Re: Ambulance restaffing talks causing stir

[Guest guest]

While I've not proposed an " empiracal formula " Wes, perhaps your concern

could be examined from the standpoint of " how many patient contacts are too

many patient contacts " , rather than from the standpoint of " ... burnout for

the the paramedic having to take most every call. " One might also want

to examine the possibility of a causal relationship between your concern and

any medical and/or medication error rate frequencies, which might negatively

affect patient outcomes. Such a revelation, if substantiated, could go a

long way in reforming staffing, assignment and deployment methodologies.

Until then, it's nothing more than an anecdotal complaint.

>

>

> Does your empirical formula take into account the added burnout for the

> paramedic having to take most every call? Many systems are reluctant to

> allow a lower level of certification attend to a patient during transport,

> based in part upon concerns of liability.

>

> Wes Ogilvie

>

> Sent from my iPad

>

> On Dec 13, 2010, at 10:34, Bob Kellow

kellow.bob@...>

> wrote:

>

> > That's not what I'm suggesting at all, Henry. What I'm saying is keep

> what

> > works and toss what doesn't work (along with their accompanying

> technologies

> > and costs), based on empirical evidence. Require technology manufacturers

> to

> > demonstrate the practicality and overall patient outcome benefits of

> their

> > gadgets before they are allowed to be introduced into the EMS marketplace

> > and all of a sudden become a " standard of care " - not by benefit of

> > scientific evidence, but rather by means of proliferation and market

> > saturation. Front line medics have been subsidizing this practice

> (through

> > suppressed income growth) for decades.

> >

> >

> >

> >

> > On Mon, Dec 13, 2010 at 10:16 AM, Henry Barber

hbarber@...>

> wrote:

> >

> >>

> >>

> >> Yea but Bob if we follow that reasoning we can work our way back to one

> guy

> >>

> >> in the hearse with no one in the back. We could get there faster than it

> >> took us to get where we are today.

> >>

> >> Henry

> >>

> >> Ambulance restaffing talks causing stir

> >>>>>> To: " A A " emsn-news@...

40att.net>

>> 40att.net>

>>>> emsn-news%40att.net > >,

> >>>>>> texasems-l

40yahoogroups.com>

>> 40yahoogroups.com>

>>>> texasems-l%40yahoogroups.com >

> >>

> >>>>

> >>>>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>

> >>

>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

> >>>>>>

> >>>>>>

[Guest guest]

I would say most concerns are perceived as the crew still consists of at least

one paramedic should ALS practices be required. How else is the basic or

intermediate supposed to get valid field experience, especially if they plan on

upgrading someday themselves?

Sent from my iPhone

McGee, EMT-P

> In a message dated 12/13/2010 1:11:03 P.M. Central Standard Time,

> wes.ogilvie@... writes:

>

> Many systems are reluctant to allow a lower level of certification attend

> to a patient during transport, based in part upon concerns of liability.

> Are they valid or perceived concerns?

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/EMSI

> Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

>

> LNMolino@...

>

> (Cell Phone)

> (Office)

> (Office Fax)

>

> " A Texan with a Jersey Attitude "

>

> " Great minds discuss ideas; Average minds discuss events; Small minds

> discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

>

> The comments contained in this E-mail are the opinions of the author and

> the author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its stated recipient and may contain private and or confidential

> materials retransmission is strictly prohibited unless placed in the public

> domain by the original author.

>

>

[Guest guest]

Coming from an all tiered system as I do and never " getting " why we needed

2 medics on every interceptor when the vast majority of the time we only

had one Medic treat any given Patient it seemed like a waste of a resource

(the medic).

I always thought OK we have 4 ALS units in the County with one Supervisor

(in a fully equipped interceptor truck) so we have 5 ALS interceptor trucks

when we could have 9. The cost of the vehicle and all that is substantial

but the TRAINED MEDIC is the resource. Further it made less sense to me that

in North Jersey where they had ALS ambulances in Newark and Jersey City

they did that 2 Medic thing (by state law mind you).

The Air Force would rather loose a plane than a pilot for a reason it takes

years and money to replace a seasoned pilot as opposed to just months and

money to get a new plane.

Plus you then have the whole skills degradation discussion etc.etc.etc.

