It’s Stopped Being Even Remotely Amusing

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I refer to the never ending train wreck known as DC Fire and EMS (FEMS). The latest incident being this goat screw of a call. You can read the details if the case yourself, I won’t bother to quote any of it.

It seems that no one in the NATION’S CAPITOL has any interest in fixing the myriad problems plaguing that system. No has in the last several years, when similar problems existed. No one does now, when the problems continue. No one will in the foreseeable future as the problems get worse and worse.

Mayor Muriel Bowser apparently thinks the problem was the previous Medical Director, not the union, the toxic culture, the complete lack of any management from the fire chief. No, the problem was the doctor who pointed out and wanted to fix the problem. Mayor Bowser is obviously a moron. The only people more stupid than her were the people who voted her into office. I guess they got the government they wanted and deserve.

DC Fire Chief Gregory Dean apparently is only concerned with fixing the issues with fire suppression. Despite coming from Seattle which has a reasonably good EMS system, he doesn’t seem concerned with the grossly negligent care, lack of any accountability, or apparent inability to maintain certification of many of the medical providers. Ambulance crews just disappear at hospitals and no one holds them responsible or sets time limits for hospital stay times. No one checks on the crews if they are off the air for extended periods of time. Apparently carrying and using portable radios is optional, for both suppression and medical personnel.

Dave Statter has, as always, an excellent take on the situation,

Fire chief & former medical director give different versions of EMS in DC – Watch hearing

The entire hearing is available at the link, but I warn you it’s a long hearing.

What the City Council and many others are really scared of is the latest news hints at more of the same for EMS in DC, despite promises of great things when the new mayor brought in the Dean and Saussy team last year. It gives the appearance of the same revolving door in leadership that has plagued the system for decades, along with another false start.

Based on that history, you have to wonder how bad it was between the two that Chief Dean couldn’t make this relationship work. It’s clear, by the questioning, that the City Council sees this divorce as a major setback.

I don’t think you need a PhD to see that the issue was that the doctor wanted to change the culture while Chief Dan wants to work “within” the culture to improve care. I would think with a system so apparently dysfunctional, changing the culture is the very first priority. Apparently, I’m wrong.

Despite that, for the most part, the City Council isn’t ready to abandon Chief Dean. The biggest challenge for the chief will be what occurs in the coming months. Council members may not be so nice if, on top of this, the roll-out of AMR to handle low priority transports isn’t a smooth one. And it will probably get even rougher for the chief if any future well-publicized mistakes in the field are related to any of the major issues highlighted by Dr. Saussy.

I don’t think it will take long before the next major incident rolls out. At the current rate, I think we are seeing about one a week.

Apparently the chief has a lot invested in the idea of having AMR handle “low priority” calls. Of course a response by DC Fire is still required to triage the patient and make that determination. Along with waiting for AMR to dispatch an ambulance. Which might be simultaneous, but I haven’t seen the details so I’m not sure.

Speaking of AMR, there is going to be a lot of resistance if the city providers get the idea that this is the first step towards privatizing the transport portion of EMS in the city.

What astounds me is that no one in the nation’s capitol seems to have a sense of urgency in fixing this. I would think that the politicians who live and work in the city would be outraged and demand action, even if it has to come from the Congress. In a city full of lawyers, you’d think that the lawyers would demand improvements. Not to mention the citizens of other nations who live and work in the District. What must they think when they read these stories in the papers or see them on TV.

As an EMS provider and as an American, I’m both disturbed and embarrassed that EMS in the nation’s capitol is a such a disgrace. I can’t believe that I’m the only person who feels this way, there have to be others.

Apparently those others don’t live in Washington, DC.  The people there by and large seem to be content to die from neglect and negligence.

4 COMMENTS

  1. Dean came from Seattle which isn’t know for having a shabby ems system (ask anybody who has attended Resuscitation Academy). He’s familiar with a very functional system using tired response of FF/EMT’s, private BLS ambulances, and FF/Medics running ALS ambulances. He knows how it can be done, just not sure why he isn’t successfully handling the issues in DC.

    • Seattle is known primarily for having a very good cardiac arrest survival rate. We don’t hear much else about the system, so it’s hard to judge how good it is overall. Dean has yet to show any real commitment to improving EMS in DC to even adequate levels.

      • I’ve lived around Seattle all my life and have never heard of anybody being concerned that prompt medical aid couldn’t be summoned by just calling 911. I don’t think I’ve ever seen or heard anything about excessive delays other than once a decade snow storms that the city doesn’t handle well. I had an elderly alcoholic neighbor for a while who was definitely a frequent flier who was always treated with kindness and compassion by the local engine company. Actual MCIs last fall’s DUKW vs. Tour Bus crash seem to be well run from what I’ve seen.

        • Those are things that any competent EMS system should be able to do. It’s not remarkable that Seattle can do it. It is remarkable that DC Fire and EMS can’t do it.

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