EMS: Erik & Matt Show
After hours style conversation focused on the hidden and often overlooked parts of first responder life. Discussing everything from continuing education and home life to health and wellness.
EMS: Erik & Matt Show
80% EMS Podcast
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
In this episode of the Erik and Matt Show (EMS), we discuss a recent article that talked about the 80% narrative. Meaning 80% of calls that the fire service runs are EMS. While not every department runs 80% EMS calls, it is the majority of what we do. Erik and Matt talk about this fact and how the fire service has evolved over the years.
Taking back the narrative why, quote, 80% EMS, unquote, is undermining the fire service.
SPEAKER_01And I get it, like I don't want to go to the nursing home around the same person five times in a shift, three times after midnight.
SPEAKER_00You're listening to EMS with your hosts, Eric XE Matt Ball.
SPEAKER_02Well, Eric, I think we might push some buttons today.
SPEAKER_07I don't mind pushing buttons, especially when it's truth, right? Sometimes truth is hard, but there's always truth, I think. Anytime you have a debate, there's truth on both sides. Yes. And and you pointed out a very interesting article to me, which prompted this podcast today.
SPEAKER_01So yeah, this uh this article was brought to me by my chief, and he wanted to know what my opinion on it was. It was a letter letter to the editor in fire engineering.
SPEAKER_07Uh could I read the title?
SPEAKER_01Sure.
SPEAKER_07So this was in May of May 26th, Fire Engineering, uh, page 24, letters to the editor. Um, and the title here, taking back the narrative, why, quote, 80% EMS, unquote, is undermining the fire service. Yeah. Interesting article. So I I just like you recommended, I read the article.
SPEAKER_02Yeah.
SPEAKER_07And a lot of truth in there. Um I I th the well, I guess we can get to this in more detail later. The one thing that I thought that, you know, I I you hadn't shared your opinion with me, but as I read through it, yeah, I felt like there was um I because I've said that a lot, you know, most of what we do is EMS, which is great. Um I think we need to protect the tradition of the the fire service is a you know, fighting fires, it's important. But uh to me I felt like there nothing was said in the article um about meeting the demand of EMS and and you know you know, and getting our cities to increase the budgets for funding EMS training, and and as that wasn't said anywhere in the article. It was more of a you know, protecting the the fire service. And I agree we should protect the fire service. There's a lot of tradition there that needs to be protected and valued and stuff that I can't fully understand as a doctor. But um uh when I look at the communities that we serve, depending upon where you are, most of the vast majority of what we do, I mean, I think you said it really well. You're gonna save more, what'd you say? You're gonna save more lives in an ambulance.
SPEAKER_01Yeah, I well in my twenty plus year career as a firefighter paramedic, I have had one patient that we pulled out of a fire one time. Didn't happen very often. Not saying in other municipalities it doesn't happen more often, right? But I have had way more opportunities to save a life in the back of an ambulance than on a fire ground. It's just a and I would argue that in most fire departments across the country that's probably the reality. And I I would say that like, okay, protect the fire service. What are we trying to protect? Are we trying to protect an image or are we actually trying to protect the fire service? Because, in my opinion, embracing EMS is protecting the fire service because it is the majority of what we're doing, and the statistics that they quote in the article back that up. In their article, they think I looked at it was like 64% NFP statistics nationally.
SPEAKER_07Yeah, this was uh yeah, the accord according to the U.S. Fire Administration, USFA, in 2020, the U.S. Fire Service responded to nearly 27 million runs, with nearly 64% or around 17.3 million being EMS and rescue services. Only 4% were fire suppression incidents. In 2004, the fire service responded to around 55% EMS calls. Again, that was, you know, 20 years earlier, um, and 8% fire suppression runs.
SPEAKER_01And that also takes into account large urban areas like New York, Chicago, LA, Dallas, Houston, these areas that are still fighting a fair amount of fire, right? But I would argue, I know in my departments, I've worked in only suburban departments, the like it's normally that number is probably 70 to 80 percent of our call volume is EMS related. And so there's no arguing, whether it's 80% or 60%, it is the majority of what we do in the fire service. And so again, this is my opinion that embracing EMS is what is going to protect and save the fire service. It might look different, it might be insulting to the people that you know they have this idea that you know they're gonna get into the fire service and all they're gonna be doing is, you know, kicking down doors and saving babies from a burning building. And the reality is that's not going to happen. We just did a podcast on pediatrics, and I have worked on way many more pediatric patients as a firefighter paramedic. I have never once seen a child pulled out of a structure fire. Again, I'm not saying it doesn't happen, but it's very rare that those incidents happen. And not to mention the fact, too, this is another thing that if we're not good at EMS, that's great. You do all these cool high-speed things, whether it's uh pulling somebody out of a structure fire, you do some technical rescue or a water rescue or high, whatever the case may be, right? You do all this cool stuff, and then you get this patient out that is now having a medical emergency, we should be just as competent as EMS providers as we are firefighters or hazmat techs or technical rescue specialists. We should be just as competent at that. Why is the why does the fire service look down upon EMS as the stepchild, so to speak, of the fire service? Well, okay, a firefighter has a medical emergency inside of a structure fire or there's a collapse and that firefighter says, say, in some sort of trauma. Do you not want that firefighter handed off to capable EMS providers that will provide good patient care to that firefighter? Great, you guys sent in the RIC team, they got the firefighter out, they did all the cool stuff that they trained to do, but now you put them in the back of the ambulance and you got two people that don't know what they're doing because they don't like EMS, and now that firefighter dies as a result of poor patient care. And that's what I I don't know, I get kind of passionate about it because I'm like, it doesn't make sense. We should be good across the board. We are not saying that we should not be capable firefighters, we should not be capable, you know, technical rescue people, but we should be just as capable at EMS. What are you reading?
SPEAKER_07No, no, I agree. I I was just reminded as you were talking about uh in the section on meaningful metrics, they went through the true measure of effectiveness is is not necessarily what we're doing, but how we're responding. So I'm thinking like from a from the firefighter perspective, comparing lives saved in a fire versus lives saved in an ambulance, is that I'm just asking you, is that a fair comparison because is the isn't now again, I'm not a firefighter, but isn't the primary goal obviously in a firefighter you know if fighting a fire, you want to save the people if there are people in the fire. That's the first thing we do on scene, right? What are those teams called? The ripped teams. Um but uh the again saving the property is is a different sort of a service we provide, right?
SPEAKER_01Yeah, and and important, right? People want their house saved, right?
SPEAKER_07Right.
