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Home > Topics > EMS Management

Vegas EMTs fired up over patient transport takeover

They walked out on the meeting after a city councilman compared the firefighters to quasi doctors and AMR employees to nurses

Las Vegas Review-Journal

LAS VEGAS, Nevada — With more than 100 private ambulance employees glaring at his back Wednesday, Las Vegas Fire Chief Willie McDonald told City Council members that he has changed the balance of lucrative hospital transports so his department will handle 50 percent of the calls.

McDonald’s goal is to eliminate the dual response system where medical calls are answered by both the Fire Department and private ambulances, with only one getting to bill for transporting a patient to the hospital. He told the council it’s a waste of resources to have both respond unless there’s a critical need. By eliminating the dual response method, he said “You don’t send ’em when you don’t need ’em.”

His report sparked some opposition from Councilmen Ricki Barlow and Bob Beers while other council members kept their opinions to themselves.When McDonald left the chambers, he was surrounded by some angry American Medical Response workers fearful of losing their jobs under his new plan. After media interviews, he took questions from the paramedics and emergency medical technicians, who challenged his contention that firefighters were better trained and faster on the scene.

Read full storyAMR workers flame Las Vegas fire chief over patient transport takeover

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Stephen Melton Stephen Melton Thursday, March 06, 2014 1:25:46 PM Be careful what you ask for Chief...
Bruce Wayne Washburn Bruce Wayne Washburn Thursday, March 06, 2014 1:42:21 PM There is absolutely no need for fire departments to be in the EMS business when there are Private EMS providers willing and able to do the job. Fire EMS is an unnecessary tax burden on the people as well as unnecessary government interference in what should be private business.
John Ryder John Ryder Thursday, March 06, 2014 3:07:10 PM I absolutely agree that EMS should stay in the private sector, and not in local or state agency departments. But this is about where the dollars go. If the local government/fire department can decide WHO gets the call and WHO transports the patient (along with WHO's gonna get paid for the service) - then they are absolutely going to get into the EMS business. With down-sizing of fire departments across the nation - getting into EMS provides income for the local governments and justifies keeping personnel on, as they now produce income rather than draining the local governments financial resources. Those that believe that this is an unnecessary tax burden on the local community should check the return on investment for EMS providers. Again, I don't support local government going into direct competition with local businesses - but in todays economy, I'm not surprised to see this happening.
Steve Thompson Steve Thompson Thursday, March 06, 2014 3:39:31 PM I have work in EMS for 24 years and have done private,county,hospital, village. And private ambulance service has no business doing 911 calls that is for local government agency not privates.
Aaron Michael White Aaron Michael White Thursday, March 06, 2014 4:27:53 PM So and yet again... We eat our own and accomplish absolutely nothing in the process. Disgraceful.
Kellan Trammel Kellan Trammel Thursday, March 06, 2014 4:46:18 PM I bet a bunch of the fire medics at Las Vegas Fire do not want to least that was an observation I had in my area when a local fire department started transporting....hell guys were dropping their paramedic cert to be EMTs so they didnt have to be on an ambulance...
Jerry Butler Jerry Butler Thursday, March 06, 2014 5:27:52 PM Oh really? Would you prefer that patients get short-changed in their initial field care? What if in the eventuality said EMS provider cannot be available to do their job because they are committed on a ER-ER transfer? It happens more than you realize and the big advantage to having a FD EMS is shorter response times and transits to the local ER. The bottom line is we as patients have the right to expect care as quickly as possible and We shouldn't have to settle for less!
Susan Ozturkler Susan Ozturkler Thursday, March 06, 2014 5:30:03 PM Good old Willy sure gets around. Last I heard he was in Mesa, Arizona, then on to Scottsdale Fire, then off to California. I guess he has turned up in Las Vegas now making more friends along the way.
Sharon McGehee Sharon McGehee Thursday, March 06, 2014 5:34:36 PM He has no idea what he is doing to his department and to the amr employee's. I hope he wakes up before it is too late.
Bruce Wayne Washburn Bruce Wayne Washburn Thursday, March 06, 2014 6:10:08 PM I can say the samething about the FD. When there is a major fire they are not able to respond. If the tax support FD did not take calls away from the private EMS they would have more crews.
Craig Minnick Craig Minnick Thursday, March 06, 2014 6:32:10 PM Las Vegas is now taking Hospital to Hospital transfers, it says so in the article. Do they practice posting/ system status mgmt like the private ambulance? So it would be fair to say that under the new system people will ge "short changed" when LVFD is on a ER to ER call. Goverment should not be allowed to compete with the private sector unless they can Prove they can do it faster, better, and cheaper. Not just because they want money that the private sector is now getting.
Kena Ricks Kena Ricks Thursday, March 06, 2014 6:34:18 PM Jerry Butler If they are committed on a transfer then by all mean another unit will be sent on the call. The patient always comes first and just because it is not a Fire-EMS unit does not mean that the patient has to "settle for less". We run EMS and Fire separately in our rural community but 15 minutes south of us in a slightly bigger city they run Fire/EMS together. I will tell you that if I have a patient that needs more than I can give I WILL ABSOLUTELY CALL FOR BACK UP!!!! We care about our patients, but you and I both know in the end it is a money game. 1/2 of calls I go on are non transport calls where there is no bill, but if a patient needs us we are there.
