Shopping for helicopters...

[WuLabsWuTecH]

So here is my question:

Shopping for helicopters in regards to weather can be very dangerous, and is unethical. At least in our area, it's frown upon as sometimes it can be seen as trying to urge others to take unnecessary risks. I know that some areas now have a policy of agreeing together, when to shut down, and unless they specifically tell you, we can't approach from the south, you may want to try LifeFlight ABC who can approach from the north, calling other companies will just get you the same result. This I understand.

Here's the new issue we are running into:

Companies are increasingly telling us that we should not shop around for the best response time. That is, since there are 4 companies that cover our (massive, 190 square mile) run district, we should not get alternate quotes for times after we already contact one company. Here's the issue we run into: (we will call the 4 companies North, South, East, and West for simplicity) we roll to an MVA north of the station and we call North Air because they are usually the closest. Unfortunately all of their close units are out, and their usual 15 minute ETA is now a 30 minute ETA. Still better than ground-pounding them to the nearest trauma center, but not by much. Usually, what we then do is have dispatch call West air and East air and get us quotes for them, knowing that they will probably have an ETA of around 20 minutes. We're being told this is bad. The companies are claiming that we should not do this shopping "costs too much time" and patient condition can deteriorate during the time you are shopping. I contend that while that may be true if you are in a more urban area or closer to an urban center, when you are 35 minutes away from the outskirts of the nearest city, the extra 5 minutes you call might be worth it to save another 5-10 minutes, or even more.

What our chief is doing now is taking our run cards (which are managed by each station, not by the dispatchers, so we are dispatched as "Station 100, respond to an MVA at highway 1, MM 100" and we the have to figure out what apparatus are going and who is going with us--dumb I know but that's another argument.) which splits our district into 8 sections and is how we determine the closest engines and rescues (our 1 medic run district encompasses 8 fire run districts) and is adding the helicopters to the run cards. So if we respond to a certain address, for an MVC, we pull that run card to see that, for example, we need South fire department's rescue, West fire department's engine, and our first due medic (on the off chance we have 2 staffed), but now we also see a list of helicopters like this:

West Air 1: 10 minutes
South Air 1: 12 minutes
West Air 2: 13 minutes
West Air 3: 15 minutes
South Air 2: 16 minutes
East Air: 20 minutes

And based on that, we request West Air. If their "first due" bird is out, we're supposed to just request their second bird and not request south air's first due--at least that's what one of the companies is strongly pushing.

The new question then becomes, what if we pull the run card and it looks like this:

North Air 1: 10 minutes
West Air 1: 12 minutes
West Air 2: 13 minutes
West Air 3: 15 minutes
West Air 4: 16 minutes
North Air 2: 25 minutes

Since we are only "allowed" to make one call, to make that one call count, should we hedge our bets and on the run card have West Air as the person we call? (Eventually once this all gets straightened out, the Chief will just have a company listed on the run card so we don't have to make these decisions in the field. It will just say on the run card:

Helicopter Assignment:
1st due: West Air
If all units out:
2nd Due: North Air

I'm curious if anyone else is running into these issues being pushed elsewhere in the country. It's interesting because while all 5 or 6 companies we are working with have mentioned this, one in particular is pushing it hard and we are wondering if it is a business decision for them as they are in that second scenario that I described where they are the closest unit but their second due is a long, long ways away.

We have helicopter representatives it seems at the station every week trying to help us devise our new run cards (perk: lots of free gear) but I feel that I've never heard of this "shopping argument" either because it's relatively new, or with the opening of a new company in the area (West Air in the second scenario described above) North air feels they are going to lose some major business from us. I'd be interested to see what their response is to our chief telling them are are second due because if we can only make one call, we're going to hedge our bets with West Air...

Thoughts and opinions?

 

[DesertMedic66]

Our nearest trauma center is in our response area but it's only a level 2. The closest level 1 and the closest burn center are 1hr 30mins away with no traffic. We call our main airship company and we also call our secondary. Which ever one has the best time gets the transport. If both are delayed we don't have another choice and we ground and pound them. Believe me driving code 3 for over an hour is not fun.