SPEAKER_01Uh so I'm I'm just saying, like, is that Do you know what the difference is? In my opinion. Again, this is Matt Ball's opinion. This is my opinion, and it's gonna rub some people the wrong way.
SPEAKER_07I feel like I'm more asking questions here because I want to know what you're doing.
SPEAKER_01Well, yeah, I and again, this is my perspective, this is my opinion. And in my opinion, I think it's and again, I'm gonna rub some people the wrong way. It's it's ego. Because tell me, if in your department, if if one of your firefighters pulls a child out of a burning building, what is gonna happen to that story? That's gonna be on the news.
SPEAKER_07It sure will be.
SPEAKER_01That's gonna be a big story, right? Hero firefighter pulls baby from clutches of death and you know rescues them from a structure fire, right? His picture, that firefighter's picture is gonna be on the newspaper, it's gonna be on the news, it's gonna be on social media, every and justifiably so, right? You did something heroic, right? I'm not neg again, I'm not negating that. How many times have your firefighters resuscitated successfully a pediatric patient and that story has made the news?
SPEAKER_07Well, it it doesn't make the news. It doesn't make the news. It what sometimes hospitals will celebrate it with their things.
SPEAKER_01Hopefully the department celebrates it, right?
SPEAKER_07But you're right though. It's a may maybe this is a cultural thing too in society, right? Where that maybe there's a misappropriation of of uh of uh well, maybe a misrec uh recognition of what we're doing.
SPEAKER_01Well, and I think that a lot of people don't understand, and that's not the public's fault, right? They don't realize. I've had physicians get in the back of my ambulance and go to the hospital with us, and they were like, You guys have this medication, you can do that. You got I had no idea. I thought you guys were just ambulance drivers, right? I didn't know you guys knew all this stuff.
SPEAKER_07What's the difference between an EMT and a paramedic? A lot of my physician colleagues don't know.
SPEAKER_01Yeah, BLS and ALS, really. It's it's it's yeah, and and I mean, yeah, physicians don't know, nurses don't know. Yeah, you know, I think when I started, you know, long ago, nurses, the the respect was not there for what pre-hospital providers did. And now I think nurses and ER physicians specifically are really seeing like, whoa, yeah, these EMTs and paramedics have a dramatic impact on patient outcomes. If you're a good practitioner of EMS, you can really make an impact. But again, back to your original point of the structure fire. I say this a lot in classes is that it's your ego. If you're a firefighter, it's your ego. Everybody wants to be the guy to pull that victim out of a fire, right? Because you know that's but again, we don't celebrate, and we should celebrate these EMS saves just as much. Yes, okay, I am not putting my life at risk. I guess that I get that there's a difference there that I'm going into what we call an ideal.
SPEAKER_07It doesn't happen as often either, I suppose.
SPEAKER_01It doesn't happen as often. And again, there's not the risk to my personal safety to rescue a victim from a burning fire. I understand that. However, being a competent paramedic, right, and knowing what to do in a critical situation to that family member, do you think that's a big deal?
SPEAKER_04Yeah.
SPEAKER_01Oh, absolutely. If that's your kiddo, do you want somebody coming that knows what they're supposed to do?
SPEAKER_07Yeah. Well, let me read the last sentence of the article here. We are the fire service 100% of the time, and all calls are fire calls. We are always ready and always there when it matters most. I guess it's two sentences, but I think if if we're going to as a fire service, which would include hazmat and all the things we talked about. All hazards. All hazards. That's kind of the term, yeah. Even they talked about s you know, shoveling snow.
SPEAKER_01Well, that was a they were making a comparison.
SPEAKER_07Yeah. Yeah. Uh but of all of the different things we do, we do this. I mean, I say we, I I'm including myself in the fire service as a medical director, but uh the fire service does these things as a service to their community because these are emergencies, whether it's a fire, a cardiac arrest, or uh the smell of gas, car accidents, smoke alarm, technical rescue, yeah. Exactly. Um and so uh I I think if that's if that's truly the calling or the what the purpose of the fire service is to respond to these community emergencies. Um one of the things we do is fire. One of the things we do is EMS, one of the things we do is you can fill in the blank. Agreed. Most of what we do is EMS. Most of what we do are medical emergencies.
SPEAKER_01Go based on the call volumes, correct.
SPEAKER_07Right. Uh now to fight a fire, it's gonna require a lot more apparatus. Sure. Right? You're gonna require more um you know, in the equipment personnel. And with more equipment, more skills, more training.
SPEAKER_01I mean, I can see why that's I wouldn't I would argue more skills and training.
SPEAKER_07Well, I'm just mean just just with fire. I mean, because of all the different apparatus, because of the I'm not comparing it to EMS. All I'm saying is because of all the different things that could happen on a fire, there's a lot of different skills you need, so it's gonna require training. Sure. And I think the same thing's true with EMS. Because of all the different diseases we could potentially treat, and because of all the equipment we have in an ambulance, you know, it may not be as sexy as a tiller, but you know, it's it's there's a lot of equipment we need to be able to use, a lot of skills we need in diagnosing things. And there's a lot of good that we can do in those seven minutes or more, depending upon where you are, uh that saves lives. So the the one thing in this article that didn't address, and I told you this before I got up here, um, that that I thought was to me, it's like I was just waiting for the author of this, this chief who wrote this to say something about it, but um, is that with the disproportionate amount of medical calls that we get, it seems to me we should be investing, and as it grows, we should be investing more in it. And the cities need to recognize that too. It's like we need I hope yeah, I I hope so. And I think that um uh by investing more in the training and more in the the work that we do on medical calls, um, we are held accountable more and more. And I think as the healthcare system evolves too, they're gonna be leaning on us more, and there's gonna be even more money and more accountability. But um, that is something I think uh as the fire service evolves and changes and becomes more medically related, and you know that and it's whether you recognize it or not, I mean we all know it. I mean, a lot of these departments are changing names, right? We've gone from the blah blah blah fire department to fire rescue, fire EMS, yeah. All these things are changing. Our relationship with the MS companies is uh uh if we're don't have med units. Um anyway, I think I think as we continue to change, we have to embrace those things. I think and that's I I love there's nothing I'm more passionate about than the fire service. Yeah, I love it, and I want to support those medical initiatives and be a a tool in the tool belt of my firefighters.
