Why don't some like the fire mix?

Ad hominem much?
1810470-that_word_inigo_montoya_word_think_means_princess_bride_mand_demotivational_poster_1260739585.jpg
 
I agree with BEN (obviously).

If you choose to feel sorely about those who have (arguably) better jobs than you do, call up your retired co-workers who agreed to do away with pension-based retirement systems in lieu of the 401k that you have now.

The fact is that, by design, fire based EMS can be superior simply because of established infrastructure and overall lower costs of doing business for that specific line item. Are we paid well? Sure. Do we arguably do much more than the standard single-function? Yes.

Those who say that EMS is 80% of what we do are comparing apples and oranges. Depending on the response area, call volume will likely be 65-85% EMS, but if you consider hours worked per member, the numbers start to reflect more accurately what we do.

Example: 3 person engine crew and 2 person medic respond to a medical. Engine is committed for 20 minutes and medic unit committed for 1 hour. That total 3 working hours for that call.

House fire call requires 3 engines (9 personnel), 1 truck (4 personnel), 1 medic (2 personnel) and a Chief. If the engine companies are committed for 3 hours each, the truck for 1 hour, the medic for 1 hour and the Chief for 2 hours, the total commitment for the call is 35 hours to run one call... And a simple residential at that. If it were a multi-alarm commercial or significant vegetation fire, the hours will grow exponentially.

We are required to respond appropriately to all calls at any time. To deny us that reality is to preach and maintain ignorance.

As for EMS, the quality of care is determined by the individual. I have worked with every kind of medic partner, both private and municipal. There are ****ty medics on both sides of the fence.

Are there plenty of single function medics who are better than I am at that one discipline? Absolutely. You ******* better be... That's your ONE JOB.

That being said, am I proficient in my skills and able to serve my community adequately, especially in a busy urban area with short transport times? Absolutely.

Bottom line is this: if you don't like the job you have, apply for mine and be a great fire medic. My guess is that if your chosen mode rebellion is to complain, you'll complain wherever you are.

I've said that before during a similar debate. Yes, EMS is 70% to 80% of calls, but there are only two people on an ambulance. Every MVA gets an engine to block, and there are four people on it. Every alarm bell gets an engine and a truck. Every inside gas leak gets two engines, a specialty unit (Heavy Rescue or Truck), and an ambulance. Our box alarm is four engines, two trucks, rescue squad, BC, EMS supervisor, and an ambulance. A RIT level one (deployed when confirmed fire) sends more engines and such. Hazmat incidents get two Hazmat specialty units in addition to the standard gas leak response. Etc. etc.

EMS is 75% or so of dispatched calls, but the fire calls are typically more resource intensive. As such, that 75% figure is inaccurate - it doesn't tell the whole picture. Our ALS engines and Heavy Rescue Squads are useful when the first due medic is out on another call.
 

Sure I do - an ad hominem seeks to discredit the source, rather than debate the talking points. In this case, the press release comment was intended to discredit or marginalize the post by saying that it resembles a press release by the IAFF rather than original thought. Then, being marginalized, there is no need to respond to the points made in that post. An abusive ad hominem is when you call the poster names or attack their character/
 
You "anti's" really need to try out this ALS first response thing. It's great to not have to move a patient, to have many hands to move equipment and such, more people for safety and scene management, and another medic to help out with ALS when you're exhausted at 0-dark 30. I can run an entire chest pain protocol and leave the scene 10-12 minutes after marking onscene- 12 lead within 5, ASA, NTG, two lines, and capno.

In NYC it was usually just my partner and I dispatched alone for most calls, moving overweight people down numerous flights of stairs on a stair chair, humping our equipment from flight to flight. 30 mins. on-scene for a real ALS, even if we get onscene and request a BLS unit for pt care assistance. No wonder there are so many broken down paramedics and EMT's in EMS.
 
If you "can't be bothered", then simply sit back and read the commentary train silently. Your input added nothing.
Welcome to the Internet.

Sure I do - an ad hominem seeks to discredit the source, rather than debate the talking points. In this case, the press release comment was intended to discredit or marginalize the post by saying that it resembles a press release by the IAFF rather than original thought. Then, being marginalized, there is no need to respond to the points made in that post. An abusive ad hominem is when you call the poster names or attack their character/
You certainly misused it. It's ok though. After all, you're just a dumb fire fighter.

(See what I did there?)
 
Your reply is full of assumptions, innuendos, and flat out ignorance.

You really shouldn't take the things said on these forums so personally. Clearly I was speaking in general terms and not about you or your department, since I have no way of even knowing where you work.

