Tuesday, June 21, 2016

The Three-man Medic Company

Three-man Medic Company
By Alan Perry, June 21, 2016

Congratulations on your promotion! Your new assignment is lieutenant on a Medic Company!? It should come as no surprise that the busiest piece of equipment, with the most at stake in the daily performance of it's duties, has finally been elevated to the company level. You and the other personnel assigned to your Medic Company are taking a huge step forward for Emergency Services. Thanks to this new concept your organization will be able to more efficiently and responsibly provide necessary emergency medical services to the public you serve.


“How did this happen?” you ask. Your City Council and the City Manager have been systematically looking at all city department functions looking for ways improve efficiency, reduce costs and improve retention of ALS personnel. The traditional Fire Department staffing model and even its name could be re-aligned to reflect what it actually does. After conducting an “operational effectiveness and efficiency” study and looking at evolving practices in staffing and deployment, the city manager and the interim Fire Chief determined that a major re-alignment of physical and human resources needed to occur. This included adding Company Officers on medics, Field Medical Officer Captains for each battalion and shift, a EMS Duty Chief for each shift, and a Division Chief of EMS.

With nearly 80% of the calls for service being related to medical emergencies, and only 5% actually involving any type of fire, the name has been changed to “Emergency Services”. Every station will have at least one three-man Medic Company in addition to a four-man Engine Company, and every Medic Company will have at least one ALS provider. These Medic Companies can handle 80% of EMS calls without the need for additional resources.

Second run engines have all been replaced by Rapid Response Companies, a three-man company in a medium duty truck equipped for firefighting and rescue operations without a pump or water. These trucks co-respond with Medic Companies on high acuity EMS calls for manpower, and function like flying squads for fire and rescue calls. They are much more cost effective to operate compared to the engines and ladders that were used before, each district has two. Engine Companies are staffed with four, safe levels of staffing are still maintained since Medics Companies co-respond to fires as well.

You noticed the changes in the promotional process you just participated in. The increased emphasis on EMS practices and operations in the process was not random. The City Manager and Fire Chief both realized that promotions within the organization need to reflect the current role of the Department as well as the need for a change in the culture of the organization.

The money your City is saving is being re-invested in a new training facility for public safety (EMS/Police/Fire), and an aggressive public education program focusing on health and safety issues through the Community Risk Reduction Division (formerly Fire Prevention). The Chief has indicated recently that the Department will be moving to correct pay compression issues due to consistent budget surpluses and possibly even provide a second set of turnout gear. As an added bonus, those who choose the EMS assignments receive a 10% salary differential.

In the Fire service these changes might seem radical, in business and politics they can't come fast enough. Many Fire Departments across the country are developing new and innovative ways to provide the public with the best return for their emergency services dollar independent of any industry guidance. At the national level there seems to be some lag in even acknowledging the need for realignment. The NFPA and IAFF are quick to protect the future of the fire Service and the employment of Firefighters but have not seriously addressed the need for any realignment of personnel or resources other than to protect the control and influence of the Fire Service on public safety. The diversity of Fire Service organizations and localities has a great deal to do with the difficulty in developing a recommendation that will work for us all. I think that if we seriously consider what the public both expects and needs in emergency services we can do what we do best, fix the problem so we can get the opportunity to be the heroes we want to be.


Sweet dreams,

https://www.ncbi.nlm.nih.gov/pubmed/10163385