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Well, actually it broke almost two weeks ago. Their medical director of seven whole months has thrown in the towel and thrown up her hands in disgust. What she didn’t do was go quietly,

You can download the letter here. It’s well worth the read.

Here are a few of the more “scathing” sections of the letter.

sauseytoxic

 

While “toxic” is a strong word, the most distressing part of this sentence is that the resistance is coming from the “top down.”

sauseydisappear

 

 

 

 

This is a variation of the well known comment about the fire service being “150 years of tradition, unimpeded¬† by progress.” We can’t hurt the EMTs and paramedics feelings by expecting them to actually answer their radios and go to calls. At Sorta Big City EMS, this was a cardinal sin. I know of at least one person who was fired because he was “too busy” to answer his radio and come out of the hospital for a priority call. Any missed response was guaranteed to generate an incident report and possibly discipline. Over the entirety of my career, this was one of the few things that never changed.

I don’t know of any EMS system that has sufficient staffing. Private, fire based, third service, everyone is chronically short of ambulances. Screwing off at the hospital and letting other crews, or no one, pick up your slack is going to make you very unpopular. It’s part of the job, so you suck it up and do the job.

sausey3rd

 

 

 

That’s a novel concept. Establish a separate agency the provide EMS and the head of that agency report directly to the Mayor or other top official. Use the fire department to provide first response to critical cases, not to stop the “response clock” so that the numbers can be pencil ripped to give the veneer of competency to management.

Interestingly, this was part of the discussion during the investigation into the death of David E. Rosenbaum, the commission discussed doing exactly this. The proposal was rejected because it was too politically unpopular. That was almost 10 years ago and nothing has changed. At least nothing has changed for the better.

sausey1

 

 

 

Chief Dean was the chief in Seattle for 10 years. Seattle has a very good ALS program, especially when it comes to cardiac arrest survival. The difference between Seattle and Washington, DC EMS couldn’t be more stark. And yet, this doesn’t seem to be a priority for Chief Dean.

More from the Washington Post,

D.C. fire department medical director resigns, delivers scathing exit letter

I could probably write a post a week about some calamity that has happned involving DC FEMS, but what’s the point, really? As Doctor Saussey stated in her letter and anyone who pays any attention to the situation understands, nothing will change until the people at the top of DC government decide to make it change.

That will mean taking on a lot of entrenched special interest groups, so it’s unlikely to happen. The taxpayers will continue to pay out large settlements because of this.

It’s a toxic situation, indeed.