 

[usalsfyre]

They're playing game with you, trying to keep business within their service. What your doing is not shopping, it's called doing what's best for the patient.

"Helicopter shopping", as defined by the AAMS, is not calling multiple programs. It's calling multiple programs without sharing weather turndown information. What if there's a thunderstorm over north operators base but the scene and south base are clear?

Remember folks, there's a lot of money in HEMS. ALOT.

 

[usalsfyre]

Our nearest trauma center is in our response area but it's only a level 2. The closest level 1 and the closest burn center are 1hr 30mins away with no traffic.

Curious outside of the burn center what they tell you the difference is. I have been told they're functionally equivalent, the main difference being in the areas of academics and research.

 

[DarkStarr]

Here our dispatch does all that already, plus, if we contact the one service, they provide the service of seeing if any of their competition is closer and if so, will send them.

 

[johnrsemt]

Here the 2 helicopter services actually talk to each other; if we call #1 and they are too far out they will call and dispatch #2. Which is weird when the other one shows up.

 

[jjesusfreak01]

Here the 2 helicopter services actually talk to each other; if we call #1 and they are too far out they will call and dispatch #2. Which is weird when the other one shows up.

They probably work on some sort of a paid referral service. This benefits the patients and increases the chance that a helicopter will be used instead of ground transportation, which benefits both helicopter companies.

 

[WuLabsWuTecH]

They're playing game with you, trying to keep business within their service. What your doing is not shopping, it's called doing what's best for the patient.

"Helicopter shopping", as defined by the AAMS, is not calling multiple programs. It's calling multiple programs without sharing weather turndown information. What if there's a thunderstorm over north operators base but the scene and south base are clear?

Remember folks, there's a lot of money in HEMS. ALOT.

Ok, I'm glad I'm not the only one who thinks of shopping as a weather related phenomenon. I had never head of shopping used in this context prior to the last couple of months!

Curious outside of the burn center what they tell you the difference is. I have been told they're functionally equivalent, the main difference being in the areas of academics and research.

My understanding is that there is also a difference of available services and readiness of those services. To my understanding, the LII's are not required to keep all specialties on 24/7 (although most are there, not all), and the LI is my area always keeps a free OR--that is to say, one OR is always unscheduled.

And in response to dispatchers calling around for you, that's definitely a plus. One of our dispatchers refused to call one of the companies once because he didn't think they were good enough quality. And while yes, there were issues with that company and patient/crew/scene safety (this is the company that almost landed their bird on top of another company's bird--they couldn't of have been more than 100 feet vertical separation between the one on the ground and them as we all frantically tried to wave him off before he saw us. To this day it remains a mystery how he missed the first bird on the ground even if it was green in color...) it was not his call to refuse to contact what was then the closest agency since one of the bases was closed for weather. He got an earful from every chief in the county for that one on Monday morning...

 

[DrParasite]

simple solution by me: we have one dispatch center for medevac state wide. every request for medevac goes to that dispatch center, and there is one person who is assigned to handle all medevacs state wide (we also only have 5 in the entire state).

if you need a helicopter, you call the statewide (or county wide, depending on how you operate), and get the closest helicopter as the crow flies. if they decline due to weather, the 2nd closest goes. if they decline, than no medivac is available. also remember, you don't determine if the weather is safe to fly that is the pilots call.

if the 1st helicopter is on a assignment, it automaticly goes to the 2nd closest, etc.

if you have more than one helo at a particular station, than just give the station the assignment. also, don't go by the company's eta, every helicopter should have a gps/avl, and use that to determine closest since other companies will lie about their eta, esp for profit ones.