SPEAKER_01And the fire service has constantly evolved, right? And the fact that we have become such good EMS practitioners in the last 70 years or so is a testament to the professionalism of the firefighters, right? That they have adjusted going from being a firefighter where that was the majority of what they did back in the 50s, 60s, 70s, right, when we were fighting a lot more fires. Yeah, but because of all the modern uh advances in fire protection systems, in building construction materials, fire alarm systems, we've done a good job in reducing the amount of structure fires. Yeah, that's a good thing, right? And the fire service has done a good job in transitioning with EMS to offer this service to the citizens and the communities that they serve. And so to say that 80% is a you know, whatever the terminology is that undermining, thank you. I just think that's what he said. Yeah, it's undermining the fire service. It's not undermining the fire service. What do you think you meant by that? I mean, I don't know. I mean, I don't I I don't I'm not trying to speak poor, you know, badly about it. We're not speaking badly about it, but everybody's got an opinion. We have a difference of opinion, but I do think that that it's undermining the fire. How is that undermining the fire service? It's a reality. Like data, it's that's that's a reality. You can't argue it. But if those are the numbers, those are the numbers. It's not saying that being prepared to fight a fire is not important. Being prepared to go in a technical rescue or to perform a complicated extrication is not important. That is important. What my big thing with this article, and something that me personally, I have, I guess I would say, fought with over the years, is I've known a lot of guys in the fire service that when it's time to go do fire training, they are locked in. When we're going to do, you know, whatever. If we're pulling a line, doing a room and contents fire, if we're practicing ver practicing vertical ventilation, they're locked in, right? Which great, they should be. Not saying they shouldn't be, right? But then they show up to EMS training. They don't want to be there. Their whole body language speaks that they don't want to be there. They don't pay attention, they don't care, right? And so that to me is the bigger issue, is that we're kind of they're they're trying to, I think, maybe hold on to this traditional fire service. Well, again, the traditional fire service was based on meeting the needs of the community. And if the needs of your community are overwhelmingly EMS, then that supports the modern day fire service. You can get funding and things of that nature to support, okay, maybe you're buying more ambulances than fire apparatus, but if that's what the community needs, that's not taking away from the fire service. You're keeping the fire service alive. We're just transitioning what we're doing day in and day out. And like you're saying, like we should be putting more time and effort into EMS training, and people should be coming in just as locked in and attentive in EMS training as they are at fire training. Now, one of the things I will say, and I would encourage uh fire departments out there to do this, is one of the things that I don't like is how when we do when we do fire training, at least in the departments I've worked with, we would have our guys from our department with our equipment teaching us our way of doing things with our stuff. This is it, because every department does things a little bit different, right? And just the equipment that they use is slightly different. The way that you load your hose in your department might be slightly different than how you might have a side mountain pump or a midship mount. So there's little changes in how we do things, right? But we put our hands on equipment, and firefighters are tactile learners. They like to put their hands on things, that's how they learn. Then we go to EMSEs, and we might have a physician or we might have some instructor from some other department that doesn't know us, doesn't know our culture, doesn't know our struggles. Doesn't know how to teach. Doesn't know how to teach, and comes in and just today we're gonna talk about pediatric fevers. The pediatric fe you know, and they read off a PowerPoint and they're just sitting in a room listening.
SPEAKER_07And I don't blame them for being frustrated with that.
SPEAKER_01I don't either. That's why I've tried to fight us, and I've argued with chiefs before and said, why do we do this? I actually had an art, not an argument, I had a discussion with one of my former chiefs, and I challenged the idea. Why do we do fire training like this, like I just described, but then we have some dude from some other department come in and read us a PowerPoint for three hours every month? Why do we not use our EMS people in our department to teach our people in our department with our equipment? Why do we not do more hands-on training with EMS, run through scenarios, get out the equipment, practice IDs, IOs, innovative that's what firefighters like. We learn that way. Yes. And so we've made we made that change in my former department, and the guys loved it. We now all ever the only people that teach in my current department are FTOs in my department. And the the rank and file, they love it because they know them, they know their capabilities, they run calls with them. These instructors they know how to teach, they know what our issues are in our department to address those issues. And so it's targeted training. They do a lot of scenarios. We've got our Sim Man in there every month. They're running them through. Let's today we're gonna work on pressers and using the pump. This month we're gonna go over difficult airway. This month we're gonna go over whatever it is, right? We're getting up and we're putting our hands on stuff. We need to change the way that we do EMS training to match how they learn, as opposed to just sitting in a room.
SPEAKER_07That's right. And that's why uh well, we're not gonna get into why we do it. We do with education here at Axe and C E, but um I think I think meeting the learning needs of of firefighters is a unique it's a unique population of of students. Yeah. Uh and uh doing it with the death by PowerPoint is missing the mark. No, it doesn't work. So I think that might even be contribute to the problem too, is that the training we have is not good.
SPEAKER_06Yeah.
SPEAKER_07I mean a lot of departments have great training, but it's the the vast majority of uh well, especially online training is just checking the box. It's not real training. Right. Um so that might contribute to it too. I think there's something to be said as well about um some some of the um excitement too that I I because of this uh kind of a culture or reputation or whatever it might be. I think image, I think I think a a lot of it is um romanticized, I think. Um it's just my opinion. Oh uh I I when I was Applying to be a firefighter. Um, I that's what I wanted to do. I just wanted to fight fire. I wasn't thinking medical at the time. I wasn't either. Um, but there's there's something in the fire service too. I I I don't know the answer to this, Matt, but I know in the all of the places where I am a medical director, you cannot promote NEMS. You ha only can promote through the fire service. Oh, you're gonna Is that is that is that a I mean that see from my experience it seems ubiquitous. Like there's there's only a few places that I've ever heard of that you can promote NEMS.
SPEAKER_01Yeah, it's I I have again had this this is one of my pet peeves with the the modern day fire service. So the traditional department, most departments, the the promotional process is you start off as a firefighter, you promote to whatever the term each department uses. Some people say driver, some people say engineer, chauffeur, whatever it is. You promote to that position where you're driving the fire apparatus, you're responsible for pumping or setting the ladder truck, whatever. Then you promote from there to either a lieutenant, if that department has a lieutenant, or to a captain. And then or from lieutenant, you promote to captain, then battalion chief, and whatever. And so in uh my former department, we had we had shift-based EMS captains. It was a new thing. After I'd been there several years, we had EMS captains. And I had always argued that why shouldn't the FTOs, and there are that the culture is changing. There are some departments I know of that do this, that the FTOs, if you have a formalized FTO promotional process, testing process, they're compensated as FTOs. Why are they not at the same promotional organizational structure level of a driver?
SPEAKER_04Yeah.