I don't begrudge you for having a good job that you enjoy. And as I wrote earlier, I'm not even necessarily against the idea of a fire-based EMS system. I'm against inefficiency when it comes to taxpayer dollars, and poor focus when it comes to the prehospital expert who needs to know more and more all the time. And unfortunately I see a lot of room for that in fire-based EMS.

First and foremost, I don't see any "extortion" taking place to pay my salary. My salary is dictated by a union contract that is renegotiated every 2 years. That contract is negotiated between the union and the elected officials of the city.

That's great. The problem though, is 1) most people pay exactly zero attention to local politics and do not vote in local elections and referenda, and more importantly, 2) just because a majority of voters support politicians who support fire-based EMS doesn't even begin to prove that it's the best way. Maybe everyone in your community really is well-informed and truly supportive. Great. Still doesn't mean there's not a better way. Remember Cash for Clunkers? Ever hear of the "Bridge to Nowhere"? I could list hundreds of other programs that were approved by taxpayers and even popular among many at the time, but in retrospect, can be viewed as nothing more than a massive waste.

And if you don't think taxation is a form of extortion.....try choosing not to pay your taxes because you strongly disagree with how your hard earned money is being used, and see what happens. Then look up the definition of "extortion". Then explain the difference to me.


Secondly, I don't work "only 2 days a week" as you put it.
Oh no? Then what did you mean in your first post when you wrote:

I work 8-9 days a month and make north of 70k a year with a 25 year pension.
Is 8-9 days a month substantially different than 2 days a week?


The problem is most of the anti fire based EMS folks do two thing; they pain with a very broad brush and they sell themselves short. Don't assume all fire based agencies are created equal as they are not. The pay, benefits, retirement, and career progression in single role jobs is poor because so many single role providers have reduced themselves to believing that it is ok and the fire guys are "extorting". They always talk about advancing clinical standards which is very improtant but they should also not settle and advance their career standards as well.

Whenever this discussion comes up, you guys brag about how much better your salary, benefits, and working conditions are than what most single-role paramedics enjoy - just look at you and 46young's first replies to this thread - and you try to frame the overall debate as one of "we are just treated like we should be treated, and you guys are letting yourselves get shafted".

Look, I'm glad you guys tend to have it good, but guess what:
your compensation isn't what this debate is about. This debate is about the best way to deliver prehospital care, not the best way to get high salaries for paramedics.

Again, I am not strictly against fire-based EMS. But as a taxpayer, I find it hard to believe that it's an efficient model. And as a clinician, I find it hard to believe that the combined firefighter/paramedic role attracts or breeds the kind of dedicated and clinically-focused expert that we need to keep improving prehospital care.
 
Welcome to the Internet.


You certainly misused it. It's ok though. After all, you're just a dumb fire fighter.

(See what I did there?)

I must have been mistaken. It appeared that instead of debating the post, you looked to downplay it by relating it to IAFF propaganda. I must have also mistaken the fact that in the next post you stated that you refuse to debate the points. My bad.
 
Sure I do - an ad hominem seeks to discredit the source, rather than debate the talking points. In this case, the press release comment was intended to discredit or marginalize the post by saying that it resembles a press release by the IAFF rather than original thought. Then, being marginalized, there is no need to respond to the points made in that post. An abusive ad hominem is when you call the poster names or attack their character/

Inigo was right; that word does not mean what you think it does. An ad hominem fallacy occurs when the user overtly attacks somebody or subtly casts doubt on their character or personal attributes as a way to discredit their argument.

What you're referring to is a Genetic Fallacy, in which an idea is either accepted or rejected because of its source, rather than its merit.

You're welcome. ;)
 
I agree with BEN (obviously).

If you choose to feel sorely about those who have (arguably) better jobs than you do, call up your retired co-workers who agreed to do away with pension-based retirement systems in lieu of the 401k that you have now.

The fact is that, by design, fire based EMS can be superior simply because of established infrastructure and overall lower costs of doing business for that specific line item. Are we paid well? Sure. Do we arguably do much more than the standard single-function? Yes.

Those who say that EMS is 80% of what we do are comparing apples and oranges. Depending on the response area, call volume will likely be 65-85% EMS, but if you consider hours worked per member, the numbers start to reflect more accurately what we do.

Example: 3 person engine crew and 2 person medic respond to a medical. Engine is committed for 20 minutes and medic unit committed for 1 hour. That total 3 working hours for that call.