 

[WuLabsWuTecH]

simple solution by me: we have one dispatch center for medevac state wide. every request for medevac goes to that dispatch center, and there is one person who is assigned to handle all medevacs state wide (we also only have 5 in the entire state).

if you need a helicopter, you call the statewide (or county wide, depending on how you operate), and get the closest helicopter as the crow flies. if they decline due to weather, the 2nd closest goes. if they decline, than no medivac is available. also remember, you don't determine if the weather is safe to fly that is the pilots call.

if the 1st helicopter is on a assignment, it automaticly goes to the 2nd closest, etc.

if you have more than one helo at a particular station, than just give the station the assignment. also, don't go by the company's eta, every helicopter should have a gps/avl, and use that to determine closest since other companies will lie about their eta, esp for profit ones.

I really wish we had a statewide (or even county-wide) helicopter dispatch center! As for ETAs our chief calculated them from each base and had the representatives who met with him go over the calculations with him. And he does track ETAs (and there is a box on our ePCRs to input this information) and if the ETAs are getting too far off, he is supposed to call up the companies and request a meeting to discuss the discrepancies.

Being in a rural area, if someone needs to go, we generally fly them and I guess even with sometimes fewer than 10 runs a month that we fly, we're profitable enough for them to meet with us. There are 3 non-profits who although they claim they are non-profit seem to be for profit, and 2-3 more for profits in our area. It's causing a lot of confusion right now since everyone is doing things a different way...

 

[T1medic]

I work for a HEMS service in the dispatch center. It seems rather complicated the way ya'll are trying to go about things. I don't know if this is the fault of your service or the HEMS services in your area over-complicating it.

A little info first. We are located at a level 1 trauma center and one of our aircraft is atop our roof, we also have another aircraft two counties away that is also affiliated with our hospital based program. We have two other aircraft we dispatch also in the state. So 4 aircraft total.

There is another aircraft 3 miles away from ours here at the hospital located at another hospital and is dispatched out of the regional dispatch center. We have a rotation of 3 trauma to their 1 and alternate medical calls 1:1. The reason being is they are affiliated with a multi-hospital health system and they do more interfacility transfers than we do.

Ok so the way if works is local EMS/FD calls us via 1 of approx. 4 or 5 different phone numbers depending on what area they are and what number they are used to calling. We then enter the location and our dispatch program automatically provides us with the closest aircraft anywhere in the United States. If it is one of our 4 aircraft we dispatch we then tone them and see if they will accept the flight. If the decline or are on simultaneous mission we will referr the call to the next closest aircraft if the agency would like (most likely longer ETA). If the original pilot declined for weather we will notify the second aircraft that aircraft 1 declined for weather. If we referr the request to another agency we will notify their dispatchers that so and so aircraft declined for weather or they were on a sim mission.

It is never up to the ground units to decide which aircraft to choose. Now one or two counties do have a preference and have a protocol to check with "xyz aircraft" prior to "abc aircraft". That is the point of dispatch, to select the closest appropriate aircraft.

What usalsfyre stated about helicopter shopping is correct. That is why we somewhat prevent that by calling the other aircraft agencies within the area and notify them so and so declined for weather or for whatever reason.

 

[Handsome Robb]

Curious outside of the burn center what they tell you the difference is. I have been told they're functionally equivalent, the main difference being in the areas of academics and research.

I was told that the only difference is, like you said, academic and research capabilities as well as Level I has the required surgeons on-site around the clock while a Level II has the required surgeons on call within a certain distance of the hospital.

Looking for a source to site but it varies state to state.

 

[truetiger]

Dispatch handles all requests for our helicopters. You tell them you need a bird and they'll come back a few minutes later with a bird and its eta. We'll put a bird on ground standby as soon as we get dispatch information if it sounds promising. We're lucky enough to have 2 helicopters in our county, and usually by the time you've got the patient in the back of the ambulance and started working them the helicopter will be on scene.

