Sir: There are many aspects to explore when considering a change in the delivery of land ambulance services, especially such a drastic shift as had been proposed for Chatham-Kent.
Cost is clearly an important consideration, but there is an issue that might matter even more at the moment when you need to call an ambulance for yourself or a family member. Which option will provide the highest quality emergency medical care for the residents of Chatham-Kent?
The best pre-hospital care comes from professional paramedics who make patient care their full-time job. Only they will have the clinical acumen to go beyond blindly applying protocols to truly assess the patient, devise a treatment plan, and continue care until transferring this responsibility at the hospital. Without routinely using all aspects of these skills, the skills will inevitably degrade.
Even if (and it is a big if) a blended model could result in a “paramedic” at a patient’s side seconds sooner than the current model by having that “paramedic” actually be a firefighter on a fire truck who also holds a paramedic certification that they rarely use, this would not actually help the patient. Though it may sound counter-intuitive, the fact is that there is no medical evidence that a slight reduction in response times like this will improve patient outcomes from most medical emergencies.
Given the decline in the number of fires overall, it would seem prudent for the fire service to find ways to increase the efficiency of their own service delivery rather than trying to find a role for themselves on medical calls that are best addressed by professional paramedics.
Other Ontario municipalities have recognized that the delivery of high quality pre-hospital care is best done independent of the fire service. This makes sense: fires and medical emergencies have little in common. Is there something different about Chatham-Kent that would make a blended model work? I wouldn’t risk it.
Dr. Christopher Foerster
London