House fire call requires 3 engines (9 personnel), 1 truck (4 personnel), 1 medic (2 personnel) and a Chief. If the engine companies are committed for 3 hours each, the truck for 1 hour, the medic for 1 hour and the Chief for 2 hours, the total commitment for the call is 35 hours to run one call... And a simple residential at that. If it were a multi-alarm commercial or significant vegetation fire, the hours will grow exponentially.

We are required to respond appropriately to all calls at any time. To deny us that reality is to preach and maintain ignorance.

As for EMS, the quality of care is determined by the individual. I have worked with every kind of medic partner, both private and municipal. There are ****ty medics on both sides of the fence.

Are there plenty of single function medics who are better than I am at that one discipline? Absolutely. You ******* better be... That's your ONE JOB.

That being said, am I proficient in my skills and able to serve my community adequately, especially in a busy urban area with short transport times? Absolutely.

Bottom line is this: if you don't like the job you have, apply for mine and be a great fire medic. My guess is that if your chosen mode rebellion is to complain, you'll complain wherever you are.
I'll pick my battles here and just comment about the bolded the statement, which I believe to be wholly inaccurate. Quality of care is absolutely determined by the system. If the system refuses to hold its providers to a reasonable standard, that is a failed system, plain and simple. And there are many fire departments that do not hold its providers to a standard under the guise of "its only one role that they play." If you're going to provide EMS, you need to do it right. Part of doing it right is designing the right system for the covered area and then having a culture that supports its implementation and continued efficacy. Leaving the individual provider to determine the quality of care is how poor expectations and subsequent crap systems develop.

And again, this is not a problem inherent to the fire service. Some EMS agencies will allow their providers this leeway to cut costs and others because they just don't care. Still does not make it acceptable.
 

You really shouldn't take the things said on these forums so personally. Clearly I was speaking in general terms and not about you or your department, since I have no way of even knowing where you work.

I don't begrudge you for having a good job that you enjoy. And as I wrote earlier, I'm not even necessarily against the idea of a fire-based EMS system. I'm against inefficiency when it comes to taxpayer dollars, and poor focus when it comes to the prehospital expert who needs to know more and more all the time. And unfortunately I see a lot of room for that in fire-based EMS.



That's great. The problem though, is 1) most people pay exactly zero attention to local politics and do not vote in local elections and referenda, and more importantly, 2) just because a majority of voters support politicians who support fire-based EMS doesn't even begin to prove that it's the best way. Maybe everyone in your community really is well-informed and truly supportive. Great. Still doesn't mean there's not a better way. Remember Cash for Clunkers? Ever hear of the "Bridge to Nowhere"? I could list hundreds of other programs that were approved by taxpayers and even popular among many at the time, but in retrospect, can be viewed as nothing more than a massive waste.

And if you don't think taxation is a form of extortion.....try choosing not to pay your taxes because you strongly disagree with how your hard earned money is being used, and see what happens. Then look up the definition of "extortion". Then explain the difference to me.



Oh no? Then what did you mean in your first post when you wrote:

Is 8-9 days a month substantially different than 2 days a week?




Whenever this discussion comes up, you guys brag about how much better your salary, benefits, and working conditions are than what most single-role paramedics enjoy - just look at you and 46young's first replies to this thread - and you try to frame the overall debate as one of "we are just treated like we should be treated, and you guys are letting yourselves get shafted".

Look, I'm glad you guys tend to have it good, but guess what:
your compensation isn't what this debate is about. This debate is about the best way to deliver prehospital care, not the best way to get high salaries for paramedics.

Again, I am not strictly against fire-based EMS. But as a taxpayer, I find it hard to believe that it's an efficient model. And as a clinician, I find it hard to believe that the combined firefighter/paramedic role attracts or breeds the kind of dedicated and clinically-focused expert that we need to keep improving prehospital care.


We bring up superior salary and working conditions because it's the truth. Everyone should enjoy the same benefits, and not settle for the single role status quo. I'm sure that single role EMS with a fleet large enough to handle significant call volume without wearing out it's medics and EMT's would be ideal, and with more appropriate pay and benefits, but that's pretty much a unicorn, save for King Co. and maybe ATC-EMS. A single role provider should be better at their job, and having state of the art guidelines and equipment make for a great system for the patients, but this is still a job - this is how we eat. Any system that pays scrub wages to it's employees is exploitative of it's employees. Paying a medic $12/hr ($39k/yr in a 24/48 system) is nearly a crime IMO. If you think that's appropriate, then don't lament about why EMS is not a degree profession - no one with any
Inigo was right; that word does not mean what you think it does. An ad hominem fallacy occurs when the user overtly attacks somebody or subtly casts doubt on their character or personal attributes as a way to discredit their argument.