SPEAKER_01And I get the traditional fire thing, whoa, that like I mean, you'd you'd have thought that I just like smacked their mom when I would make that statement. Like, you should be able to promote from FTO to captain. What do you mean? You mean promote to captain without being a driver? Well, first off, I'll say this. I personally don't believe you have to be a driver to be a good leader. Okay? I when I first started in my fire department, you did not have to be a driver to test for captain. In a certain number of years, it was a shorter amount of time you could test for driver. In a longer period of time, I believe it was five years. If you are a firefighter for five years, you could test straight to captain. And during that time frame, we had some firefighters that made captain, and they were some of the best captains that our department ever had. Some of them still work there, some of them have continued to move up through the ranks. They were some of the best leaders and captains in the fire service. And I personally don't believe that just being a driver makes you a good leader. Being a good leader is more about following this rank. It's about mindset and different things. But I would also, my other argument was okay, as a paramedic, as an FTO, I would be completely by myself with maybe a new EMT or a new paramedic that I was training and my partner, and I am responsible for making split-second clinical decisions on this patient. A driver, he's got an officer with him on every single call that he can bounce things off of. He's got a firefighter. If he's on a structure fire or most incidents, there's going to be multiple companies there. And so he's got lots of people that he can use as resources. I will argue all day long, every day that I was an FTO, I was doing mentoring, I was doing documentation, I was doing teaching, training, walking through the new guy, through how to be successful in your career, while the driver was sitting over in the recliner. And I'm not, I'm not knocking drivers. Like I love my drivers, that's a great position. If that's what you aspire to be, God bless you, go for it. But to say that that is a more important role than the FTO that is doing these things every single day. They're doing more leadership things than the driver is in most departments because it's the officer of that company that's doing all the administrative tasks. The firefighter or the FTO is doing all the administrative tasks.
SPEAKER_07Can I ask you a question? Please. So I was uh on a c a fire, we have a structure fire. Man, we're gonna rock some fully involved fire. And I I actually I was there before the fire department got there. I remember you telling me and they they were there and they set up and all that stuff. But it and it was uh um anyway, I'm I'm just asking you from a training standpoint. So I noticed that my captain was kind of he was heavily involved in, you know, the driver was doing all the getting the LDH hooked up and all this stuff. And then the battalion chief was there with incident command, and our chief was there too, and you could see there's a lot of planning and delegation and tasks tasks and and uh strategy, where to set up and all this stuff. Um if you have been an FTO and you've been you know medically minded or whatever, and you kind of that's been your your niche because you just love EMS. And then you promote to uh a uh a rank in the fire in your department captain, whatever, yeah. You are then going to be the one making some of these strategic decisions, maybe with less experience in the fire service as a firefighter. I'm just asking the question. Is that part of the resistance to this? Because these eventually, I guess, if you keep climbing the ropes, right, you're gonna become a battalion chief and you're gonna be running incident command, right? So, and then would that be some of the pushback on this? Is that getting uh somebody who spent ten years or whatever as an FTO didn't have that 10 years of experience as a a driver engineer where maybe they wouldn't understand I mean I'm sure they understand it, but is would that be some of the pushback on on the what we're talking about? The mindset?
SPEAKER_01Yeah, I think that first off, it's tradition. I think that's the number one thing is this is how we always have always done it. Okay. Right? That's how we've always done it. So I think that's the number one thing. The other argument I've had is, and I not necessarily disagree with that, is that as a driver, you have a lot of what they call windshield time with the officer. So on every call you're going, you're learning from your officer how to respond to these emergencies. Don't disagree with that, right? However, in every fire department that I've worked with that runs EMS, you still fight fire off the ambulance. I've fought many fires off while I was riding on the ambulance. Okay, cool. So absolutely, yeah. If we had a structure fire in our district, I'm going putting my gear on just like the guy riding backwards on the truck or the engine, and I'm going in. So I'm fighting just as much fire on an ambulance as the the guy on the fire truck.
SPEAKER_07Be a devil's advocate again. You you and I have talked about this and you've experienced it now that you're in administration. Your job in leadership is a whole lot different than your job when you were riding uh when you were a firefighter. Right. So I wonder too, again, I'm just trying to imagine the the the the pushback on some of this is being maybe the uh um I guess I guess this is really culture, is what I'm trying to say. Is that when you're uh uh when you're uh in leadership, things are a whole lot different. When you're when you're wearing the is it a white hat?
SPEAKER_01Uh yeah, if you're a chief.
SPEAKER_07Uh like a battalion chief or whatever, or a red hat, I guess that would be the the capital. Well, red yeah, red helmet. Red helmet, sorry.
SPEAKER_01Yeah, the white hat would be their uniform hat, yeah. That's a totally uniform. Or their helmet, I guess.
SPEAKER_07Now that you're in leadership, right? And in uh as an administrative servant in your fire department, um an admin, your job is totally changed. Yep. Totally different, right? Yep. Managing people where and I'll be transparent. I I remember when I was a teacher, I I I did, I was a vice principal for a while. I didn't. I went right back to the being a teacher again.
SPEAKER_01Oh, it's easier. It was yeah. I would say it's easier to be in operations than to be an admin.
SPEAKER_07I agree. It takes a unique skill set. Yes. And you kind of said it before is uh being a leader is more than just your well, and let me say this too, back to your point about being a driver versus an FTO.
SPEAKER_01I am not saying and have never said that if you're gonna promote as an FTO to lieutenant or captain to an officer, a fire officer position, you 100% need to be tactically minded. You have to know firefighting strategies.
SPEAKER_07Absolutely.
SPEAKER_01You've got to understand fire behavior, you've got to understand how to perform extrications or technical rescues. I am not negating at all. You have to be a capable fire officer. But what bothers me is that a lot of departments or guys that I've talked to said, well, if you go the EMS route, you can only stay in EMS. You can't cross over to the fire side.
SPEAKER_07I've heard that before, yeah.