At times I think passion blinds us.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Office)

(Office Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and

the author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only

for its stated recipient and may contain private and or confidential

materials retransmission is strictly prohibited unless placed in the public

domain by the original author.

In a message dated 12/13/2010 2:21:40 P.M. Central Standard Time,

summedic@... writes:

I would say most concerns are perceived as the crew still consists of at

least one paramedic should ALS practices be required. How else is the basic

or intermediate supposed to get valid field experience, especially if they

plan on upgrading someday themselves?

Sent from my iPhone

McGee, EMT-P

> In a message dated 12/13/2010 1:11:03 P.M. Central Standard Time,

> wes.ogilvie@... writes:

>

> Many systems are reluctant to allow a lower level of certification

attend

> to a patient during transport, based in part upon concerns of liability.

> Are they valid or perceived concerns?

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/EMSI

> Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

>

> LNMolino@...

>

> (Cell Phone)

> (Office)

> (Office Fax)

>

> " A Texan with a Jersey Attitude "

>

> " Great minds discuss ideas; Average minds discuss events; Small minds

> discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

>

> The comments contained in this E-mail are the opinions of the author and

> the author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

unless I

> specifically state that I am doing so. Further this E-mail is intended

only

> for its stated recipient and may contain private and or confidential

> materials retransmission is strictly prohibited unless placed in the

public

> domain by the original author.

>

>

[Guest guest]

On Monday, December 13, 2010 14:20, " McGee " summedic@...> said:

> I would say most concerns are perceived as the crew still consists of at least

one

> paramedic should ALS practices be required. How else is the basic or

intermediate

> supposed to get valid field experience, especially if they plan on upgrading

> someday themselves?

Easy. They go to paramedic school and then work with a senior medic partner.

It's been decades since I worked anywhere that utilised basics, and the new

medics never seem to have any problem upgrading their experience level.

The day they require nursing school as a prerequisite for nursing school, I'll

look into the possibility that stair-stepping medical education is a valid

theory. Until then, I know better.

Rob

[Guest guest]

On Monday, December 13, 2010 14:58, " rob.davis@... "

rob.davis@...> said:

> The day they require nursing school as a prerequisite for MEDICAL school, I'll

> look into the possibility that stair-stepping medical education is a valid

theory.

> Until then, I know better.

Ooops! Fixed original post to make sense.

Rob

[Guest guest]

I disagree totally. A paramedic with a lower patch is perfectly fine. I have

been in the business since 1995. I have worked public and private. In an

emergency setting, seen some paramedics go straight from emt to paramedic and

turn out to be the worst. I have seen most emt's stay at each patch and practice

with a solid paramedic turn out to be great paramedics. It is cost effective to

have a paramedic and lower patch on truck. This " rule " smells like bad politics.

It will cause more problems in the big picture. If it isn't broken, don't fix

it. Leave it up to each individual service.

Lt. H. " Tony " Iagnemma

F.F. EMT

Sent from my HTC on the Now Network from Sprint!

Sent from my HTC on the Now Network from Sprint!

[Guest guest]

I disagree totally. A paramedic with a lower patch is perfectly fine. I have

been in the business since 1995. I have worked public and private. In an

emergency setting, seen some paramedics go straight from emt to paramedic and

turn out to be the worst. I have seen most emt's stay at each patch and practice

with a solid paramedic turn out to be great paramedics. It is cost effective to

have a paramedic and lower patch on truck. This " rule " smells like bad politics.

It will cause more problems in the big picture. If it isn't broken, don't fix

it. Leave it up to each individual service.

Lt. H. " Tony " Iagnemma

F.F. EMT

Sent from my HTC on the Now Network from Sprint!

Sent from my HTC on the Now Network from Sprint!

[Guest guest]

I second that opinion, Wes. As someone who has worked for a busy 911 system at

times running in excess of 20+ calls in a 24 hour shift, the delirium that sets

in can't be good for a paramedic's well-being, much less the patient's. I found

A/TC's system unique in that not only can the transport paramedics switch calls,

but also bounce ideas off each other.