What you're referring to is a Genetic Fallacy, in which an idea is either accepted or rejected because of its source, rather than its merit.

You're welcome. ;)

No need to split hairs, call it what you want, the end result is the same - attempted marginalization of the post, then willfully avoiding further discussion on the topic.
 

You really shouldn't take the things said on these forums so personally. Clearly I was speaking in general terms and not about you or your department, since I have no way of even knowing where you work.

I don't begrudge you for having a good job that you enjoy. And as I wrote earlier, I'm not even necessarily against the idea of a fire-based EMS system. I'm against inefficiency when it comes to taxpayer dollars, and poor focus when it comes to the prehospital expert who needs to know more and more all the time. And unfortunately I see a lot of room for that in fire-based EMS.



That's great. The problem though, is 1) most people pay exactly zero attention to local politics and do not vote in local elections and referenda, and more importantly, 2) just because a majority of voters support politicians who support fire-based EMS doesn't even begin to prove that it's the best way. Maybe everyone in your community really is well-informed and truly supportive. Great. Still doesn't mean there's not a better way. Remember Cash for Clunkers? Ever hear of the "Bridge to Nowhere"? I could list hundreds of other programs that were approved by taxpayers and even popular among many at the time, but in retrospect, can be viewed as nothing more than a massive waste.

And if you don't think taxation is a form of extortion.....try choosing not to pay your taxes because you strongly disagree with how your hard earned money is being used, and see what happens. Then look up the definition of "extortion". Then explain the difference to me.



Oh no? Then what did you mean in your first post when you wrote:

Is 8-9 days a month substantially different than 2 days a week?




Whenever this discussion comes up, you guys brag about how much better your salary, benefits, and working conditions are than what most single-role paramedics enjoy - just look at you and 46young's first replies to this thread - and you try to frame the overall debate as one of "we are just treated like we should be treated, and you guys are letting yourselves get shafted".

Look, I'm glad you guys tend to have it good, but guess what:
your compensation isn't what this debate is about. This debate is about the best way to deliver prehospital care, not the best way to get high salaries for paramedics.

Again, I am not strictly against fire-based EMS. But as a taxpayer, I find it hard to believe that it's an efficient model. And as a clinician, I find it hard to believe that the combined firefighter/paramedic role attracts or breeds the kind of dedicated and clinically-focused expert that we need to keep improving prehospital care.

The debate is about why some people don't like fire based EMS. That includes salary/benefits, staffing/deployment, working conditions, as well as guidelines, training, and equipment. I'm not bragging about salary, benefits, and career ladders; it's simply the truth. I think that EMS workers deserve more than a dead end job with subsistence pay. That's why I left single role EMS. I'm 100% for the best situation for the employees - this is supposed to be a career. This is how we eat. The training, equipment, guidelines/protocols, and working conditions vary greatly from department to department, as well as from fire based to hospital based to muni third service to the privates. Every system has it's stellar systems, and every system has it's losers.

All I'm saying is that on the average, fire based EMS takes much better care of it's employees than in single role EMS. I'm sure that single role medics should be more proficient than fire based medics, although I don't find it particularly difficult to handle ALS and fire. They don't put you through medic school and fire school simultaneously. Usually either they get hired as medics, or get put through medic school a few years after being hired as a firefighter. It's not as difficult to manage suppression and EMS as some would have us believe. Really, think about it - medic school is anywhere from six months to two years; mine was 13 months long at NY Methodist in Brooklyn. Fire school certifying in FF I/II takes about 23 weeks give or take. That's about the time and effort it takes to earn an ADN at best, let alone a Bachelors degree. Yes, they're two different skill sets, but don't tell that to my FDNY firefighter friends that work part time as nurses, PA's, hospital based medics, as plumbers, electricians, carpenters, personal trainers, etc. There are a few guys that I work with that own landscaping companies, and others that do roofing, siding, and handyman work. I don't know how they could ever do that well - it's two unrelated skill sets. To use the logic that to do fire and EMS is to spread yourself too thin is to say that no one should ever focus on more than one source of linear income.

Yes, our pay and benefits should be the norm. It is practically criminal, IMO, to pay a medic $12/hr, but I've just described the hourly rate for someone that works a 24/48 and makes $38k/yr, which is a typical pay rate in the Carolinas. The equipment, training, and protocols vary greatly in single role EMS, before even considering fire based systems. We've had many single role medics escape to Northern Virginia from places like Ohio and the Southeast, as well as California and AZ. If anyone thinks that $12/hr for medics, and $8/hr for EMT's is normal, and that firemedics are overpaid, should not lament the lack of a degree as a barrier for entry into EMS. No one with any common sense will waste 3-4 years in college for a $12/hr job with no promotional track.