 

[Dr.NREMT-B]

My 2 Cents

There are a number of different reasons why HEMS crews don't want you to shop around. Here are some good points that I have learned working on a specialty team (HEMS) over the last few years:
1. You are putting a team into action only to cancel them. --- They might have taken off and then need to get another flight release from the FAA for their next flight when they return.
2. When you request, (at least in the case of AirEvac and AirMethods- two of the biggest operators in the nation) the crew/pilot is the actual "dispatcher" of the flight, meaning that a command center can only request a flight, not dispatch the crew. This means that the pilot (while usually having a support network at the communications center), has to look up the weather, wake up, prepare the helicopter for takeoff, and
3. COST: the cost of flying (maybe not catching another call because of this bogus call), and not making a full "pt. run," adds up after a while. We flew and stabilized a patient and then the patient decided to go by ground. You should have seen how mad administration got at that one!
4. They really want the business!

I did 4 years as a volunteer firefighter and we always did our helicopter shopping! We would get a weather turndown and then another before getting someone who would accept. This is DANGEROUS and the FAA knows that departments weather shop, therefore, AirMed International created a website (The Weather Turndown Website) where pilots are supposed to list their turndowns or look to see if another crew turned down the request before accepting one in questionable weather. Also, the FAA Aviation Rulemaking Committee is constantly looking into HEMS weather minimums that get applied to all HEMS agencies (Fact Sheet – Helicopter Emergency Medical Service Safety). If one pilot turns you down, chances are that they should all turn you down.

All of that being said, you are the requesting department/customer. You wouldn't be requesting HEMS if time wasn't a factor. If one service gives you an ETA of 30 min, cancel the flight request and call another.

NVRob is correct that Level I hospitals must have Trauma Teams on site 24hrs. Trauma II doesn't require on site coverage.

 

[usalsfyre]

1. You are putting a team into action only to cancel them. --- They might have taken off and then need to get another flight release from the FAA for their next flight when they return.

Unless you operating IFR this is untrue. Depending on the airspace your in another flight may require an additional clearance, but that simply requires a radio call.

2. When you request, (at least in the case of AirEvac and AirMethods- two of the biggest operators in the nation) the crew/pilot is the actual "dispatcher" of the flight, meaning that a command center can only request a flight, not dispatch the crew. This means that the pilot (while usually having a support network at the communications center), has to look up the weather, wake up, prepare the helicopter for takeoff, and

Which is not that different than a ground ambulance. The reason the word "dispatcher" is not used is due to the fact that the term has a special meaning to the FAA as someone who has say in the flight request.

3. COST: the cost of flying (maybe not catching another call because of this bogus call), and not making a full "pt. run," adds up after a while. We flew and stabilized a patient and then the patient decided to go by ground. You should have seen how mad administration got at that one!

The cost of a HEMS program is astronomical it's true. But so is the reimbursement. If it wasn't profitable there wouldn't be so many privates.

4. They really want the business!

The real reason behind all this.

I did 4 years as a volunteer firefighter and we always did our helicopter shopping! We would get a weather turndown and then another before getting someone who would accept. This is DANGEROUS

Maybe, maybe not. Depends on whether the turn down info is shared, the type of program (VFR vs IFR), direction, ect.

and the FAA knows that departments weather shop, therefore, AirMed International created a website (The Weather Turndown Website) where pilots are supposed to list their turndowns or look to see if another crew turned down the request before accepting one in questionable weather. Also, the FAA Aviation Rulemaking Committee is constantly looking into HEMS weather minimums that get applied to all HEMS agencies (Fact Sheet – Helicopter Emergency Medical Service Safety).

Those are minimums, some companies have set their minimums higher. Pilots and crews may set their PERSONAL minimums higher for that matter.

If one pilot turns you down, chances are that they should all turn you down.

Again not true, see above.

All of that being said, you are the requesting department/customer. You wouldn't be requesting HEMS if time wasn't a factor. If one service gives you an ETA of 30 min, cancel the flight request and call another.

I've seen them used for other reasons...

NVRob is correct that Level I hospitals must have Trauma Teams on site 24hrs. Trauma II doesn't require on site coverage.

Your talking about 5 min call for for general trauma services and 15 min call for certain specialty services vs "on campus" coverage. On campus can have a pretty loose definition.

 

[Dr.NREMT-B]

Unless you operating IFR this is untrue. Depending on the airspace your in another flight may require an additional clearance, but that simply requires a radio call.

