon at a Bar.
What an EMT or Medic does for Traumatic Patients is Peanuts compared to a Trauma Doc and an OR suite.
Report Finds that Privatizing Houston EMS would Save Money
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He doesn't mean at their level, he means at the EMS level it is simple. And that I will say to a Trauma Surgeon at a Bar.
What an EMT or Medic does for Traumatic Patients is Peanuts compared to a Trauma Doc and an OR suite.
bigbaldguy
Former medic seven years 911 service in houston
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Previous statement redacted due to false assumptions caused by skimming between commercials.
I read your comment on the cardiologist thing then his and thought they were part of the same chain of thought from same poster my bad.
DrParasite
The fire extinguisher is not just for show
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it's probably right. 40,000-80,000 for a FF/EMT or Medic, vs $9-$12 an hour for a private EMT or medic. benefits are more for public employee, vs cheap poor benefits for private. privates run as cheap as possible (SSM, postings, ambulances equipped to the minimum guidelines, poor trucks in excess of 200,000 miles), vs top of the line equipment, stations, and training in down time for HFD.
Will it save money? sure..... will the quality of patient care, employee, and support system decrease? sure.....
If the guys doing EMS are fully trained firefighters, I'd bet there won't be that many jobs lost. 9/11 ensured a future for most fire departments in the US for a few decades. No one's going to want to be the politician that has to run for re-election against an opponent showing images of angry/sad firefighters.
If there's an administrative separation between fire and EMS, and the only thing "fire" about the EMS side is the word "Fire department" on the ambulance, and the firefighters are only there to get OT, then I can see them pushing through larger lay offs.
If there's an administrative separation between fire and EMS, and the only thing "fire" about the EMS side is the word "Fire department" on the ambulance, and the firefighters are only there to get OT, then I can see them pushing through larger lay offs.
Anyone doubting the complexity of a trauma patient and the impact EMS treatment have on them is welcome to take me to the bar and I will explain it to them in detail that will likely result in first hand experience when they start drinking heavily enough to fall off the bar stool.
Never said they were not complex, never said that at all. What I said is the treatment that an American Paramedic provides in the field for one is not complex, there is not much we do for Traumatic patients compared to Medical. Thus making the Trauma call less "challenging" and easier to run, because our treatment options are very limited....... Most of what a Medic caries is for Medical Patients. That doesn't mean we do not have an impact on the patients outcome.
Well since the big bald guy decided to flurry everyones taste buds by talking about drinks, I think he is buying first round.
From what I've seen of HFD's EMS system (they were the original push behind TEEX 10 week medic program) it'd be hard for care to suffer that much.
DrParasite, I know you love to hate privates but I know of several who provide far better benefits and work environments than many FDs I've been involved with.
They've got a total of 130 apparatus when counting only the engines, trucks, Haz-Mat and Rescue units alone, and that's not counting command staff and various day work positions such as instructors, fire prevention, PR, logistics, etc. etc. Assuming four on each rig, that's 520/day x 4 shifts, or around 2080 to staff the rigs. There are 50 ambulances and 27 medic units, for 154 personnel, so that's 616 right there, plus another 70 for pad. Many of the larger FD's have one or two pad personnel per station to detail out for vacation/sick relief, training, etc. With 92 stations, that's another 150-200 people. There's airport units, squads, and other units I'm not familiar with, so that's more people yet again.
If you laid off every ambulance position, and also cut each engine company by one, that's "only" 656 positions. What happens during a proposed Reduction in Force is that then dept will first look to eliminate positions due to attrition, or move office personnel back to the field. That will save more than a few jobs. Also, with a dept that has a headcount of 3851, you're probably losing 100/yr in retirement, probably more. If you lay off a bunch of FF's, you'll have to recruit more in the next year or two, and every year thereafter. In my dept, it costs at least 50k/FF to recruit, test, and train in the academy. Medics are closer to 100k each. This fact makes it less beneficial to lay off so many. They might lose a couple of hundred if the fire apparatus destaffing goes through. If they go from four shifts to three, then you're looking at a much higher number.
Sure, it would save money. When you go from a municipal employee with a well stocked apparatus with all due pay and benefits, to a $8-$12/hr person with much more modest benefits and (if they're lucky) a DC (not a pension) retirement, run by a for profit corporation, it's not difficult to see why.
The Union will argue against the privates using examples of past failed relationships in other municipal systems. There are enough examples of private companies leaving when the contract becomes unprofitable for them, substandard equipment, the low average tenure (experience) of their employees, taking chances by pulling available 911 units to run the more profitable IFT, the lower hiring standards (the public trust being placed with EMS), the average employee tenure (experience) being subtandard due to that type of job being transient, or a "stepping stone," etc. These are the same arguments that FD's use to take over an existing privately operated 911 system, so the talking point must be effective. These may or may not be true for the privates bidding for the contract, but there have been enough problems with private EMS that these negative attributes could be projected onto the good employers.
Then you get into how dual role personnel curb OT due to their versatility, and other staffing/deployment discussions skewed to favor the FD.
