Course changes in crisis will take strong leadership

A call to action to fix big-picture issues within fire and EMS


There have been moments that cause us pause and reflection, then there have been defining moments that cause us to chart new courses.

Like the course change of the Mississippi River in 1876, the fire service has reached one of those defining moments.

As the COVID-19 virus courses through America’s heartland and beyond, it’s time fire service leaders make our own course correction.

As the COVID-19 virus courses through America’s heartland and beyond, it’s time fire service leaders make our own course correction. (AP Photo/Elaine Thompson)
As the COVID-19 virus courses through America’s heartland and beyond, it’s time fire service leaders make our own course correction. (AP Photo/Elaine Thompson)

We can be reactionary, as is often the case, or we can power through change that is critical to our future, while still responding to our core mission. The kinetics of this exercise are predictable, like the river’s water that meanders through curves, faster on the inside curve, slower on the outside where more and more sediment deposits build.

The combination of time and our own ideological disagreements resemble the deposits of sediment in the river that swell its ever-changing course. Yet unlike the river, human power allows us to continue building sediment to avoid change, which produces sludge that slows forward movement to a crawl.

In the river, eventually, silt and sediment will clog the river’s main channel, the river will rise, and it will ultimately switch channels, finding a path that is steeper and more direct in its path to its destination.

We have clearly seen the real environmental changes that shifts in our behavior can make. Social distancing has helped flatten the curve in COVID-19 infections, and the enormous reduction in vehicular and industrial emissions has resulted in clear skies where smog once choked large cities across the globe. What we have yet to see is the economic course change that undoubtedly lies beyond the next curve in the river.

During this crisis, thousands of firefighters and EMS personnel have found themselves on the inside curve, swiftly being swept into an abyss of unknown. From supply chain collapses to never-before-seen mass isolation of first responders to provider fatigue to the regular and well-known squabbles with public health professionals, this IS a defining moment in time for the fire service.

While our providers continue riding the tip of the spear through the COVID-19 unknown, it is time for our leaders to change the course of our river. Our history of protectionism and popularity has led to a crisis in leadership that is crippling our capacity to solve recurring problems. This is bigger than you or I – and more important than either. We need bold and decisive leaders who are the next generation of critical thinkers among us, stepping up to do the right thing.

A call to action

In the face of this current crisis, we have witnessed EMS systems shutting down, fire departments refusing routine medical calls, and a dysfunctional reactionary liaison between public health departments and fire/EMS departments across the country. We need to fix these problems – now.

This will take leadership.

We will go nowhere while we continue to argue “EMS-based fire” or “fire-based EMS” delivery – that’s just a moniker, not worthy of the time wasted on the arguments the topic generates.

Let’s focus on the service our community needs and how we provide it. Municipal differences on what’s medically necessary for firefighter response? Sounds more like an argument to justify fire staffing instead of the coverage needs of your community. Paid or volunteer? While our funding paradigm is all out of whack, let’s face it, every community isn’t set up to be able to PAY for fire protection, which in 2020 is not only a reality but also CRAZY. We need to stop these arguments, standardize our physical responses, and develop sustainable funding streams – now.

It will take leadership.

Public health agencies using a top-down 1970s-era communications model, but not communicating within their own state/local communications systems? This directly impacts fire and EMS chiefs around the country. Public health generally hides behind HIPAA as the reason they won’t communicate directly with fire and EMS agencies, despite the changes to the Ryan White Act. Not tracking “recovery” because they can’t define that? How about for the sake of our community psyche, we at least focus on survival statistics? I think we can define that!

HIPAA is a discussion for another day, but let’s be clear that it was developed to protect patient information from third-party intrusions. HIPAA was never intended to prevent healthcare providers from sharing patient information for valid public safety reasons with other healthcare providers.

I call on the Health & Human Services Office for Civil Rights to clarify and enforce the ability for public health and public safety to share patient information when it is in the interest of protecting police officers, firefighters and paramedics, and keeping public transport units on the street. We work for the same communities, yet we’re caring for them in two very different ways. We must come together – now.

It will take leadership.

The voices of our leadership are muted by the dysfunction of our organizational form and function. In my article “What’s the next ‘giant leap’ for the fire service?,” I called for the creation of a cabinet level first responder department – EMS and firefighting under one federal “parent.” The malfunction of fire under FEMA, EMS under Transportation, and wildfire under Interior creates an alphabet soup of bureaucracy that feeds our perpetual dysfunction. I call on our fire and EMS chiefs to come together to change the course of our river – now.

It will take leadership.

I don’t suspect for one moment that a singular federal agency responsible for our street-level first responder service will solve ALL of our problems. It will, however, provide the framework for one course, devoid of the sediment caused by divergent agendas, funding streams, and priorities that manifest daily from the current federal triad.

Why does it seem we are always paddling against the current? While riding the current is always easier, sometimes we need to cross the river. Like George Washington’s pivotal crossing of the Delaware River, I call on our collective passion of duty, honor and service to make change that’s right for our responders and for the citizens we serve. It is time to sit at the table outside of our organizational currents of stove-pipe pride – now.

It will take leadership.

This is the time when we need to take drastic action to affect change in our service and organizational river. Without violating public trust or, heaven forbid, HIPAA, without feeding the media frenzy and without stooping to infantile name-calling or political hyperbole, we CAN bring positive systemic change – now.

Let’s use this stay-at-home opportunity to change our course for the better.

It will take an infection of leadership – now!

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