-Alfonso R. Ochoa, BS, RN, LP

> >>>>>>

> >>>>>> From: Ron Haussecker

> >>>>>>

> >>

> >>>>

>> 2540cebridge.net>

> >>

> >>>>>

> >>>>>>>

> >>>>>> Subject: Ambulance restaffing talks causing stir

> >>>>>> To: " A A "

>> 40att.net>

>>>> emsn-news%40att.net > >,

> >>>>>> texasems-l

>> 40yahoogroups.com>

>>>> texasems-l%40yahoogroups.com >

> >>

> >>>>

> >>>>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>

> >>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

> >>>>>>

> >>>>>>

[Guest guest]

Well, you'll also need an internist and a cardiologist for the medical calls, an

endocrinologist for the diabetics, a psychiatrist for the crazies, a urologist

for kidney stones and so forth. We'll have to get much larger busses.

GG

Ambulance restaffing talks causing stir

> >>>> To: " A A " emsn-news@...

40att.net>

>> emsn-news%40att.net > >,

> >>>> texasems-l

40yahoogroups.com>

>> texasems-l%40yahoogroups.com >

>

> >>

> >>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>

> >>>>

> >>>>

> >>>>

> >>>>

> >>

>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

> >>>>

> >>>>

[Guest guest]

Well, you'll also need an internist and a cardiologist for the medical calls, an

endocrinologist for the diabetics, a psychiatrist for the crazies, a urologist

for kidney stones and so forth. We'll have to get much larger busses.

GG

Ambulance restaffing talks causing stir

> >>>> To: " A A " emsn-news@...

40att.net>

>> emsn-news%40att.net > >,

> >>>> texasems-l

40yahoogroups.com>

>> texasems-l%40yahoogroups.com >

>

> >>

> >>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>

> >>>>

> >>>>

> >>>>

> >>>>

> >>

>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

> >>>>

> >>>>

[Guest guest]

Well, you'll also need an internist and a cardiologist for the medical calls, an

endocrinologist for the diabetics, a psychiatrist for the crazies, a urologist

for kidney stones and so forth. We'll have to get much larger busses.

GG

Ambulance restaffing talks causing stir

> >>>> To: " A A " emsn-news@...

40att.net>

>> emsn-news%40att.net > >,

> >>>> texasems-l

40yahoogroups.com>

>> texasems-l%40yahoogroups.com >

>

> >>

> >>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>

> >>>>

> >>>>

> >>>>

> >>>>

> >>

>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

> >>>>

> >>>>

[Guest guest]

Gene the busses are too freaking big already n

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos.

(Cell)

LNMolino@...

> Well, you'll also need an internist and a cardiologist for the medical calls,

an endocrinologist for the diabetics, a psychiatrist for the crazies, a

urologist for kidney stones and so forth. We'll have to get much larger busses.

>

>

> GG

>

>

>

>

>

> Ambulance restaffing talks causing stir

>>>>>> To: " A A " emsn-news@...

> 40att.net>

>>> emsn-news%40att.net > >,

>>>>>> texasems-l

> 40yahoogroups.com>

>>> texasems-l%40yahoogroups.com >

>>

>>>>

>>>>>> Date: Monday, December 13, 2010, 12:57 AM

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>

>>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

>>>>>>

>>>>>>

[Guest guest]

Gene the busses are too freaking big already n

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos.

(Cell)

LNMolino@...

> Well, you'll also need an internist and a cardiologist for the medical calls,

an endocrinologist for the diabetics, a psychiatrist for the crazies, a

urologist for kidney stones and so forth. We'll have to get much larger busses.

>

>

> GG

>

>

>

>

>

> Ambulance restaffing talks causing stir

>>>>>> To: " A A " emsn-news@...

> 40att.net>

>>> emsn-news%40att.net > >,

>>>>>> texasems-l

> 40yahoogroups.com>

>>> texasems-l%40yahoogroups.com >

>>

>>>>

>>>>>> Date: Monday, December 13, 2010, 12:57 AM

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>

>>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

>>>>>>

>>>>>>

[Guest guest]

Gene the busses are too freaking big already n

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos.

(Cell)

LNMolino@...

> Well, you'll also need an internist and a cardiologist for the medical calls,

an endocrinologist for the diabetics, a psychiatrist for the crazies, a

urologist for kidney stones and so forth. We'll have to get much larger busses.

>

>

> GG

>

>

>

>

>

> Ambulance restaffing talks causing stir

>>>>>> To: " A A " emsn-news@...