We fly VFR and request a flight clearance first thing in the morning when we get up to make sure we have one ready to go. You go online and get a new one every day to release your aircraft with a new pilot/crew. You will also notice that a good percentage of HEMS flys VFR --- at least in the midwest. We are just now getting to flights under NVG. And, there is an FAA person in every command center for AirEvac and AirMethods (24/7) overlooking our operations. If we liftoff without a release, we get a mighty big fine.

Which is not that different than a ground ambulance. The reason the word "dispatcher" is not used is due to the fact that the term has a special meaning to the FAA as someone who has say in the flight request.

The difference, according to the FAA's AMRN (Air Medical Resources Management), is that we have 100% responsibility for the flight/mission - communications is just relaying us information. We can't say that the dispatcher should have known better than to send us into that tornado.

The cost of a HEMS program is astronomical it's true. But so is the reimbursement. If it wasn't profitable there wouldn't be so many privates.

We get reimbursed on average <46% of what we charge. The main way we make money is by admitting our critical patients (that we fly into the hospital) for a long period of time.

Maybe, maybe not. Depends on whether the turn down info is shared, the type of program (VFR vs IFR), direction, ect.

Causes of crashes: "Controlled flight into terrain [human error], inadvertent operation into instrument meteorological conditions [weather] and pilot spatial disorientation/lack of situational awareness in night operations [human error]." (Fact Sheet – Helicopter Emergency Medical Service Safety)

Those are minimums, some companies have set their minimums higher. Pilots and crews may set their PERSONAL minimums higher for that matter.

I agree. Our minimums Conditions are lower than anyone in the area. If I were a patient who needed HEMS badly, I would want someone who would fly through anything -- that doesn't make it safe.

I've seen them used for other reasons...

Yeah, our paperwork lists about 10 different reasons that you have to check off. Time is #1 then things like: hospital unable to provide life saving services, special equipment needed, specially trained staff needed, etc. Nothing used more than time critical injury/medical condition.

Your talking about 5 min call for for general trauma services and 15 min call for certain specialty services vs "on campus" coverage. On campus can have a pretty loose definition.

Our CathLab is 30 minutes and the Level II's in the area have the same required times or longer.

 

[MSDeltaFlt]

This whole thing about which of the several aircraft to call for from the scene should be, and is in my honest opinion, uncalled for.

As a former flight medic and a current ground medic I can say this with all certainty: not my problem. If I need an aircraft I call my dispatcher and tell him/her I need an aircraft. My company's, my former company's, one of the other two companies', I don't/won't care. If I can get on the road before they land wherever I am and still need an aircraft that's fine. We'll meet up at a helipad or some other Pre-established Landing Are (PELA).

If I can get them to the most appropriate hospital before they can get to me, then I don't need them at all.

I don't get the big deal here.

 

[WuLabsWuTecH]

I work for a HEMS service in the dispatch center. It seems rather complicated the way ya'll are trying to go about things. I don't know if this is the fault of your service or the HEMS services in your area over-complicating it.

A little info first. We are located at a level 1 trauma center and one of our aircraft is atop our roof, we also have another aircraft two counties away that is also affiliated with our hospital based program. We have two other aircraft we dispatch also in the state. So 4 aircraft total.

There is another aircraft 3 miles away from ours here at the hospital located at another hospital and is dispatched out of the regional dispatch center. We have a rotation of 3 trauma to their 1 and alternate medical calls 1:1. The reason being is they are affiliated with a multi-hospital health system and they do more interfacility transfers than we do.

Ok so the way if works is local EMS/FD calls us via 1 of approx. 4 or 5 different phone numbers depending on what area they are and what number they are used to calling. We then enter the location and our dispatch program automatically provides us with the closest aircraft anywhere in the United States. If it is one of our 4 aircraft we dispatch we then tone them and see if they will accept the flight. If the decline or are on simultaneous mission we will referr the call to the next closest aircraft if the agency would like (most likely longer ETA). If the original pilot declined for weather we will notify the second aircraft that aircraft 1 declined for weather. If we referr the request to another agency we will notify their dispatchers that so and so aircraft declined for weather or they were on a sim mission.