SPEAKER_01But if you're a fire captain, you can cross over to the EMS side. I'm sorry. Hang on a second. Wait a minute. So you're saying uh as an EMS guy, I have to prove myself tactically. I'm not disagreeing with that, but I can't cross over and be a if I'm a good leader, you're a good leader, period. Right? Yes, you have to know tactics as well, but how can you do one way and not the other way? That really bothers me, that mindset. Because that's what we did. If you were a fire captain, you could move to an EMS captain, but they were making the argument if you took the EMS promotional pathway, you could not cross back over to ride on an engine or a truck. Well, wait a minute, why not? Why not? I don't understand that. Because guess what? If you're riding on an engine or a truck, you're still responding to medical emergencies. Sure, you might not be doing direct patient care, but you're still in charge of the overall scene. Yeah, you should have a general idea of what's going on, right? That would be the some of the best captains I had were good EMS people. And they would jump in the back and help if I had a critical patient and I was thankful for them that they were willing to jump back there and help me, even if it was just documentation or they knew what questions to ask the family, right? They didn't have to necessarily do the skills. That's what I teach my guys now is look, drivers, officers, if you're on a CPR or you're on a critical patient, let the paramedics do paramedic stuff, you're in a support role. Obviously, your number one job as the officer is keeping your people safe, right? You make sure the scene is safe for them. That's your number one job. Two, but then you can be getting out hand-heavy. You can be using the app, you can be getting information from the family or whatever it is and documenting that. Or you could be using a checklist. If we're if they're gonna RSI somebody, we have RSI checklists, right? As a driver, stand back with the checklist. You don't need to know all the things. I get it. Now you're focused more on driving and pumping, or you're an officer, you're focused on you know, fire tactics. That's fine. But then when you're on an EMS call, pull out that checklist. Okay, guys, we're about to go through this RSI procedure. Hey, do we have SPO2? What's their SPO2 at? Yeah, we got that. Hey, what's their end title at? Hey, what are we doing here? Hey, do we got the meds pulled up? These are and you're just reading off a checklist. That is helping your paramedics while they're physically doing the skills, you're helping them manage these patients. I've been on numerous calls where the captain just stands in the corner, does nothing, or goes back, I'll I'll be in the engine while we're sitting there working a critical patient in the back of an ambulance, and they're like, Well, I'll be in the engine. Well, how does that look to your guys? You're basically that would be I I relate the load and go or the let's just go to the hospital, let's give them a dose of diesel. And again, I'm about to Brocks blow some brains out here because this drives me nuts.
SPEAKER_07That might why why is it blow brains?
SPEAKER_01Because people don't want to let go of this image or this traditional. And again, I'm not saying that being a good firefighter is not important. I'm not saying that. But my scenario is this if I walked up to a structure fire and it is it's ripping, and we force that door, and I've got the hose line, or we're doing search, or whatever it is we're doing, or I look up at the roof and I'm like, I'm not getting on that roof. Yeah, there's too much fire in there, I'm not going in there, I would be crucified as a coward in my department, and rightfully so. Like you, that's your job. That is your job to go into that IDLH and you know, within reason, right? Sorry, I don't risk ideal uh basically in danger of life and health, right? You're going into this high safe, I'm putting my safety at risk because there's a lot of fire in there. That is my job. Obviously, we risk a lot to save a lot, we risk a little to save a little. If the building is fully involved, it's gonna be torn down, we're saving the slab, there's nobody inside, there's nothing to save. Why are we putting our lives at risk? That's stupid, right? That's dumb. But if there's somebody in there, right, and there's a lot of fire, we're gonna do everything that we can to get that person out and put our personal safety at risk, right? If I say I'm not doing that, I'm not gonna, I they'd be like, get out of here, and I'd probably be terminated. And I probably should be. Tell me the difference between that and you have a critical patient that you have the ability to do something to help, and you say, Well, I I'm just too scared to do that skill. I don't want to do that, let's just go to the hospital. You've just quit on that patient. You've just quit on that member of your community that is entrusting you with taking care of their emergency. You just quit on them and said, Let's just take them to the doctor at the ER.
unknownYeah.
SPEAKER_01Right? And so to me, I don't see a difference in that. You know, I I don't personally see a difference in that.
SPEAKER_07Well, I think there's um I guess I'll ask you this question. So uh is it I mean part of it's the culture, right? Sometimes as a driver or as an engineer, or you know, you in going up the ranks in the fire service, you kind of get further and further away from the EMS calls, right? And so when when you are in a situation where you're in an engine and you're the first one on for some reason, maybe there was a delay with the med unit, or who knows what, you could be there for a significant amount of time and be in a situation where you're gonna need to know your stuff.
SPEAKER_02Yeah, absolutely.
SPEAKER_01So um have we lost the training, the the commitment to training for EMS with I think that people have gotten burned out, and I do understand the burnout because 911 does get abused. You know that just as well as I do, right? People call 911 for I was gonna go burn out next.
SPEAKER_07Yeah, absolutely.
SPEAKER_01Yeah, honestly, I mean, people call, you know, like people are calling 911 for a headache. Like, come on. I mean, uh, you know, we're gonna show up, we're gonna treat you nicely, we're gonna take you to the hospital if that's what you want to do, but understand that you're taking an emergency service out of service for your headache when your husband is at home and you have two working automobiles in the driveway. He could have easily this isn't a life threat. I'm not talking about somebody that's having a stroke or something. This is not a life-threatening situation. And now somebody could experience a truly life-threatening situation in that same area. Now their response is delayed.
SPEAKER_07Well, you said it.
SPEAKER_01People don't fully understand. No, they don't. And they just think that it's interesting to different.
SPEAKER_07Like, yes, I uh I they I pay for this with my taxes.
SPEAKER_01I'm calling on yeah, but people get burned out because a lot of what we do, I and I don't know the specific numbers, but I would say 80 percent of the EMS calls that we run aren't life-threatening emergencies.
SPEAKER_07Well, I can tell you, and I think that the ER is a reflection of what we see in the pre hospital. And I can tell you statistically, and this is a New York University study, forty and by the way, they pulled out behavioral emergencies from this. These weren't included, 49%, 49.2 percent were deemed non-emergent, didn't need to be in the ER. So if half of our patients in the ER don't need to be there, yep. Right, and one third of most agencies the patients are refusing.
SPEAKER_04Yes.
SPEAKER_07So of the patients that get to the ER that come to the ER, half of them didn't need to be there. It's really over half when you include behavioral health emergencies. So I I would wager that you're you're probably close.
SPEAKER_01I mean, oh yeah, I would say a minimum 50% don't need to be calling 911 for their emergency, you know. And a lot of there's this misnomer that, well, if I go by ambulance, I'll get in faster. No, you won't.
SPEAKER_07I'm gonna just go to triage. Yeah, you're just taking them to triage.
SPEAKER_01Before 2020, I would say, yeah, you probably might get in a little bit faster. Since 2020.
SPEAKER_07Depending upon how busy they are.
SPEAKER_01Well, yeah, exactly. But like I never before 2020 took a patient in that I had given narcotic pain medicine to that didn't get a room.
