Some Things Don’t Change


FOX 5 Investigates: DC Paramedic Shortage

WASHINGTON –  Paramedics, the most elite medical responders in the city’s fire department, are leaving the District’s Fire and EMS agency at such high rate due to overwork and stress that the department is now facing a critical shortage, multiple department sources told FOX 5 News.

Call volume in the city has been rising over the past three years as a result of increased population, but the department’s emergency medical system, especially its staffing of paramedic units, has fallen short, FOX 5 has learned.

Stop me if you’ve heard this one before. There is no shortage of paramedics. What there is, is a shortage of paramedics willing to put up with the low pay, lousy benefits, and crappy working conditions most EMS systems impose on their employees. This is more prevalent in the private sector than in the public sector, but it happens in both.

Several years ago, the city shelled out $7,000 in bonuses to recruit paramedics, but many of them have already left for other jurisdictions like Montgomery County, Md. and Annapolis, according to the firefighters union. Moreover, there hasn’t been a paramedic class or hiring effort since to replace those that have left, the union says.

I don’t know what the pay scale is for DC paramedics, but even if the pay is more I’d have to bet that Montgomery County and Annapolis offer better working conditions and likely a lighter work load. Hence, people will hire on in DC, get a boat load of experience and be eagerly hired by the other departments. I’ve seen that in many placed including my own system. It’s not just EMS, it’s human nature. That Los Angeles Police Department is renowned for it’s excellent training and certainly officers will get a boat load of experience. After about five years, a lot of officers seek transfers to more upscale communities that pay better and offer better work conditions.

Even more serious, FOX 5 has learned the department has been forced to hold over some paramedics who have already worked a 24-hour shift for as many as 12 more hours, just to keep some units on the street, leading to fatigue and low morale.

“Somebody’s going to die or get hurt from this and I don’t want a part of it anymore,” one veteran D.C. firefighter/paramedic told FOX 5.

I don’t think that this forced overtime consists of lying around the day room watching TV. Not if you’re on an ambulance in a city that chronically can’t put more than about 3/5 of the required number of ambulances on the street.
I thought this was funny, but only in a sad, almost pathetic way.

Still, in a follow-up interview at the chief’s request the day our story was to air, Chief Ellerbe declined to answer questions on the safety of the system, referring questions about whether a 36-hour shift for a paramedic puts patients at risk to his medical director, David Miramontes.

“I can tell you we provide really good patient care,” Miramontes told FOX 5.

As Rogue Medic would say, anecdote is not data. In fact, given the number of law suits filed against DCFD for poor or no patient care, I’d say that what data there is contradicts the good Dr. Miramontes.
So, what’s the answer?   I don’t know, but I don’t think this is it,

To reduce the fatigue on paramedics and EMTs, the city has come up with a new deployment plan for its ambulances called “power shifts” where more units will be on duty during the daytime, when the call volume is highest, and be reduced at night when there are far fewer calls.

“That will allow us to put from 25 to 45 units on the street, particularly during our heaviest call volume hours,” Ellerbe said.

Still, union chief Ed Smith has his concerns, saying the plan actually leaves the District without a dedicated paramedic-staffed ambulance from 1 a.m. to 7 a.m. The power shift was to go into effect this month, but FOX 5 has learned it has been delayed, at least until next year.

Sounds like more cutting material off of one of the the blanket, sewing it on the other end, and declaring the blanket longer. Maybe they’ll try System Status Management next!

Maybe they should try more pay, better benefits, better equipment (remember those non air conditioned ambulances), more staffing to lighten the work load, and other things like that. Maybe they should, as should many other fire departments, recognize the fact that they are an EMS system that also fights fires instead of the other way around.

Nah, that will never happen and we’ll continue to read stories like this from DC, Detroit, and other cities for years to come.

At least it will give me something to blog about.


  1. One of the stipulations in the settlement of the Rosenbaum lawsuit, IIRC, was that DCFD would improve their EMS system, and left open the possibility of re-instating the suit if concrete steps weren’t taken.

    Not that I’m blaming them, but has the family been paying attention at ALL? I’d consider this breach of contract a loooong time ago if it were me.

  2. “To reduce the fatigue on paramedics and EMTs, the city has come up with a new deployment plan for its ambulances called “power shifts” where more units will be on duty during the daytime, when the call volume is highest, and be reduced at night when there are far fewer calls.”

    Genius! My god. Why didn’t we think of that.

    Further cost savings could be achieved by charging per droplet of NS and limiting chest pain patients to exactly 162mg of aspirin.

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