It is never up to the ground units to decide which aircraft to choose. Now one or two counties do have a preference and have a protocol to check with "xyz aircraft" prior to "abc aircraft". That is the point of dispatch, to select the closest appropriate aircraft.

What usalsfyre stated about helicopter shopping is correct. That is why we somewhat prevent that by calling the other aircraft agencies within the area and notify them so and so declined for weather or for whatever reason.

I agree it's mightily complicated, but it is the results of the companies not working together and using borderline, if not outright unethical, practices to tray and get as much business as possible. The lying about ETAs is probably the biggest one I've seen. It's why our chief is tracking them now and wants to see if anyone is consistently 5 minutes late because that shows a pattern of deception (if they are occasionally late and the times vary, it's just poor estimation which we in the ground services are guilty of as well from time to time, but if there is a significant statistic that shows a pattern, he's going to get suspicious)

This whole thing about which of the several aircraft to call for from the scene should be, and is in my honest opinion, uncalled for.

As a former flight medic and a current ground medic I can say this with all certainty: not my problem. If I need an aircraft I call my dispatcher and tell him/her I need an aircraft. My company's, my former company's, one of the other two companies', I don't/won't care. If I can get on the road before they land wherever I am and still need an aircraft that's fine. We'll meet up at a helipad or some other Pre-established Landing Are (PELA).

If I can get them to the most appropriate hospital before they can get to me, then I don't need them at all.

I don't get the big deal here.

In the city where I work, we call for the bird and our dispatchers go work on it. There are only 2 or 3 companies there, and each dispatcher in the dispatching center will call a different one, share the ETAs with each other, and then call back the closest chopper and call us back on the radio with their ETA. All we have to do is mention that we need air support. Which is great when you work in a system with literally 50 dispatchers on duty during the day dedicated to fire EMS. You can spare the resources to tie up 2 or 3 of them to make that call.

Out in the rural area, we have only 2 dispatchers on, sometimes 3 during the day. They are not dedicated to Fire/EMS and also dispatch the township police and county sheriffs. If they were to call all 5 HEMS companies each time we needed a chopper, we would definitely always be at the hospital before the chopper got here!

Here is some information I found out recently that may explain more about what is going on:

• First off, the new SOP is in place, and each of our 8 "quadrants" has it's own "Due Up" list for HEMS in addition to the normal Due Up lists
• There was an incident a few months ago where a dispatcher refused to call a certain company; we'll call it "South Air" (I mentioned this in a previous post). It came to our Chief's attention that he is also a dispatcher in his off days for the competing company, "North Air." Because of this, our chief wants to make sure that we don't rely on "dispatcher's discretion" while a conflict of interest may be occurring. (There is further investigation on this matter but I am no privy to that information at this time)
• North Air, who was the one that was pushing for not "shopping" in the new sense of the term that they coined has been losing a lot of business lately. They used to be the exclusive provider of HEMS for at least a dozen counties, but as new companies moved in, they were still complacent. Gradually, they have been pushed out of markets. One such example was a county that had requested them to set up a new base in their county to reduce transport times. They several times over a decade declined due to "not having enough run volume to justify it." It was a catch-22--Their ETA was so long that the fire departments in the county started either taking the patients to the county hospital, or ground pounding them up to the trauma center which reduced the run volume for HEMS...
  
  About a few months ago, a private HEMS service moved into the county with 2 birds, one based at the hospital and one based on the far side of the county from the Trauma Center's Metro Area. Apparently, the fire chiefs and the hospital got together to put together a contract that as long as they were available, this company would get the first call for all emergent and inter-facility transfers if the company would bring in the 2 birds. Now the departments in the area have the option of ground pounding to the county hospital knowing that stabilization and upgrade will happen quickly, or the ones that are farther out have an ETA of just over 10 minutes in most cases. North Air has parked a bird at the GA airport hoping that they could get in while they build a base out there to try and get those transports again, but in reality I doubt they will get much, if anything, due to the contract

I'm assuming it's these developments that is causing North Air to try and convince us not to shop and just to call them all the time since for a portion of our district, they are the closest, even if the second through fifth closest are now someone else.