SPEAKER_04Yeah.
SPEAKER_01Since 2020, I've had that happen where it's just like we have no rooms. We have no rooms, they're relatively stable. Okay, they got an IV, you gave them a little bit of fentanyl, they didn't need to go in the waiting room because we just don't have any rooms. And that's a reality. But again, I think that a lot of people have a bad taste in their mouth for EMS because a lot of it is you're getting the nursing home calls.
SPEAKER_07Oh, I I was out in a large urban area somewhere in the United States in the southwest, huge urban area, and I was in one of their fire stations and just listening, and the vast majority of their calls all through the night, transients and drugs and and uh behavioral health emergencies, good Samaritan seeing a you know some transient sleeping on the side of the thing. They call 911. Thinking that I mean they're they're doing they're doing the right thing. But but the problem is that that's the reality now of the fire service is where there's a lot of uh really big problems in our society, a lot of huge problems in our medical community, our healthcare system that's creating this uh repetitive problem with no solution, and they're the ones getting called. They're the ones that are being called to the same person over and over again.
SPEAKER_01And that doesn't want help most of the time. Yeah.
SPEAKER_07It's it's hard. And and this is this creates, like you said, burnout. And this this is another reason why, hey, you know, get me off of the med unit.
SPEAKER_01Yeah, yeah.
SPEAKER_07Yeah.
SPEAKER_01Which is why a lot of people promote, you know, they I want to get off of this thing because that's once you typically once you promote. Now, some departments, you promote to driver, you're the supervisor on the ambulance. There are departments that do that. But I think you know, a lot of guys they get worn out with EMS just because they're running on a lot of calls that don't need, you know, and I get it. Like, I don't want to go to the nursing home or on the same person five times in a shift, three times after midnight. No, nobody wants to do that, right? But again, kind of back to the article, you know, one of the things that they mentioned in here, which I felt was a little bit misleading, is they talked about snow plows in the Midwest, and they said, Well, you're not gonna reduce the number of snow plows in the Midwest just because you have one year of less snow.
SPEAKER_02Yeah.
SPEAKER_01Okay, yeah, you're right. They're not going to do that. They're gonna look at the global numbers or the long-term numbers, and they're gonna say, Yeah, typically we need this equipment. However, here in the state of Texas, we don't have, I grew up outside Chicago. We it would snow, we'd have snow plows and salt trucks and the whole thing, right? It was part of the infrastructure. We don't have that here. Yeah, why? Because it's not needed that much. Yeah, we get maybe one snow or ice storm a year, right? And it's usually gone within two or three days. They might come by. I mean, we have some plow trucks, usually, yeah. And when it's not, like, yeah, okay, things in 2021, things shut down for a week, right? Because that was that happens once every hundred years. It was a very unusual event. Typically, we get that one snowstorm. We do have some plow trucks, certainly not to the number that they do in the Midwest or in the northern part of the country. We don't put salt on the roads here. Why? Because it's not needed. We're not gonna spend all this money on this resource that we're not using. That would be dumb. That doesn't make any sense. And these politicians, people in uh positions of power aren't stupid. They can look at the numbers and go, wait a minute, you guys fought how many structure fires last year, but yet you ran how many EMS calls last year? Wait, it looks like the majority of what you're doing is this. So, and and I get it, like there's guys that struggle with that. Like, well, we're not gonna be buying fire trucks. There's a lot of departments that are looking at a squad concept. Wait, we could have a squad running on 90% of the emergencies that were going on, and I'm not just talking about EMS, you know, and we could save a lot of money, right? So again, I think that the fire service has evolved over the years from you know, bucket brigades to horse-drawn to you know, motorized apparatus to more technical rescues and added on EMS. And I think that EMS is so busy, you're so busy when you're on the ambulance. Another thing I'll disagree with them on is that the fire apparatus are the workhorses of the fire service. Yeah, not in my experience. I mean, if I was on the engine, that was usually a break because you're running five calls or engines get dispatched with everything. It depends on priority dispatching. Yes, same with the same in my department. The engine or the truck goes on every day. But they're typically recalled, they're not transported in the hospital. In my other department, we had priority dispatching, so our ambulances would would go out on uh a lot of calls without backup because the call didn't need it, right? And so I was making 10 to 12 calls a shift where the engine was running five or six. Yeah, you know, and that's not you know, everywhere's a little bit different, right?
SPEAKER_07Do I have time to make another point? How are we? We got yeah, we got time. Make another point. Um so I always get really frustrated uh in the emergency department when I have administration tell me that we don't need X number of staffing. Hospital administration. Hospital administration. Um and and uh and it's and then they'll they'll they'll show me numbers and they'll say, Yeah, you look at this, you don't need this, right? Historically, I mean look look in the last quarter, look at your census here in the ER at these times. We can we can take some of your staff away.
SPEAKER_02And to me haven't your censuses gone up?
SPEAKER_07Well they have, but I'm just saying but but in you know, uh a lot of the um administrative folks in the hospital system that I work at are incentivized to minimize staffing.
SPEAKER_02Yeah, because it saves money.
SPEAKER_07Yeah. And and staffing is expensive. Sure. And you don't want to waste money. I get it. That's wise. But the thing that frustrates me is their philosophy isn't isn't like ours. I think in emergency medicine we we hope for the best, but we prepare for the worst. We're we're prepared for that MCI. Mm-hmm. If I get and I one night we had a tr massive Trauma head-on collision, nine patients. I didn't receive all nine patients, but we heard this thing happening on the radio. Right. Um, we split them up amongst the facilities in the area, but it could have been 18. And I mean it could have been uh who knows how many or mass shooting. We in the ER, that's what I think about, and that's what I prepare for is being ready to go for a mass event where I'm in big trouble and I need to have and I and either way it's going to be an MCI, because the definition of an MCI, you don't have enough staff to take care of it. Right. Right. So but my point though is to minimize staffing based on data is not emergency medicine.
SPEAKER_06Yeah.
SPEAKER_07We are prepared for that terrible, unthinkable event as best we can. Yep. And I think I wonder if the same thing would be true. Uh you know, in Los Angeles, that big fire that came through and they didn't have the water they needed, it's kind of controversial. I don't really know the details of it. But but, you know, in the fire service too, even though we may not get as many fire calls, being prepared for that massive event. Now I don't know what that means as far as apparatus goes, but being prepared for that massive fire event that could occur anytime, anywhere, or or the West explosion or whatever, having the capability to be able to keep the community safe and to be able to run on that type of a massive fire that's gonna rampant over, I don't think that was like 3,500 houses or something like that. Um is there some of that to this where that philosophy of you know me being frustrated as an ER doctor to have administration tell me I don't need so much staff? And I'm like, hold on a second. We never know when this is gonna happen. We should not decrease staff just because last week we didn't need it. Is there some of that too with with fire and like you never know when you're gonna because you're training for those big things?
