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Permalink Reply by Ben Waller on August 18, 2008 at 11:05pm

WestPhilly,

That one was packed full of logical fallacies...
Throwing the "Obama supporter" non-sequitur out there, for starters.

That aside, sometimes the people who provide local entry-level service have a pretty good idea of what works and what doesn't...and sometimes they're too close to the problem to either ask the right questions or to see all of the possible solutions. Most of us have pet solutions for up-close-and-personal problems. Sometimes the pet solutions work miracle cures. Sometimes they don't.

I don't know you, so I don't know which of the above applies, or maybe some other option is applicable. You have a very definite opinion as to what the problems and the solutions are. Is your solution working? It doesn't sound as if it is.

My point about smoke detectors is that they're a life-saver that doesn't rely on engine or medic unit responses...or manpower. You're right about them not being an "either/or" proposition when compared to reducing medical responses, but which one is the least expensive and most cost-effective - and quickest - way to get people out of a burning buiilding? Unless you work in a mythical city with unlimited resources, the powers that be are going to look for the most bang for the least buck. Smoke detectors and the pub ed campaign that go with them are pretty cheap compared to a new engine company 0r a couple of medic units.

One of the most important things I picked up in my classes at the National Fire Academy is that sometimes outsiders have a more clear picture of local problems than do the locals. I've learned some pretty startling things just from listening to an outsider's viewpoint about my department. It didn't take any extra testosterone for them to look up some public information about my department, just a few minutes on the internet.

A while back you made a statement that equated the Phoenix FD customer service model to social work. What Philly FD does is social work, too like it or not. Guess where I got my copy of Report from Engine Co. 82? I picked it off of the "Social Sciences" shelf at my local bookstore. Ditto for about three bookshelves of other fire and EMS books I own. It was social work for FDNY back when Dennis Smith wrote the book, too.

I try my best to fight fires with my brains, not my balls. Testosterone poisoning combined with firefighting is a pretty deadly disease. A lot of the NFPA LODD stats attributed to heart attacks, exposure to combustion products, structural collapses, and apparatus accidents would probably be more accurately traced to testosterone poisoning if we had autopsy techniques that could make the determination accurately.

Albert Einstein once famously said "The significant problems we have cannot be solved at the same level of thinking with which we created them." There's a lesson for the fire service in that thought.

As for lifesaving being pretty nice, yes, it is. Doing it while being nice to people is even better.

Fire service...emergency medical service...social service...customer service...I may be reaching here, but I'm starting to think that they all have something in common.

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Permalink Reply by Reg Mathis on August 19, 2008 at 8:58am

Once again, I have to ask, "Have you ever seen a cat skeleton in a tree? They WILL come down on their own!"

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Permalink Reply by Reg Mathis on August 19, 2008 at 9:33am

Probably nothing you can do about it. Just pass along the same advice you do every other time you roll on a lift assist, etc. Then just grin and bear it...

And come back here and bitch about it

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Permalink Reply by Sara Hall on August 19, 2008 at 4:15pm

good point on the seatbelt issue, my dad is a deputy coordinator with our county in ny and is pushing for everyone to sign the seatbelt pledge. If their ain't enough seatbelts, their aint enough room

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Permalink Reply by Ben Waller on August 19, 2008 at 6:16pm

Then again, there's the old "can't see the forest for the trees" thing that affects a lot of firefighters - and other professionals, too. In my case, it was someone else's perspective, not a lack of knowledge of my department that opened my eyes. I had plenty of knowledge about my department. I just hadn't considered one of the most important concepts..."I never thought about it that way before". Until an outsider pointed it out to me, that is. My department has made some pretty dramatic improvements by using ousider's perspectives, particularly in the areas of benchmarking and best practices. Accurately comparing your department to other departments is the primary objective of benchmarking and adopting best practices...and it's something you can't do very well without involving outsiders, no matter how well you know your own department.

A lot of what FDNY Engine 82 ran was BLS medical calls with looooooooooong waits for an ambulance. A lot of it was urban renewal by arson. Do you really want your city to burn down around your ears in order to provide that kind of social service. I don't - I like the work, but I don't like it THAT much.

There are essentially three different options to get the solution you want - two versions of more ambulances and load shedding.

More ambulances Method 1 - throw a few extra million dollars at the problem...yeah, right. The only way that has a snowball's chance of working is to have Phoenix-style "over the top" customer service and social services point-of-entry through the fire department, with so much popular support that the elected officials get support to throw the bucks to the FD or get unelected if they don't. Not an option in Philly...OK, if you say so.

More ambulances method #2 - Close some fire companies and use the manpower to staff additional ambulances on a 2:1 or more basis. You can use this method to run additional BLS ambulances or split with existing all-paramedic ambulances and run a 1 EMT 1 PM configuration. Baltimore City closed a few fire companies and added the ambulances. Did it fix every problem they had, nope. Did it get reduce the workload-resource mismatch between the engines and medics - it did, at least partially. They still put on "Code Red" units by using temporary engine brownouts to staff reserve ambulances when they start running out of the front-line ones. Has Philly tried this option? It may be the only way get more ambulances in service at no additional net cost to the city. No one wants to lose fire companies...but...if those fire companies aren't available due to sitting with BLS cases waiting on an ambulance all the time, then splitting their manpower 50/50 to get two additional BLS ambulances per disbanded engine gets the patients transported more quickly, and the remaining fire companies are in service a higher proportion of the time. A complete cure - no, but a positive impact - you don't know until you try it.

Load shedding - already discussed, and it sounds as if it might be the best answer to Philly's problems...IF the funding for the franchising is there for it. If not, then load-shedding might end up being a backdoor way to cut some fire companies to fund the load-shed transport service. If that's the option, closing some fire companies to staff new ambos without losing firefighter positions is a more appealing idea than privatizing some of the EMS call volume, laying off firefighters, and eventually losing the fire companies anyway. That's what happens to lots of urban fire departments.

Most of us would rather run only life-threatening emergencies. Unfortunately, in this age of demand for public-sector productivity, reduced budgets, and anyone who can dial 911 gets a response, the workload for most of is is going to increase, and most of them won't be life threats or working building fires.

Good luck in getting the workload problem fixed.

And the Obama thing was a non-sequitur. Who is Obama? :-)

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Permalink Reply by Brian Dumser on August 19, 2008 at 6:23pm

Bottom line, people- Our job is to respond to "emergencies". An emergency is whatever the caller perceives it to be. The public doesn't have the training and Fire/EMS education that we do. That's why we're the ones responding! Will some of those "emergencies" turn out to be bullsh*t? YES! The people who call us (like it or not) are our "customers". So yes we are in the customer service business. Essentially, what we do can be equated with social work...we're solving problems! Will we get called for problems that are not the realm of the F.D? YES! In that case, our job is to refer them to the proper agancy to help them, etc., etc...

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