> 40att.net>

>>> emsn-news%40att.net > >,

>>>>>> texasems-l

> 40yahoogroups.com>

>>> texasems-l%40yahoogroups.com >

>>

>>>>

>>>>>> Date: Monday, December 13, 2010, 12:57 AM

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>

>>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

>>>>>>

>>>>>>

[Guest guest]

And the rent's too damn high!

Wes

Sent from my iPhone

> Gene the busses are too freaking big already n

>

> Louis N. Molino, Sr. CET

> FF/NREMT/FSI/EMSI

> Typed by my fingers on my iPhone.

> Please excuse any typos.

> (Cell)

> LNMolino@...

>

>

>

> > Well, you'll also need an internist and a cardiologist for the medical

calls, an endocrinologist for the diabetics, a psychiatrist for the crazies, a

urologist for kidney stones and so forth. We'll have to get much larger busses.

> >

> >

> > GG

> >

> >

> >

> >

> >

> > Ambulance restaffing talks causing stir

> >>>>>> To: " A A " emsn-news@...

>> 40att.net>

>>>> emsn-news%40att.net > >,

> >>>>>> texasems-l

>> 40yahoogroups.com>

>>>> texasems-l%40yahoogroups.com >

> >>

> >>>>

> >>>>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>>>

> >>>>

> >>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

> >>>>>>

> >>>>>>

[Guest guest]

Wes,

I have found that to most employees it is more about who will have to write the

report. Burnout is a whole other subject that has two sides to the issue, those

that believe it exist and those that do not.

Henry

Ambulance restaffing talks causing stir

>>>>>> To: " A A " emsn-news@...

> 40att.net>

>>> emsn-news%40att.net > >,

>>>>>> texasems-l

> 40yahoogroups.com>

>>> texasems-l%40yahoogroups.com >

>>

>>>>

>>>>>> Date: Monday, December 13, 2010, 12:57 AM

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>

>>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

>>>>>>

>>>>>>

[Guest guest]

Wes,

I have found that to most employees it is more about who will have to write the

report. Burnout is a whole other subject that has two sides to the issue, those

that believe it exist and those that do not.

Henry

Ambulance restaffing talks causing stir

>>>>>> To: " A A " emsn-news@...

> 40att.net>

>>> emsn-news%40att.net > >,

>>>>>> texasems-l

> 40yahoogroups.com>

>>> texasems-l%40yahoogroups.com >

>>

>>>>

>>>>>> Date: Monday, December 13, 2010, 12:57 AM

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>

>>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

>>>>>>

>>>>>>

[Guest guest]

Wes,

I have found that to most employees it is more about who will have to write the

report. Burnout is a whole other subject that has two sides to the issue, those

that believe it exist and those that do not.

Henry

Ambulance restaffing talks causing stir

>>>>>> To: " A A " emsn-news@...

> 40att.net>

>>> emsn-news%40att.net > >,

>>>>>> texasems-l

> 40yahoogroups.com>

>>> texasems-l%40yahoogroups.com >

>>

>>>>

>>>>>> Date: Monday, December 13, 2010, 12:57 AM

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>>>

>>>>

>>

http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-1116\

081.html

>>>>>>

>>>>>>

[Guest guest]

On Tuesday, December 14, 2010 07:53, " Henry Barber " hbarber@...> said:

> I have found that to most employees it is more about who will have to write

the

> report.

Heh... I completely agree.

> Burnout is a whole other subject that has two sides to the issue, those

> that believe it exist and those that do not.

It definitely exists, just like PTSD exists. But the biggest problem I see is

self-induced burnout. It's like a self-fulfilling prophecy. The rookies are in

such a hurry to 'fit in' with the senior personnel, that they immediately begin

to emulate their attitudes. Consequently, they end up sounding and acting like

burnouts long before they've had the experience to have actually achieved that

status. Then it becomes a vicious cycle that feeds upon itself, bringing down

the morale of all around them to the lowest common denominator until you end up

with Medstar.