SPEAKER_01Sure. So a couple of things. So, yes, you could have a major incident, right, at any time. Anybody could have that. It's all a risk versus benefit, right? How many millions and millions of dollars are we willing to spend to have the max amount of fire trucks, fire engines, personnel, everything fully staffed for an incident that might happen once in 30 years, right? So, yes, we want to protect our communities as best we can. That's also fiscally responsible.
SPEAKER_04Right.
SPEAKER_01Right?
SPEAKER_04I agree.
SPEAKER_01And so the other thing is too, is that you have mutual aid, right? You get a big incident, you're calling in surrounding departments. Hey, we need some help, right? So your surrounding departments can send over a, you know, they can split, okay, yeah, we can send you a truck, we can send you an engine, a tank, or whatever it is, right? And you might have five other departments that say, hey, if we have something, you guys agree to send us some help. If you have something, we'll agree to send you some help, right? Because those incidents are so rare, right? Thankfully, they're so rare that you can't staff, you can't put a fire station on every corner with a fire engine, fire truck, ambulance, police car. Like you can't do that, right? You can't, in a perfect world, maybe, but you can't do that because it's not fiscally responsible. Now, reducing staffing, even though it's expensive, the fire service is different because not only are you talking about staffing, you're talking about million dollar apparatus. Yeah. You know, million, two million plus dollar apparatus that it costs that's just sitting there, maybe not they're running one or two calls a day. How many of those do you want to have that's costing your city, your taxpayers, millions of dollars, and they're running, you know, a handful of calls, and there was zero big incidents in the last five years or ten years or whatever it is, right? So I think everything is a risk versus benefit. And two, you know, a hospital, they're they're a profit-driven agency, so they're worried about they want to make money, right? Cities aren't interested in making money, right? They're they're wanting to save money, be fiscally responsible. And so I think that they build their fire departments and police departments and all the public safety things to the best of their ability within a budget, right? Within, well, let's look at the data. What is the data showing that you're doing? And again, that's what this article is speaking to. What are you guys really doing? Okay, 80% of your calls are EMS. Okay, well, maybe we and we fought, you know, 10 structure fires last year. Okay, well, maybe we could prolong the life of our fire trucks. Maybe not reduce the numbers, but maybe instead of a 10-year replacement plan on fire trucks, we go to a 15-year because you're not getting as many miles in 10 years. And instead, and we save that money, and instead we're gonna put another ambulance in service. Again, that's not undermining. Undermining, thank you. I keep forgetting the word they use. That's not undermining the fire service. That's keeping the fire service alive, that's keeping it current. Because again, as we go on, structure fires are decreasing and EMS calls are increasing. And I believe they're only going to sure we're gonna get waves where you know different cities, oh man, this year we had more structure fires than we did the last 10 years. Okay. You know, but I think that EMS calls are gonna continue to increase, and like you said earlier, the healthcare system is gonna continue to lean on pre-hospital providers.
SPEAKER_07I believe it will. Yeah, I really do. It has to. There's we're overutilizing our healthcare system. We should be able to transport play uh patients to multiple different types of facilities to provide the the best care they need. Behavioral health. We can't all just go to the ER. We are that's not that's primitive.
SPEAKER_01We have to be more just strategic in how we do things, 100%. Yep. I just think, yeah, the article, again, I'm not, you know, I'm not harping on these guys. Um, you know, they're entitled to their opinion. Um, I just what I don't want is I don't want people to not look at the data and not look at, okay, what are we really doing and what is the best use of the taxpayer dollar for the community? What are we really running on? Does the community really call 911 80% of the time for a medical-related emergency, or is it for a fire emergency? Obviously, in the city of New York, they're still fighting a lot of fire up there. You're not going to reduce fire trucks up there, you know, and Detroit and these big, you're not gonna, they're still fighting a lot of fire up there, right? And so you need those resources. In a lot in a lot of suburban departments, you might not need that many resources. We need to be able to adapt as we have over the last hundred plus years. We need to be able to adapt to what this community needs are. That is embracing the fire service, that's not undermining the fire service. I think so. In my opinion.
SPEAKER_07No, I think uh in my uh experience, I uh I'll speak to being an ER doctor, uh and I think firefighters might identify with this. Um depending upon the level trauma center I'm working at, I may only see 10% trauma patients. Right. But in emergency medicine, a lot of what we train for are those traumatic injuries that need to be emergently cared for. I mean, those are when seconds count, and that's what I love. Yep. And and to be able to deliver that kind of care and save lives, that gets my blood flowing.
SPEAKER_02I agree.
SPEAKER_07And and and if you go to most ERs, like the ERs that I worked at, these level one or two trauma centers, there may be maybe a half a dozen to maybe six to twelve trauma bays. And then depending upon the size of the ER, you might have thirty or forty regular beds, right? Right. Well, if I if I was so excited about trauma and my ER was just a bunch of trauma bays, I wouldn't be serving my community well because a percentage of patients that come in with traumatic injuries that need a trauma bay. You know, I I in some ways I feel like that might be a good analogy here, with maybe to a certain extent to what we're talking about, where it would be uh foolish for me to build an ER that only had two regular beds and then 47 trauma bays.
SPEAKER_01Yeah, for one trauma patient.
SPEAKER_07Right. Yeah. Uh and I don't think maybe that's the extreme obviously.
SPEAKER_01No, yeah, you're making the point.
SPEAKER_07And then I felt like this article was saying, hey, hold on a second here. Uh you know, we like our trauma bays, and uh we gotta stop, you know, focusing on EMS because this is one of our services we do.
SPEAKER_01I think that's kind of I don't care if 80 percent that's undermining the trauma bay.
SPEAKER_07I don't think EMS is undermining the fire service. I think so.
SPEAKER_01I don't think that statement is, which I think is what their point was, is that that statement is undermining the fire service.
SPEAKER_07I don't think as an ER doctor, uh and I hope as a firefighter, but as an ER doctor, I I can say this from my own experience is that I don't feel undermined by recognizing the fact that most of what I do in the ER is like you've said, belly pain and poo lift, what is it? What do you think?
