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Washington DCFD & EMS considering use of PAs

By Dave Statter
dstatter@wusa9.com

STATter 911 — http://www.statter911.com
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WASHINGTON, D.C. — STATter 911 has learned details of a new plan that is expected to make more ambulances available in the District of Columbia. D.C. Fire and EMS is getting ready to hire 6 physician assistants who will, during peak hours, work out of the busiest emergency departments in the city.

D.C. Fire & EMS Chief Dennis Rubin says the goal is to reduce the drop-time for city ambulances and paramedic units. Statistics for the last 6 months show that crews are spending an average of more than 40 minutes before emergency departments take over patient care and the unit is ready for the next run. Often the delay can be hours and officials cite one case where the wait was 7-hours long.

Dr. Michael Williams, D.C. Fire & EMS medical director, says a physician assistant assigned to the emergency department, could treat as many as 4 patients at a time. The plan calls for the physician assistant, wearing a D.C. Fire & EMS uniform, to take charge of the patient from the medics and EMTs until the emergency department staff is able to accept the patient. Williams, who also has the rank of assistant chief, believes the drop-time average could be brought down to around 25 minutes.

Dr. Williams came up with the plan while working with then Interim Chief Brian Lee. Chief Rubin says he now has approval to move forward and to soon begin hiring for an October 1st start-up date. Rubin says some hospitals are already on-board and he is hoping to eventually have the 5 busiest hospitals in D.C. participate in the program.

Chief Rubin says the next step in revamping EMS is to cut down on what he calls “the misuse of the system”. Rubin believes a physician assistant could be part of a medical clinic set-up at a firehouse. A fire station in Southeast Washington has already been identified for a pilot program.

Chief Rubin is also talking about the idea of providing taxi vouchers to those who aren’t ill enough to need transportation by an ambulance crew.

A decision that hasn’t been made is whether EMS will remain in Chief Rubin’s department. Rubin is chairing a task force to look at, among other things, the idea that EMS should be an agency separate from the fire department. The task force was formed by Mayor Adrian Fenty as part of reform efforts following the death of former New York Times reporter David Rosenbaum.


Since 1972 Dave Statter has covered the news. A good deal of Dave’s reporting has focused on how fire and emergency medical services are delivered in and around Washington and Baltimore. Along the way, Dave was also a volunteer firefighter, an emergency dispatcher and a cardiac rescue technician.