Part 2: Are We Any Better Than the Cable Company?

To summarize Part 1, our cable went out.  Comcast gave us a two hour window when someone was supposed to come fix it, but they didn’t show up.  Some EMS systems I’ve been affiliated with use a similar deplyment strategy, and customers of both services are left with few other options.  What happened next with Comcast really set me off,  but I soon found paralells between that and EMS too.

Our repair person was supposted to arrive by 3.  At 3:05 we got a phone call saying they would be late, and that they should be there in about two hours.  That woudn’t work, because I had to leave for work and my wife would not be home yet.   I rescheduled for the next day.  At 7 PM my wife called to say that a Comcast tech was at our house, but told her he had to leave after learning we rescheduled.  Can’t you just fix it now? my wife asked.  No, he said, and left.  How in the world could a cable guy be on our front porch, within sight of our problem, and not fix it?  After a curse-filled rant, I started thinking about us.

There is a poorly designed intersection of two major highways where I once worked.  There are lots of high speed crashes there, some bad enough to show pictures to high school students.  If the crash is on one side of the street, a fire company is alerted with stations located 1.5 miles, 6.1 miles, 7.3, miles, and 7.8 miles away.  On the other side of the street, another fire company with stations 3.4 miles, 4.6 miles, or 7.6 miles away is alerted.  They never alert both, and I’m not sure how the dispatchers determine which side of the street it is on.  Each company staffs stations are staffed at various times and use the same tone out procedure described in part 1 to supplement.

 A half mile away from the intersection, within earshot, is a paramedic station staffed 24 hours a day hosuing a Roy- and-Johny- like respone truck.  Those paramedics cover the entire region, but are only sent on calls believed to be life threatening.  They are not sent on crashes unless the Clawson Roulette  Wheel  Priority Medical Dispatch determines that the mechanism is bad enough.  Usually paramedics are not requested for serious injuries until BLS responders from the fire department, who always respond from further away.     

To people inside the local EMS system this makes perfect sense.  If paramedics were sent right away, they woudn’t be available for the big one.  Fire department grids were drawn before anyone heard of Google Map or GPS, they’ve alsways worked for us, so why change?  There’s also ambulance billing revenue at stake, as well as pictures in the newspaper.  Those high school kids will notice which company’s fire trucks and ambulances are in them. 

Now imagine you are in a crash.  Maybe you are seriously injured.  Maybe your children are injured and you don’t know how badly.  Maybe the airbag just knocked the wind out of you and you’ll be fine in a few minutes, but it scared the crap out of you.  No matther how bad the accident is,tractor trailers continue to whiz by.  From your perspective, is there any reason not to send the closest unit? 

For us inside-EMS baseball types, it can be hard to see alternatives to the way things have  always been done.  For those outside, that can make as much sense as the cable guy on our porch who says he can’t come it.  I’m sure that makes sense to Comcast for some reason too.

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