Terence Valengavich Terence Valengavich Thursday, March 06, 2014 7:59:42 PM I've worked both private ems and fire and haha dish think ems should be public sector. In the end a private company has a responsibly to make money and if the patients aren't getting short changed the personnel definitely are. When starting pay for a medic where I am in the private sector is 38k/year and we often run stand up 24s you can't tell me that getting paid crap and running your butt off doesn't negatively affect your quality of life and ultimately the quality of patient care. Profitability should not be in the equation when it's people lives in the line.
John Ryder John Ryder Thursday, March 06, 2014 8:00:15 PM Steve - it's interesting that you mentioned "village" in your reply. Seems you might live in a more rural area. (Looked up Buncombe, Illinois: Buncombe is a village in Johnson County, Illinois, United States. The population was 186 at the 2000 census.) I also live in a more rural area. In my area - the better Advanced Care is provided by the private EMS provider, rather than the local fire department. But they do work in unison - with the local fire department often being the First-Responder in more remote areas and the private EMS provider with ALS and Transport capabilities. This isn't saying that the fire department doesn't have well trained and qualified EMS staff - but the overall volume of medical calls the local fire dept. receives is far less than those handled by the private EMS provider - thus the private providers' staff are afforded more experience and opportunity to refine their EMS knowledge and skills than their fire dept. counterparts. Each area in the country will have different circumstances - some where fire dept. EMS is preferred, and some where private EMS providers are preferred. But the issue IS NOT about providing Emergency Care (every fire department I'm aware of provides some level of Emergency Care). It's about local governments expanding the fire departments' role to include transporting patients (even in non-emergency situations), thus directly taking money away from, and doing harm to, local businesses. This is just wrong - no matter how you slice it...
Don Leuchtag Don Leuchtag Thursday, March 06, 2014 8:05:59 PM This is going to be a losing propasition for the community in the long run. What the good chief has failes to take into account is that the reimbursement rates are going to go down because of Obama care. Like any urban area, a large number of their patients will be on goverment assiatance so they are going to get zip notta nothing. Insurance companies are also going to stop paying for transports that are deemd not medically necessary. We need to realize that EMS is part of the health care system and treat it accordingly. Wheather this means turning it over to the hospitals or some type of non profit agency whose sole purpose is to provide quality EMS and healthcare. Until that happens EMS will never realize its true potential and will never gain true respect from the rest of the health care community.
Steve Thompson Steve Thompson Thursday, March 06, 2014 8:10:40 PM Yep I said village south suburb of Chicago next to Harvey,Blue Island. Town call Dixmoor. How is it hurting businesses it helps the community. How private ambulance service will do transfers and leave one or no ambulance in the 911 call area. have seen it done in large and small counties. When I worked for the village it was with the fire department and took ride in fire and EMS that where I got my start 24 years ago.
Mark Singer Mark Singer Thursday, March 06, 2014 8:38:57 PM City of Scottsdale Fire Department On July 1, 2005, Scottsdale's fire protection service went through one of the most dramatic transformations in recent U.S. fire service history. After nearly 54 years of contracted fire protection service with the Rural/Metro Corporation, the City of Scottsdale established its first municipal Fire Department with operations beginning July 1, 2005. The City of Scottsdale appointed Chief William L. (Willie) McDonald as its first municipal Fire Chief. Under Chief McDonald's leadership between June 2004 and June 2005, the transition of the emergency fire and medical services for the Community was successfully executed, creating the Scottsdale Fire Department.
Tony Smith Tony Smith Thursday, March 06, 2014 9:06:12 PM ha ha ha
Scott Hochstetler Scott Hochstetler Thursday, March 06, 2014 10:27:42 PM I honestly don't know what to say anymore when I hear high ranking fire officers say that they are better at medicine than I am solely because they are firefighters. I'm still waiting for an explanation as to how riding in the big red road flare and being essentially un-firable makes someone a better and more knowledge provider than me.
Gerald E. Thompson Gerald E. Thompson Thursday, March 06, 2014 10:30:00 PM Nothing nice to say about this.....I'll stay quiet!
Nick Ramsay Nick Ramsay Thursday, March 06, 2014 10:43:03 PM Do you have a cool helmet and sweet ass boots? I rest my case. In all seriousness, there's both sides of the spectrum right? No one agency has 100% better medics than any other agency, there's always that one guy...
Alex Lee Alex Lee Thursday, March 06, 2014 11:21:51 PM I think we each get good at what we do most. Fire is good at the initial contact, transport medics are better at the extended care side and all that it entails. I can do a good assessment - but get me in the back and start trying to figure out what treatment to get em to the ER? Oh hell no. It's like "you got this Scotty right?" LOL Any idiot who just presumes he's a better medic than you because he's on a big rig is on clown patrol. Don't listen to that shit
