Wow...
I don't know how long ago you worked here in King County, but it is not as bad as you make it sound. Sure, there are some engine crews that couldn't give a rats a** about us. That happens in every system. I have worked with almost every station in the city and can say that Seattle Fire and Medics have treated me with respect and been respectful of my company.
Ever think that maybe it was you that had the conflict? Some people don't fit in. I agree with KingCountyMedic. I have been invited to the stations for meals and to hang out. Both Seattle and King County Medics have BS'd with me at Harborview. In fact it is their encouragement that has made me want to pursue EKG education.
Our system is unique yes. The relationship between fire and private is good. That doesn't mean that everyone gets along. Just because some crews may have personality issues doesn't mean the system is flawed. I would assume that in every system there are those that have conflicts. Besides, its not like FF's never have a bad day.
I enjoy working for AMR in Seattle and I enjoy my interactions with Seattle Fire and Police. If you can't hack our system then get out. Not everyone will fit in and be accepted.
Hmmmm.... I guess could weigh in here, but there isn't really much to say, it seems like everyone is pretty well entrenched. But I guess I'd like to address things in my perspective. I have been involved with King County EMS for a decade, starting with TriMed in '03. I am also a WA State EMS evaluator and King County CBT evaluator. In my experience, there are definite personality conflicts that lead to very poor working relationships, and unfortunately those faces get tied to the AMB company, so sooner rather than later, the poor experience is associated not with the crew, but with the sign on the side of the ambulance. Guess what, then the next (insert name here) AMB shows up, all they remember was the poor experience that they had. From that point on, it becomes an accumulation of bad experience blamed on the company, and good experiences credited to the crew. There are crews that have been running together for a significant amount of time, and they work well with the FD crews. They do community events together, superbowl, fill the boot stuff, etc... Kind of like an extended family, which in an ideal world is how things should be. They recognize that each has a specific role, and make very sure to fulfill their role to the best of their ability. I was lucky, I guess.
There are bad crews though, both on the FD side and on the AMB side. The outcome of that is never pretty. We'll use AMB crews for instance, crews that are regularly late, lost, argue onscene with FD are probably not going to make friends. It's never really about what you know, but how you present it, especially if you try to help someone instead of coming off as a know it all. Unfortunately, new EMTs are usually in that boat, they don't understand the system that they are working in, and they are just trying to show how much they know. They also have a poor ability to think outside of the box, and ultimately what is best for their patient. (guess what, sometimes it's faster for the patient to get them to a hospital then to argue about medics) My personal issue with EMTs is those who don't know their protocols. Now on to the bad FD crews, the ones that don't have any interest in EMS are really easy to pick out, and provide the most cookie cutter service (when it's convenient) and are most likely to turf without any patient care/evaluation or even a med/hx. The bad FD crews are also the least likely to have any clue about protocols, and perpetuate the "this is the way it's done" attitude. The upside with the bad FD crews is that if you've worked with them and they trust you, it becomes your call. They step back because they don't want to be up at 3a in some stinky apartment trying to figure out what cookie cutter approach will work, and they know that you do the "medical" stuff and really want to help the patient. The hard part is earning their trust, and getting to that point. Once you've hit that point, you can not only run your scene, but help your FD co-workers learn the medical side better. I don't like fire or extrication, but they like to explain how things happen, that is usually how medical works, just inverse. Now bad Medics, well, I do have to give them their due, most of the KCM1 medics that I have worked with have been far easier to discuss the patient in detail as well as the plan, and answer questions regarding the hows/whys. There are definitely calls that you know you're going to take (depending on the crew and dinner time, etc...) but those are the exception, generally not the rule, and it's usually based on the probability of the patient tanking in the 10min to get to the ER. Some of the most valuable lessons that have helped me in my career (tactical/disaster/remote and military medic) were taught to me in my first year on a rig by KCM1 medics, alot of them from Lee and Michael.
LEOEMT, I can empathize with your position, as I'm assuming from your posts that you primarily work Seattle, however alot of this focus is at S. King. Also there are alot of jaded responses particularly from TriMed. AMR has the benefit/detriment of being a union organization. (I'm not going to get into the benefit/detriment argument here) TriMed is not union. For me, personally I liked it, but it does bring a certain amount of uncertainty about the future. It is a well known fact that for most employees that if a FF calls the company with a complaint, there is a high probability that you need a new job. This causes animosity from the begining especially when someone dictates a questionable course of action and you feel stuck between what you feel is substandard care and your ability to provide an income. This also causes the feeling that "you can't talk on scene." FDs in S. King are guard their reputation very jealously, and if you’re going to make them look stupid, be prepared to pay the piper. From my personal experience, I have never been quiet on scene, and between dumb luck and what I'd hope is skill, but probably more dumb luck, I was never fired.
I guess that I would summarize South King County EMS as a work in progress, but it has improved for the basic level transport EMT significantly since I first became involved with the system. From my perspective there are a lot of personalities, they don’t always agree, and they can't always behave like adults. It is a progressive system that is trying to drag along some very cookbook minded individuals and departments (FDs and AMBs) into the future. Are there some issues that I think could be handled differently? Absolutely, but they are being considered and adjusted according to the vision of the Medical Director, and his vision is different than mine, but he’s got a whole lot more education, insurance, a license and several thousand prehospital providers at stake, and I’ve got an opinion. Having met with him though, he is very open to new ideas, provided they are properly thought through, have data to back them, and a concrete educational plan. I think that there are various issues which cloud the water, including EMS/FD funding based on municipalities instead of county, companies’ strategies, as well as education at the basic provider level.
Well, that’s my two cents, and it’s worth all you paid for it.