Yep. Agree all the way with OEMS. P/B could work in many places, but too often green medics and basics are put together. Best systems I've heard of run Basic or P/B rigs with some strategically based intercept trucks with Advanced scope Medics. Works well in other states so MA should see it in about 30 years....<quoted text>
OEMS is a useless agency with different enforcements for public agencies and private agencies. A do nothing agency that does nothing to ensure that good care is provided by those that it certifies.......all they want is the money they suck out of EMTs and Paramedics. It has been that way for years.
As for the P/B system, it is used and abused by privates and cities alike, it has been for years. I hated working under the P/B system. The class for basics was a freaking joke.
The vast majority of EMS calls do not require an ALS rig, but every service wants to run ALS all the time. Fortunately, there are a few services and areas in this state that do believe in providing good and proper care. As I have said, Boston EMS has only a handful of their ambulances on the road at any one time being staffed as Paramedics. Being a Paramedic is considered a promotion.
As for regionalization, you have to also understand that those same hospitals saw it as an expense because the ALS call volume started to decrease. More and more towns wanted their own Paramedics.....The IAFF/PFFM pushed it as well to increase staffing. The communities liked it because they got more money (while not necessarily making a profit, or acting in best interest of tax payer dollars.)
I began working in EMS back in the day when there was a regional ALS truck out of Fitchburg serving the city and surrounding towns. Then Leominster got a truck. Emerson Hospital ran a regional truck, as did Greater Lowell. Now every freaking town their own Paramedics. Winchendon, Ashburnham, Townsend, Princeton, Sterling, etc. Can't swing a dead cat without whacking a Paramedic upside the head around here. Is it better for patient care? Probably not.
But I don't look to OEMS for guidance on the issue. I would look to the fire chiefs for guidance, but they don't really seem to care either, all they want are their own Paramedics. I poll a lot of the Paramedic students rotating through the hospital I work in. Most say that they are doing Paramedic school to help them get on a fire department. That just gives me all kinds of warm and fuzzies.
My history (FD by the way) goes back to the days of Montachusett Ambulance having the only ALS unit in the region. I still remember the days of doing BLS 911 work.
I'm pretty sure Ashburnham and Townsend went online mostly because of the loss of the Leominster and Burbank Intercept Trucks. As I recall, Patriot didn't want to play in the sandbox the surrounding towns anymore.
Not sure on Sterling, but keep in mind they are also providing ALS to Part of Lancaster. They also have some sort of a system to assist Boylston and Princeton too. Same with Ayer FD. They provide ALS to Shirley, Devens and parts of Groton, Harvard and Littleton. Don't know about Winchedon. Many of the FD based units are providing ALS to the communities around them that don't have ALS.