Scott Hochstetler Scott Hochstetler Thursday, March 06, 2014 11:50:27 PM Alex Lee... You and I have spent plenty of time in the back of my rig. You run a solid crew. There are exceptions to everything, and you and your crew are top notch. I'm speaking about what your former chief has spewed.
Kristie Jones Holstrom Kristie Jones Holstrom Friday, March 07, 2014 12:11:59 AM It's all about politics and money. It just needs to be worded in a way the public will feel justified about people loosing their jobs. You should be familiar with this ;)
Angie Absten Angie Absten Friday, March 07, 2014 4:40:21 AM To tie up these brave persons for chronically ill persons while others are perishing from nature's chaos is a significant waste of talent.
Trevor Shelor Trevor Shelor Friday, March 07, 2014 5:22:24 AM I would love to see anyone be able to provide statistical data that proves that a firefighter certification somehow magically makes one a better medical care provider. Hint, it doesn't.
Adam Yarlott Adam Yarlott Friday, March 07, 2014 5:28:48 AM I can agree. However, working for a profit based company does not promote much different. Especially the ones that do not reinvest in their employees. Good medics will be good medics when they want to be.
Patrick Murray Patrick Murray Friday, March 07, 2014 8:26:26 AM Just from my experience. They need to bring in an outside agency to evaluate this issue and it has to be someone that has noting to gain on how they report back on the findings. I see way to many people involved who have a personal and or financial gain for it to go one way or another. Need to have an outside team look at it from outside as well as inside the box. If this does not happen I see that only the patients being treated as the ones who are damaged. This is not a game people, try working it out together in the interest of the people you give care.
Patrick Murray Patrick Murray Friday, March 07, 2014 9:14:08 AM Then must all governments stay out of water supply systems, electricity systems, waste water treatment, landfill's and trash services???? Tax money helps pay for Level 1 trauma centers so does that need to stop???? How many basic tax payers have gone through an entire city budget just to see what their tax money is being spent on??? Answer: Not many have or will. I don't know the answer but I pray you all find some answers and solve it because I would like to come to your city some day and hope I will have service if I need it.
Bryan Goodridge Bryan Goodridge Friday, March 07, 2014 11:26:32 AM I think that the bugles that chiefs wear on their collars are magnetically charged to kill brain cells. The more bugles, the less working brain cells.
Joe Feinhals Joe Feinhals Friday, March 07, 2014 1:54:30 PM Some people need history lessons on fire and ems. Medical care was a service provided by the fire service before the ems service ever existed. Many large cities still provide emergency medical services through the fire department. That being said, does not mean that a fire service paramedic or emt is any better. The key is knowing your trade and being well trained. We all need to eat humble pie every now and then. Remember all that you make contact with are your customer whether you are employed by a government or private entity they pay your salary. Be nice and treat your customers with respect and dignity along with your professional counterparts. The well being of the community needs to be first. Not personal agendas.
David Padilla Jr David Padilla Jr Saturday, March 08, 2014 7:24:33 AM Don't speak out f turn that has very little to do with the problem, mullet
Kellan Trammel Kellan Trammel Saturday, March 08, 2014 9:12:47 AM It is a side effect....the undertones of the article is about money under the premise of "multi agency response"....Chief wants more money that's it...forcing guys to transport that dont want to could cause customer service problems, and then we have a DC fore situation in Vegas...AMR sounds like they WANT to transport and if they're not doing a terrible job then let them stay..
Kellan Trammel Kellan Trammel Saturday, March 08, 2014 9:21:56 AM just government attempting to control EMS...because Obama Care is sooooo awesome right? and they do such a great job at everything else they control
Edward Jason Zubia Edward Jason Zubia Thursday, August 21, 2014 5:41:30 PM It's not like AMR generates a substantial revenue on 911 calls. Its $ is most generated on interfacility transports.
Jacob Chernov Jacob Chernov Monday, September 08, 2014 12:13:01 AM Why is it bigger cities have fire based EMS and in the west we have a mentality that it's better to run private? Don't get me wrong I've worked Municipal, and Private either one isn't a bad gig, but honestly I'd rather drive by each fire station and see more ambulances and less fire trucks. This would take away some of the "tax burden" people speak of. It costs more money to run a "fire truck" to a sick person than it does an ambulance so why does a fire truck need to run on sick people? They aren't on fire. Fire Fighters didn't sign up to do EMS calls they signed up to do Fire calls, EMS people signed up to do EMS calls not Fire Calls, why not have municipal EMS units staffed with people who love medicine, and let them work on those units without having to pass fire fighter standards? What is the harm in this? Municipal benefits for EMS providers. Firefighters stay on their respective fire trucks. It works in the FDNY, Chicago FD, and many other departments around this country but for some reason in the western half of the country there is a mentality of "we do it better this way." Rural Metro is going to crap, other private companies will eventually fall, and EMS will become a municipal gig. Why not do it the correct way and save the tax payers money. With the numbers of calls fire departments run on figure out the math, how many are fire and how many are EMS? Overall it would be a savings for the citizens of the cities if the departments where set up correctly.

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