Why? With the Union, the employees have a strong opposing voice when matters such as this come up. For example, D.C. has beat back numerous attempts to go from four shifts to three. That would screw a lot of people that live far away, but they've held on to their schedule.
Without a voice, the city could just do whatever it wants without any opposition whatsoever. That's bad for the employee. My Union saved my job and 90 something others back in 2008 when the County Executive wanted to implement a Reduction in Force. We also fought off rolling brownouts, and got the sunset clause of our DROP removed, which was a huge benefit for our retirements.
My point in mentioning Dr. Ken Mattox earlier was that he doesn't just hand out compliments to anyone; he is VERY critical of medical practices, EMS or otherwise. Despite whatever easiness trauma should be, I think it is pretty often not done nearly as well as one would think in EMS, so I think a compliment from Dr. Mattox is not something to be dismissed easily. Anyhow, it was offtopic of me to bring up, so I'll move on.
Anyhow... I, despite being in favor of EMS being split from fire, won't root for people losing their jobs or service being removed from a current provider unless there is demonstrated need to do so. Need to balance a budget isn't necessarily a "demonstrated need" in my opinion (though, this is not to say that there isn't some fat in need of trimming). EMS is worth paying for with tax money and I do not think it is something to be tossed to private companies just to save money.
Anyhow... I, despite being in favor of EMS being split from fire, won't root for people losing their jobs or service being removed from a current provider unless there is demonstrated need to do so. Need to balance a budget isn't necessarily a "demonstrated need" in my opinion (though, this is not to say that there isn't some fat in need of trimming). EMS is worth paying for with tax money and I do not think it is something to be tossed to private companies just to save money.
bigbaldguy
Former medic seven years 911 service in houston
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I'll have a fuzzy navel and slippery nipples for everybody!
DrParasite
The fire extinguisher is not just for show
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you know, you might be right.
IF the private service doesn't cut salaries, doesn't cut benefits, does include a pension/retirement plan, and uses equipment that is decent, than the transition form HFD to private won't be detrimental of the EMS system and the patients who are treated by it.
So if the private can meet all those requirements, and still save the taxpayers money, than go for it. otherwise, I stand by my original statement.
If that was the case, the operating costs for the private provider wouldn't be much lower than what the FD was already providing, so there would be no point in going private. Personnel costs are usually the largest part of an operating budget. Actually, the dual role FF's would make it easier to fill schedule holes and curb OT more than a single role department could. Unless the private intends to use System Status Management to get by with the least amount of employees possible. The FD/Union would caution against this flawed practice anyway, as they have done successfully in the past.
socalmedic
Mediocre at best
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this is not a dig at DrParasite, quote is only included to show relevance to the topic at hand.
I work for the big bad three letter company, my division as a paramedic I make equal to a Firefighter with the same tenure. our oldest ambulance is a 2008 with 120,000 miles with its replacement already ordered. our stations could use some upgrades but they are safe and comfey. we have 15 trucks on 24 hour shifts following the fire departments kelly schedule, we have a few day cars to run the transfers. 1/2 of our trucks are dual medic, with a multi tiered paramedic level allowing for career ladder. the mean tenure of our paramedic workforce is 13 years. all of our training CE are paid for. we have a 401k program with 3% matching. 4 weeks of vacation per year. we have all of this because we are union. and yes the company still turns a profit, so it can be done.
Edit: this division has had this operating model for over 30 years.
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There are a few privates around Houston that would be plenty capable of handling their EMS. And they all pay well, have nice equipment and have retirement plans
sweetpete
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Anyone who thinks it's a good idea to cut a FF off the apparatus has never fought a fire in an urban setting.
You simply can't do this job safely with 3 guys on a truck unless you sit around waiting for the next in truck. Even then, you still have to wait for them to arrive to be RIT before the first crew can even make entry to perform a search/rescue.
And as has already been mentioned, HFD rotates FFs off the ambulance/squad to the pumper/ladder every few shifts. So, to do away with this system is only going to force more OT somewhere.
Lastly, after having worked in the "private" industry for a company that provided both FIRE and EMS I can honestly state that the training of a municipal service and the training of a private are light years apart. The city I work for now requires training every shift (except on Saturdays/Sundays) as opposed to maybe once a month for the private I worked for.
In my opinion, there's no comparison. And I'm certainly not saying EVERY private is bad. I'm just pro-city.<_<
You simply can't do this job safely with 3 guys on a truck unless you sit around waiting for the next in truck. Even then, you still have to wait for them to arrive to be RIT before the first crew can even make entry to perform a search/rescue.
And as has already been mentioned, HFD rotates FFs off the ambulance/squad to the pumper/ladder every few shifts. So, to do away with this system is only going to force more OT somewhere.
Lastly, after having worked in the "private" industry for a company that provided both FIRE and EMS I can honestly state that the training of a municipal service and the training of a private are light years apart. The city I work for now requires training every shift (except on Saturdays/Sundays) as opposed to maybe once a month for the private I worked for.
In my opinion, there's no comparison. And I'm certainly not saying EVERY private is bad. I'm just pro-city.<_<