Rob

[Guest guest]

I don't believe that a preemptive cheap shot at MedStar (or any other

provider) serves any useful purpose on this List. That said, another

contributing factor is employers who don't set limits on the amount of hours

employees are permitted to work per week. Rolling the dice on worker fatigue

vs. filling shift vacancies can be perilous - even deadly. At that point,

" burned out " can become " snuffed out. "

On Tue, Dec 14, 2010 at 1:49 PM, rob.davis@... <

rob.davis@...> wrote:

>

>

> On Tuesday, December 14, 2010 07:53, " Henry Barber "

hbarber@...>

> said:

>

> > I have found that to most employees it is more about who will have to

> write the

> > report.

>

> Heh... I completely agree.

>

> > Burnout is a whole other subject that has two sides to the issue, those

> > that believe it exist and those that do not.

>

> It definitely exists, just like PTSD exists. But the biggest problem I see

> is self-induced burnout. It's like a self-fulfilling prophecy. The rookies

> are in such a hurry to 'fit in' with the senior personnel, that they

> immediately begin to emulate their attitudes. Consequently, they end up

> sounding and acting like burnouts long before they've had the experience to

> have actually achieved that status. Then it becomes a vicious cycle that

> feeds upon itself, bringing down the morale of all around them to the lowest

> common denominator until you end up with Medstar.

>

> Rob

>

>

>

[Guest guest]

I don't believe that a preemptive cheap shot at MedStar (or any other

provider) serves any useful purpose on this List. That said, another

contributing factor is employers who don't set limits on the amount of hours

employees are permitted to work per week. Rolling the dice on worker fatigue

vs. filling shift vacancies can be perilous - even deadly. At that point,

" burned out " can become " snuffed out. "

On Tue, Dec 14, 2010 at 1:49 PM, rob.davis@... <

rob.davis@...> wrote:

>

>

> On Tuesday, December 14, 2010 07:53, " Henry Barber "

hbarber@...>

> said:

>

> > I have found that to most employees it is more about who will have to

> write the

> > report.

>

> Heh... I completely agree.

>

> > Burnout is a whole other subject that has two sides to the issue, those

> > that believe it exist and those that do not.

>

> It definitely exists, just like PTSD exists. But the biggest problem I see

> is self-induced burnout. It's like a self-fulfilling prophecy. The rookies

> are in such a hurry to 'fit in' with the senior personnel, that they

> immediately begin to emulate their attitudes. Consequently, they end up

> sounding and acting like burnouts long before they've had the experience to

> have actually achieved that status. Then it becomes a vicious cycle that

> feeds upon itself, bringing down the morale of all around them to the lowest

> common denominator until you end up with Medstar.

>

> Rob

>

>

>

[Guest guest]

On Tuesday, December 14, 2010 14:06, " Bob Kellow " kellow.bob@...> said:

> I don't believe that a preemptive cheap shot at MedStar (or any other

> provider) serves any useful purpose on this List.

I admit that my English is not native. And maybe your dictionary says

differently, but I've never thought of an objective observation based upon

personal experience to be " preemptive " . And it certainly wasn't cheap, unless

you are referring to my wages.

Rob

[Guest guest]

You must experience MedStar to understand. That was not a strike, but the

truth.Even their last evaluation by the city proved it.

Bill

>

> On Tuesday, December 14, 2010 14:06, " Bob Kellow " said:

>

> > I don't believe that a preemptive cheap shot at MedStar (or any other

> > provider) serves any useful purpose on this List.

>

> I admit that my English is not native. And maybe your dictionary says

differently, but I've never thought of an objective observation based upon

personal experience to be " preemptive " . And it certainly wasn't cheap, unless

you are referring to my wages.

>

> Rob

>

[Guest guest]

You must experience MedStar to understand. That was not a strike, but the

truth.Even their last evaluation by the city proved it.

Bill

>

> On Tuesday, December 14, 2010 14:06, " Bob Kellow " said:

>

> > I don't believe that a preemptive cheap shot at MedStar (or any other

> > provider) serves any useful purpose on this List.

>

> I admit that my English is not native. And maybe your dictionary says

differently, but I've never thought of an objective observation based upon

personal experience to be " preemptive " . And it certainly wasn't cheap, unless

you are referring to my wages.

>

> Rob

>

[Guest guest]

AMEN!

