Volunteer Firefighter (VF)?

[deleted432032]

Is it possible to volunteer as a Firefighter and work as a physician?

Most Firefighters I know have to maintain at least an EMT-B certification, if not an EMT-P, to work in the department, active and volunteer. So I am curious whether or not anyone volunteers ,or has in the past, as a Firefighter either in residency or as an Attending? Would there be any legal issues with becoming a VF since the fire departments respond to a lot of fall calls and most if not all MVA's? I'm unable to find anything on the state medical boards website about this, or at least my search skills have failed me thus far, so I figured I would ask here and see if anyone does this, and if not why?

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[DeadCactus]

You're a free citizen and can do whatever you want and I'm sure someone does it. The reality however is that a physician has close to a million dollars in public and personal money invested in their education and commands a high hourly wage when working in their chosen profession. Given that, volunteering as a firefighter essentially means spending $1000+ dollars a shift to ride on a truck and watch TV while grossly underutilizing the services you could be rendering. Most would find it more professionally and personally rewarding to volunteer as medical director for a smaller department than to run around playing fireman though they can incorporate scene response into that role...

 

[deleted547339]

A recent grad from my program did/does this. Seems to still love it.

 

[Apollyon]

Most would find it more professionally and personally rewarding to volunteer as medical director for a smaller department than to run around playing fireman though they can incorporate scene response into that role...

Now, now, I believe you are just making that up. Also, I work all that I can, and I still have a LOT of time left over. You implied that such a person would be on the "volley trolley" instead of working. I am considering joining up with my local department, and I shall NOT be taking ANY time off work to do it. As for medical director, I knew of one that rode around in a fly car. Oh, and there was another agency where one of the office guys made the residents on the EMS rotation go (like, came to the office and said "come on!"), because they were happy to NOT be in the field.

 

[deleted432032]

I am talking about being a volunteer firefighter, not full-time staff at a fire department. As a volunteer you take calls from where you are at, if you have the time at the moment to go, and either go to the station to leave on the truck or meet them at the scene. Where I am at, all fire department personnel must be EMT-B certified.

My concern is if there is any conflict in operating at a EMT level while volunteering when you are licensed at such a higher level as a physician, especially since EMT's work under protocols and the medical directors license. As a physician, you really can't work under another physicians license. So, I am curious if any physicians do volunteer as a firefighter and if so how they overcome this. Do you just not respond to certain calls or is it not an issue as long as you do not take over the scene?

I hope this helps in clarifying what I was asking in my original post.

 

[jwk]

...run around playing fireman ...

Nice to know you hold firemen, volunteer or otherwise in such high regard. Small cities and counties may depend totally on volunteers for fire and EMS services. I worked as a medic for such a service many years ago - I did it while a full time college student. One professor was a total jerk when we used to get paged out of class to go on ambulance runs - that is until the day we picked up his mama and saved her life. He never talked bad about us again.

I am talking about being a volunteer firefighter, not full-time staff at a fire department. As a volunteer you take calls from where you are at, if you have the time at the moment to go, and either go to the station to leave on the truck or meet them at the scene. Where I am at, all fire department personnel must be EMT-B certified.

My concern is if there is any conflict in operating at a EMT level while volunteering when you are licensed at such a higher level as a physician, especially since EMT's work under protocols and the medical directors license. As a physician, you really can't work under another physicians license. So, I am curious if any physicians do volunteer as a firefighter and if so how they overcome this. Do you just not respond to certain calls or is it not an issue as long as you do not take over the scene?

There may be issues for you, but much will depend on various state laws and good Samaritan statutes, as well as what actions your malpractice carrier will cover - or won't. If you're functioning as a firefighter, that's not really a problem - but if you also do some EMS work, that's where it may become trickier. If you stray into the EMS role, or lets say medics arrive on the scene and you direct their actions, that may become more problematic.

 

[MSmentor018]

I do something similar as a volunteer with the swat team and "observe" more than anything else. the paramedic still functions under the county med director's license and follow county guidelines. if I medically intervene for whatever reason, then I take over the case, they work under my license (within paramedic scope) and I ride with the pt into the ER. just meet the med director and set things up so they don't get any surprises.

 

[Birdstrike]

I see no reason you couldn't do this, but I wonder if you'll feel differently when you're done with your training. I liken it to that of a professional athlete. There's no reason they couldn't work as a volunteer firefighter, but once you've gotten to the point where you're able to generate they kind of money using your most valuable asset, why take the risk?

It's the same in the ED. You've earned the ability to generate a high enough wage to put you in the top 1-2% of earners, and now you're going to take a chance at having some flames scorch your eyeballs that you use for intubating, or take a chance on some other disability creating injury for what, zero dollars per hour?

Sure if you love it, are driven to do it, then fine. But my advice would be to learn to love saving lives for $200/hr so you don't feel the need to risk all you've worked for, to be able to save lives for $0/hr as a volunteer firefighter. That being said, it's commendable work on the highest level and I wouldn't criticize if you chose to do it, but start to think about your body and mind as your most valuable asset. And BTW, disability insurance usually doesn't cover you 100%, nor does it reverse injuries obtained while volunteering.

