S.F. EMS crisis is ripe for bottom-up change

Leadership doesn't have to come from the top, and San Francisco’s EMS shortage is a chance for rank-and-file leadership to advocate for major changes


In yet another article showing EMS at a crossroads, the San Francisco Fire Department’s labor union is calling for the resignation of the fire chief in wake of yet another ambulance crisis. Not enough units, not enough staffing, turnover rate, disparate delays to lower socioeconomic neighborhoods; sadly, it's been going on for decades.

I've mentioned before that adding more ambulances and staffing will not make a difference. The city has tried far more innovative approaches to reducing call volume while providing the right care at the right time, to the right patients. But it appears that, unless the solutions come in the form of shiny red trucks and turnout gear, it won't be acceptable to labor.

What an opportunity this is for the rank-and-file leadership to advocate for major changes in the way it provides emergency and non-urgent medical services to a city known for its progressive political stance. It could take the lead and show the nation how EMS could be done.

The location is perfect: a compact jurisdiction with well-positioned community halls (i.e. fire stations); plenty of medical, environmental and socioeconomic experts; the center of a technology hub with the ability to create cool gadgets and software to improve care delivery and patient tracking; and most importantly, a bunch of smart folks working within the department who could bring about that level of innovation.

I suppose it's a lot simpler to just ask for more money, though. Each man, woman and child spends about $400 per year to directly fund the fire department. Residents in Los Angeles city spent about $122. 

The solution is short sighted, and a really great example of throwing good money after bad. Rearranging the deck chairs while the ship is sinking is not likely to save it. Leadership at all levels can do better in advocating for real, long-lasting change to improve the department's approach to public safety and health.

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