  Don Abernathy,CCEMT-P

AHA Regional Faculty

________________________________

To: texasems-l

Sent: Mon, December 13, 2010 10:14:14 AM

Subject: Re: Ambulance restaffing talks causing stir

Wes,

It's not reductio ad absurdum, but rather an extension of the same

" rationale " that has been employed by EMS for decades. The only thing that

matters is clinical outcomes - not preferences, not unions, not politics and

certainly not system cost increases that cannot be justified by measurable

and beneficial clinical outcomes. Using improved clinical outcomes as

the standard will necessarily distill the provision of EMS to its core

components, which in turn will produce economies that are essential to the

industry's survival - which is in my opinion is seriously in doubt.

>

>

> Bob,

>

> Respectfully, Rick and I were just mentioning services that do use dual

> paramedic staffing. About the only universal truth that I've discovered in

> my career as an EMS clinician and educator is that no one solution fits EMS

> as a whole.

>

> I've always respected your opinions even when we disagree. Reductio ad

> absurdum is not something I'd have expected from you. And for the record, in

> several EMS systems in continental Europe, you do get trained physicians for

> ALS response.

>

> Best,

> Wes Ogilvie, MPA, JD, NREMT-P/Lic.P.

> Austin, Texas

>

> Sent from my iPad

>

> On Dec 13, 2010, at 9:41, Bob Kellow

>kellow.bob@...>

> wrote:

>

> > Since empirical evidence apparently doesn't mean anything (i.e., OPALS),

> and

> > governmental payers are paying less and less, thus shifting more of the

> > unjustified direct cost burden to the local tax base - why not staff

> > ambulances with residency trained, board certified emergency physicians?

> Oh

> > wait, make that two per unit. If some is good and more is better, why

> stop

> > with dual paramedic staffing?

> >

> > On Mon, Dec 13, 2010 at 9:14 AM,

>rick.moore@...>

> wrote:

> >

> >>

> >>

> >> City of Fredericksburg runs dual paramedics, City of San Angelo runs

> dual

> >> paramedics, I believe City of Kerrville also.

> >> Rick

> >>

> >> From: texasems-l

40yahoogroups.com> [mailto:

> >> texasems-l

40yahoogroups.com>] On Behalf Of

> >> Wes Ogilvie

> >> Sent: Monday, December 13, 2010 9:12 AM

> >> To: texasems-l

40yahoogroups.com>

> >> Subject: Re: Ambulance restaffing talks causing stir

> >>

> >> If I remember correctly, Lubbock runs dual paramedic trucks. on

> >> County too. I believe that several of the fire-based systems also run

> dual

> >> paramedic.

> >>

> >> And several services that I've been around require the primary medic to

> be

> >> a paramedic and are flexible about the certification level of the second

> >> provider.

> >>

> >> Wes Ogilvie

> >>

> >> Sent from my iPad

> >>

> >> On Dec 13, 2010, at 9:06, Bob Kellow

>kellow.bob@...

>

> >>

2540gmail.com>>> wrote:

> >>

> >>> As a matter of static staffing policy (and not demand or necessity), I

> >> would

> >>> speculate that there are very few - if any at all.

> >>>

> >>> Bob

> >>>

> >>> On Mon, Dec 13, 2010 at 9:02 AM, McGee

>summedic@...

>

> >>

2540yahoo.com>>> wrote:

> >>>

> >>>>

> >>>>

> >>>> Just out of curiosity, how many major services run double paramedics

> in

> >>>> Texas? I have always worked rural and smaller services and have always

> >> ran

> >>>> paramedic with a basic or intermediate partner.

> >>>>

> >>>>

> >>>> McGee, EMT-P, EMT-T

> >>>>

> >>>>

> >>>>

> >>>>

> >>>>

> >>>> From: Ron Haussecker

>haussecker87@...

>

> >>

2540cebridge.net>

> >>>

> >>>>>

> >>>> Subject: Ambulance restaffing talks causing stir

> >>>> To: " A A " emsn-news@...

40att.net>

>> emsn-news%40att.net > >,

> >>>> texasems-l

40yahoogroups.com>

>> texasems-l%40yahoogroups.com >

> >>

> >>>> Date: Monday, December 13, 2010, 12:57 AM

> >>>>

> >>>>

> >>>>

> >>>>

> >>>>

> >>

>http://www.statesman.com/news/local/ambulance-restaffing-talks-causing-stir-111\

6081.html

>l

> >>>>

> >>>>