Last night at a SFFD Fire Commission Meeting, the Chief of Department was able to report something positive to the Commission. A report of an occasion that was momentous in my 28 year paramedic career in San Francisco. It was the first time in 28 years that the public ambulance service in San Francisco had met it's response time goals in all districts of the City of San Francisco. From January 2010 to Feb 2010, the overall Citywide 90th percentile response time for a transport ambulance was 8 minutes and 58 seconds.
I remember when I first started riding along with the DPH ambulances in 1976. I was a Medical Explorer Scout at the United States Public Health Service Hospital at 15th Avenue and Lake Street. Robert Giudice was one of the paramedics I got to ride with. There were only 8 ambulances on during the day and 5 at night for a city of 700,00 people. There was no 9-1-1, the public had to call 431-2800 to reach CMED at 50 Ivy which was also Central Emergency Hospital to request an ambulance.
In the 1980's I went to paramedic school at John Adams and did my internship on a DPH unit with Ben Dorcy and Tom Pickford as my preceptors. The number of ambulances didn't change much in the 1980's. In the mayoral administration of Diane Feinstein, the SF Chronicle headlines castigated the ambulance response times of the Department of Public Health as, "Same Day Service."
In the lat 80's and early 90's, there was much hope that the ambulance response times would improve because of a change in leadership of the DPH SFGH Paramedic Division. A young emergency physician named Charles Saunders brought new management tools and administrative skills to upgrade the ambulance service. Dr. Jim Pointer was the Medical Director of the SF EMS Agency and revamped many of the backwards and antiquated medical protocols bringing San Francisco EMS to the forefront of the time in progressive EMS service.
In spite of all their efforts, the SF General Hospital just wouldn't expend any resources to fully fund the ambulance service the way it needed to be. When the merger of the Paramedic Division into the SFFD happened in 1997, the ambulance fleet consisted of 19 vehicles and we fielded 12-14 in our best days. The average response time was 10 minutes which meant that the 90th percentile response time was in the range of 14-15 minutes. Today, the ambulance fleet numbers 41 ambulances and we deploy 21 ambulances at the peak times.
I know the merger has been very hard on the paramedics and EMT's of the public ambulance service in the past 12 years. We lost some very good people because of many missteps and failures to address problems that arose. But regardless of how my colleagues feel the path should have been, one thing is unchallenged.
The San Francisco Fire Department has committed the resources necessary to achieve a goal that had been eluding my professional efforts for 28 years. I think I will try to absorb that for a few days to let it sink in and see if I can postulate about what that means for the future and what is in store down the road for EMS in San Francisco.