I work a variant of the 24/48, so I work 10-11 days/month. Yes, technically I work 2.5 days a week or so, but it's a 56 hour workweek. That is 140% more hours than the normal 40 hour employee. I'm not going to work every day, but I am gone from home a lot, and I consider myself lucky if I get manage the first off day without having to sleep at some point in the day to recover from the previous night's work. As far as our pay, it's 53 hours straight pay every week, and for our 25 year retirement, we work the equivalent of 33+ 40 hour workweek-years. So, we're putting in 33 years on the clock for our "lucrative" 25 year retirement. Again, the employer saves on benefits/retirement on two employees for every seven hired, compared to 40 hour people. This also goes for single role people on a 56 hour workweek, so when looking at these figures, the $12/hr is practically welfare wages. I made $30/hr as a medic in NYC, so making $70k/yr in a dual role FLSA system is not unreasonable, since it's about $23/hr of mostly straight time, while being responsible for two skill sets. The real crime is not having EMS and fire work a 24/72 like it should be. Sorry that my input always comes back to salary and working conditions, but all of the other stuff doesn't matter if I'm not going to last ten years in an underpaid position while getting beaten down day in and day out.

One consideration: what do we think the average employee tenure is between hospital based, third service muni, private contract third service, and fire based EMS? Just from personal observation, I see fire as having the most longevity, private EMS as the worst, with hospital and third service being a mixed bag but still less than fire. I've worked in all four systems. The turnover is huge in each one. When I worked in SC, they had a one day orientation and put us right into the field as the second provider, which saves them money in training, which is necessary because so many people were joining and quitting on a regular basis. Why is this important? I would prefer an ambulance crew that is career-minded and experienced (typically fire based, and hit-or miss with muni third service) rather than a two year guy being driven by a two month probie, which is likely when working for an abusive muni third service system or the majority of privates. I know that I'm not off base on this, since it's well known that EMS is a transient, more or less "stepping stone" job for many. This issue comes up whenever the discussion about why EMS doesn't have a degree requirement, which leads to EMS not being organized but rather fragmented, which leads to the fact that many people leave EMS for greener pastures well before retirement. I remember reading somewhere that the average tenure in single role EMS is only 7-10 years at best. That sounds about right. In contrast, people that join fire based EMS typically stay until retirement. They may trade up once or twice for their dream department, but it pays to stick it out.
 
And I find that most people that express "like" for the FF/EMS mix are either FFs for whom becoming an EMT or Medic was the cost of admission to join their local fire department or fire department leaders who are riding the back of EMS to keep their departments solvent.

Makes sense from a budget, management and training standpoint? Show me a study not sponsored by the IAFF, IAFC or any other entity with a vested interest in the fire side that demonstrates that to be the case. From a call numbers stand point? Only if you are using EMS calls, which now typically account for upwards of 80% of a Fire/EMS system's calls, to justify the budget for the fire side of the system. Almost all tangible measurements? What other measurements are there that might make your case?

Ultimately, the only measurement that truly matters is the level of care provided by a system and that is a direct measure of the competence (which is the sum of the education, training and experience) of the EMTs and Paramedics providing that care. Prove to me - empirically, not anecdotally - that the typical fire system provides a higher level of care than a typical third service and you might convince me. Otherwise, your simply regurgitating IAFF/IAFC propaganda.

/soapbox

Define "higher level of care," then please provide a link that shows how third service EMS provides this "higher level of care." I've already addressed the "80% EMS call volume" fallacy.

There are just as many substandard third service departments as there are fire based. There are just as many high quality fire based EMS employers as there are third service singles.
 
Reign it in.
 
Define "higher level of care," then please provide a link that shows how third service EMS provides this "higher level of care." I've already addressed the "80% EMS call volume" fallacy.

There are just as many substandard third service departments as there are fire based. There are just as many high quality fire based EMS employers as there are third service singles.
Oh oh pick me lol. I'm an odd municipal private hybrid that provides a higher level of care than most places.
 
Love it or hate it. Right, wrong or indifferent fire based ems is better for those looking for a career and not just a job in MOST cases.

I think a lot of egos are getting involved and the discussion is becoming less productive, but hearif from you fire based guys has mostly, only confirmed my desire to go fire.
Just not sure if CA is the place to do it in.

So for that, I thank you.
 
Back
Top