SPEAKER_02Lyft assists and poo-poo pain. Yeah. Because most of what I do Well, you don't do lift assist, but yeah.
SPEAKER_07Well, most of what I do is that the non-acute type call. And 50% of what I see is didn't even need to be there. And the vast majority of the rest of them aren't gonna die. Right. Uh but I live for those patients that need life-saving care in the ER that I can deliver. Yes. And that's what gets my blood flowing. Yes. And if I had somebody come in and tell me that uh that's not as important as this or something like that, I I would be a little frustrated. That's and that's not what we're saying here. I think what we're saying here is that we need to recognize the fact that as a fire service or for me as an ER doctor, as emergency medicine, as a community, we need to recognize the fact that our patient populations are what they are, and to meet the demands of that patient population, I need to be prepared to service that community of emergency patient. Yes. And so I will have facilities in the emergency department to meet that demand. Yeah. And I think what we're seeing right now, it seems to me almost like a misappropriation of funds in some way, where so much of what we do in EMS, um, you know, we we can't afford to to get uh a a small whatever device potentially, but we we got these uh multimillion dollar uh fire apparatus and the and the department right next to us has the same thing. Yeah. Uh so I I I don't know the answers, and uh and I think that's uh what the article is saying is that EMS is is undermining that.
SPEAKER_01I don't think well they're saying that that statement is undermining to the fire service. That's what how I interpret it. But I look at it like this the fire service is an insurance policy, just like you said, right? We're prepared for the worst emergency.
SPEAKER_04Yeah.
SPEAKER_01The fire service, the fire department is an insurance policy that if somebody's house catches fire, if there's a whatever, we're there to respond, right? That's what they're paying for. It's an insurance policy. You're not gonna buy flood insurance living in Iowa, because you're probably that would be dumb, right? You don't need flood insurance in Iowa because it doesn't flood in Iowa, at least I don't think it does.
SPEAKER_07I was born in Iowa and you can have floods in Iowa.
SPEAKER_01Okay, you can. So you get my point. But that's like saying, well, we want to put all of our money or 80% of our money into flood insurance and none of our money on tornado or natural disaster insurance. Right. That wouldn't make any sense because you're probably more likely to have a tornado rip your house down than your the house to be flooded out. Or like you go to California, you live in the mountains of California.
SPEAKER_07You're not gonna pay for hail damage.
SPEAKER_01You're not gonna pay for hail damage in California, but you probably are gonna pay for fire damage because that's the highest threat, right? That's what the way I look at it is that the insurance the fire service is an insurance policy, and you have to look at what's the greatest threat to my community. Is it fire? Maybe it is. Then you need to keep investing money into fire trucks and firefighters and all that kind of stuff. If it's more EMS-related stuff, then you need to put your money in that bucket. Again, I'm not saying get rid of all fire apparatus and put ambulances. That's not what I'm saying. And I'm sure that there's people out there that are cussing at me and throwing, you know, Red Bulls at their radios or earphones or whatever. I want to punch this guy in the face. But it's just reality, right? You have to be common sense. These city, these again, these people in power that make these financial decisions for the fire departments, they're not dumb people, right? They can pull the numbers, they can look at the data and say, hey, you guys did so many of this and so many of this last year. If you're in an insurance policy, we had more flooding than we had fires. Let's put more of our money in flooding than fires, right? Let's only put 20% in fires and 80% over here because this is what we're seeing more of.
SPEAKER_07And it's not because it's less important.
SPEAKER_01No, it's just the reality of what the numbers are.
SPEAKER_07Trauma is what gets me excited. And because I only have 10 trauma bays in my 50 bed a yard doesn't mean it's less important. Right. Uh it's just being appropriate. And I thought we're saying anything's more or less important here. Right. I'm just I had trouble with the title saying that. Yes, I agree. That's undermining the fire service.
SPEAKER_01And I also want to say, like, I love my firefighters. I love being a firefighter. I love it. It's the greatest job in the world.
SPEAKER_07So anything I said just to be able to do it.
SPEAKER_01No, not at all. You work very closely with firefighters, and having a medical director is a huge part of the fire service. We couldn't do our jobs without medical directors. That's a fact. But I love firefighters. I love the fire service, and I love the meaning behind the fire service. If you really look back at when you thought about becoming a firefighter, at the bottom line is because you want to help people. Yeah. That's what it should be about. It wasn't, well, I want only want to help people if they're in a fire. I only want to help people if it's a technical rescue. No, you want to help people. I understand we can get burned out running the BS calls of EMS, right? Because that's what people call it. I understand that. But if if you're truly there and your heart's in the right place, that I just want to help people, right? Doesn't matter what their emergency is, you're going to help them. That is a successful fire department. That is embracing, as they said, the mission of the fire service. Doesn't matter what the emergency is, whether it's EMS or whatever. We're responding and we're bringing our best trained, highly professional people to your emergency to handle whatever your emergency is. And we're not going to negate that it's just an EMS emergency and it's not a structure fire or something cool where we get to put on our gear and do whatever we want to do. But again, I love my firefighters. I love the fire service. I think it's a fantastic thing. I hope that more and more people join the fire service because you're truly doing something above yourself. You're serving your fellow man, you know, it's more than just a paycheck.
SPEAKER_07You're part of something a whole lot bigger than you're.
SPEAKER_01Yes. And I just think that EMS is an evolving part of the fire service. I think it's a great thing that the fire service has. And I think the fire service, the modern day fire service, would look a lot different had we not adapted with EMS, you know, 70 years ago or whatever it was. I think it was a great union of the two things because we're well suited for it. But anyway, I hope we didn't tick off too many people, but we're just this is just Matt and Eric's opinion on things.
SPEAKER_07And uh so I think I'll say as we finish this up, I know we're we're probably done with time. Yeah, we're good. Um is that um, you know, as a physician, there are a lot of physicians that like things. Uh there's nothing I like more than serving firefighters. And and paramedics, EMTs, and be those companies, all that. Being able to use my passion for the the human machine to help people understand the human machine better so they can treat diseases better. There's nothing that gets me more excited. Yeah. So I I I hope that we can be a force for that um respectfully in a fire service that is uh what they love, just like an ER doctor loves trauma. They love the fire. I get it. And I think that should be celebrated.
SPEAKER_02Yeah, I like fighting fire too. I get it. Yeah, yeah. So but anyway, well, it was a good one. I'll see you on the next one.
SPEAKER_00Be safe out there. Thank you for listening to EMS, the Eric and Matt Show.