 

[deleted432032]

Thank you for every that has responded thus far. I definitely hear what is being said and am thinking about it. It is nice to know that if I so chose I could continue as a volunteer. It does seem that if I choose to continue as a volunteer firefighter I would have to be careful about responding to accidents or other medically related calls, or just not respond to those due to a conflict with licensing. I look forward to others that respond with their opinions and will definitely be able to think things through more clearly at a later time. However, until then, the question about volunteering and possible conflict on the medical side should be an interesting topic to continue researching and reading about on this thread.

 

[shookwell]

Depends on state and local law also. In NYC you can work as an EMT or medic even if you are a physician if you are certified, but you must remain within the scope of that certification. If you are not EMT certified or want to practice beyond the EMT/medic scope, then you have to be certified by the regional EMS council as a "REMAC (Regional Emergency Medical Advisory Committee) physician" which also gives you the ability to direct crews on the scene and provide medical control. Protocols do not allow any non-REMAC physician to intervene on the scene of a job.

 

[DoctorMedic]

+1 to Shookwell. As a physician I don't think you could ever really operate at the level of an EMT or Medic and not physician. You would have to get EMS physician liability and malpractice insurance to do those runs is my guess. I don't see you practicing under the license of another doctor which is what you would be doing as a emt or medic. Other problem is if this is a BLS crew and you ride with them and only provide BLS service and there is a bad outcome it could be troublesome that a physician only provided BLS care. A LOT of issues with that. I would consider either diving more into EMS physician role for them or just doing fire based calls and no medical calls. Good luck not intervening when you know you can help save a life though.

 

[deleted432032]

Doctor Medic,

The last part of your post is what I was thinking would have to happen. I would either run only fire calls, being a volunteer I do have the choice of what calls I run, or look into a physician EMS role of some type. That would probably entail either working as a supervisor on scene, with the approval of the acting medical director and what ever license or certificate I would need to do this in the state I reside in, or work at becoming an assistant medical director, if that allows the supervision of these types of calls. Either way, it seems if I were to go on a MVA I would either limit myself to the role of a firefighter or step back and become scene supervisor of sorts as to not interfere with the EMS staff on scene for that call. The not intervening part would probably be hard, unless I can find a way to intervene safely according to state law and protocol. Definitely something I am going to have to look into. I did find something about being a medical director in my state, but have not looked at the document closely. I will have to sit down and review it sometime.

Thank you

 

[gutonc]

Serious but naive question. If you are a VF, do you get to pick and choose the calls you go on?

 

[Apollyon]

Serious but naive question. If you are a VF, do you get to pick and choose the calls you go on?

Usually, yes. Each firefighter is issued a pager (such as a "minitor"), and, when that FF's company is "toned out", the tones set off a beeping - so that is what you hear. I think youtube has some simple videos of minitors going off. Well, when it sounds, there will be a verbal description of what is the event (EMS, MVC, fire, haz-mat, water rescue, whatever), and the address. FFs will respond to their station. When any apparatus starts responding (chief units will usually have their own vehicle, either truly their own, or provided by the department, so they go right to the scene), the dispatcher will give more information. It can be such as my old department - "Hamburg Control to Big Tree firefighters - simplex alarm of fire at Bethel Estates" - that one has all you need in the original call. Another would be "Hamburg Control to Big Tree firefighters - EMS. 3973 Roundtree. 57 y/o male, chest pain." Then, on responding, more detail, such as "chest pain, difficulty breathing, passed out twice." Or, another is "cardiac arrest. Instructions being given." Or, the "cardiac arrest. Prearrival instructions not being given." (<-- that one is usually b/c the caller is the tiny wife of the old man in arrest, or the victim is cold and stiff).

Now, someone will pipe in and give some idiosyncratic difference that their company does. One thing into the 21st century is that some dispatch agencies have the option to send the call out as a text, so people with smart phones get all the information.

Some agencies with either a tradition, or with difficulty staffing regularly, will have the volunteers in the station, much like professional FFs - except they aren't getting paid. In that case, they'll respond to all calls, immediately. Another is having scheduled people for certain nights, so that those people will take all the EMS calls, and others can safely ignore them, with the others being "on call" for the other nights. There are many ways to do it.

But, to answer your question, the essence of the volunteer is to respond to the calls that you can. Departments that have a "service awards" program (a retirement plan) dictate a percentage of calls that one must make to get credit for a service year. That is a motivation. Also, you'll find that many volunteer departments have young 20 somethings hanging around the hall during the day, because they are under- or unemployed, and just waiting for things to do, so they'll Xbox/PS it until the tones go off. If someone is EMT or paramedic certified, or, during the day, can drive the trucks and run the pump or ladder, then there might be a little more pressure to respond (or individual sense of duty).

 

[gutonc]

Thanks for the explanation.