 

[MSDeltaFlt]

I agree it's mightily complicated, but it is the results of the companies not working together and using borderline, if not outright unethical, practices to tray and get as much business as possible. The lying about ETAs is probably the biggest one I've seen. It's why our chief is tracking them now and wants to see if anyone is consistently 5 minutes late because that shows a pattern of deception (if they are occasionally late and the times vary, it's just poor estimation which we in the ground services are guilty of as well from time to time, but if there is a significant statistic that shows a pattern, he's going to get suspicious)




In the city where I work, we call for the bird and our dispatchers go work on it. There are only 2 or 3 companies there, and each dispatcher in the dispatching center will call a different one, share the ETAs with each other, and then call back the closest chopper and call us back on the radio with their ETA. All we have to do is mention that we need air support. Which is great when you work in a system with literally 50 dispatchers on duty during the day dedicated to fire EMS. You can spare the resources to tie up 2 or 3 of them to make that call.

Out in the rural area, we have only 2 dispatchers on, sometimes 3 during the day. They are not dedicated to Fire/EMS and also dispatch the township police and county sheriffs. If they were to call all 5 HEMS companies each time we needed a chopper, we would definitely always be at the hospital before the chopper got here!

Here is some information I found out recently that may explain more about what is going on:

• First off, the new SOP is in place, and each of our 8 "quadrants" has it's own "Due Up" list for HEMS in addition to the normal Due Up lists
• There was an incident a few months ago where a dispatcher refused to call a certain company; we'll call it "South Air" (I mentioned this in a previous post). It came to our Chief's attention that he is also a dispatcher in his off days for the competing company, "North Air." Because of this, our chief wants to make sure that we don't rely on "dispatcher's discretion" while a conflict of interest may be occurring. (There is further investigation on this matter but I am no privy to that information at this time)
• North Air, who was the one that was pushing for not "shopping" in the new sense of the term that they coined has been losing a lot of business lately. They used to be the exclusive provider of HEMS for at least a dozen counties, but as new companies moved in, they were still complacent. Gradually, they have been pushed out of markets. One such example was a county that had requested them to set up a new base in their county to reduce transport times. They several times over a decade declined due to "not having enough run volume to justify it." It was a catch-22--Their ETA was so long that the fire departments in the county started either taking the patients to the county hospital, or ground pounding them up to the trauma center which reduced the run volume for HEMS...
  
  About a few months ago, a private HEMS service moved into the county with 2 birds, one based at the hospital and one based on the far side of the county from the Trauma Center's Metro Area. Apparently, the fire chiefs and the hospital got together to put together a contract that as long as they were available, this company would get the first call for all emergent and inter-facility transfers if the company would bring in the 2 birds. Now the departments in the area have the option of ground pounding to the county hospital knowing that stabilization and upgrade will happen quickly, or the ones that are farther out have an ETA of just over 10 minutes in most cases. North Air has parked a bird at the GA airport hoping that they could get in while they build a base out there to try and get those transports again, but in reality I doubt they will get much, if anything, due to the contract

I'm assuming it's these developments that is causing North Air to try and convince us not to shop and just to call them all the time since for a portion of our district, they are the closest, even if the second through fifth closest are now someone else.

HEMS is way too competitive which is why I call Bravo Sierra on their methods and tactics. Whoever is called is not my problem. If I need a bird I don't give a rat's hairy patooty who's bird it is as long as they get my pt where they need to go.

 

[WuLabsWuTecH]

I don't care who it is either (as long as they don't try to land on another bird causing a second emergency on my scene!) but I do care how far away they are. If they are going to take 40 minutes to get here, we'd have them at the trauma room and be writing our report sippin' on a coke in the EMS room by then!