So I have explained that private EMS can be done correctly. Although from what I have heard from different parts of the country, it is not done right very often. The story does not end there. I have yet to drag my readers through an intricate web of ineptitude and shadiness. And that has to do with my experiences at a private provider in Kentucky much later in my career.
I moved to Kentucky because AMR had completely deconstructed my beloved first job. When they were finished, they were barely profitable and had downsized many of my friends in an attempt to centralize many departments. My family had all moved to different parts of the country and I really had no reason to stay in Dallas anymore. My wife’s family was from Kentucky and many of them lived in the Louisville area. I had met several contacts through my wife that would allow me to easily get a job in Kentucky, so the move was made.
I have heard many people say that EMS is pretty much the same where ever you go. There is just a different name on your truck and different scenery. I find that nothing could be further from the truth. EMS in Texas was vastly different from Kentucky. Having come from a very progressive private service, I was shocked to find myself working for an urban 911 service that didn’t even have aspirin, morphine, or phenergan on the trucks. In fact, our complete inventory only included 17 drugs. They also had this fetish for nasal intubation which I am still wrapping my head around, but these differences should be the source of another post.
I tried a few services on for size and finally landed at a fire-based suburban service that seemed comfortable. The equipment was up to date and well maintained. The employees were treated well. I usually got off on time, and the benefits package was reasonable. There was also a project that greatly interested me. This particular department was interested in offering paramedic courses. Education had always been my chosen track to advancement and so I dove right in. After about four years I was teaching my third paramedic class as the Lead Instructor. However, I had learned a few things working for a fire-based service that distressed me. Since my concentration was EMS, and I had little to no experience in fire, I was never going to be promoted. Period. No ifs, ands, or buts. If I wanted to stay with this department to retirement, then 16 years in the future I would be retiring from my current position: on a truck. Just like any other firehouse, there is more management staff than entry level workers. And I was never going to be promoted unless I went somewhere else to get more fire experience and then came back to this department.
Then a student in one of my classes told me that one of the private companies in town was going through some major changes. He said their corporate headquarters had completely replaced the management staff and was pumping money into the organization to revitalize it and become a major player in this region. They were sorely in need of an educational director, and since I was one of very few people in this region who had the credentials to put on his own paramedic class, my name had come up several times. The student told me that if I turned in my resume I would probably be offered a management position and could argue for a nice salary.
As it so happened, the new Operations Director of this service was from Texas. The interview went on forever while we talked longingly about how we missed the progressiveness of Texas. We talked about how backwards prehospital care in Kentucky had become. He then told me that he was brought in knowing there were problems with this service, but that he was charged with fixing them. If I agreed to come on board, I would be given the task of starting paramedic and EMT courses, as well as doing chart review and launching a field training program. This is the chance I had been waiting for. My entire career had been slowly working up to this moment. The salary was not bad either so I accepted. In retrospect, this was probably the single worst decision I have ever made in my life. What followed after this led to financial hardships that I am still trying to recover from, as well as damage to my reputation that does not have a price tag.
One of my first tasks after quitting the fire department and reporting to work at my new position was to set up my office. I was given a dingy little room and was told that it was badly in need of paint and carpet. When I inspected the room there was not so much as a chair for me to sit in, so I asked if there was any furniture I could use. The Operations Director told me that there was nothing and gave me a catalog to order a desk and a chair, and some shelves. I ordered something that was cheap but functional and gave the catalog back to him. I bought some paint on my own credit card and turned in an expense report for the supplies as suggested.
The original deal was that I would have to work on a truck for a short period of time because we were so short staffed with paramedics. However, I was told that I could come in for an additional two days per week to just work in the office to start planning some of the programs I was hired to create. I was to be paid overtime for these efforts, and just as soon as we got to an acceptable staffing level I would be taken off the truck and be offered a salary that would be comparable to what I was making with the overtime. That was a lie as well. After six months I had still not been taken off a truck. But I’m getting ahead of myself.
One of the first tasks that I was given was to take over continuing education for the neighboring fire departments. We served a small suburban 911 contract, and we provided continuing education to the local fire department as a marketing gesture. Another nearby department wanted a similar arrangement. It wasn’t long before a third chimed in. My boss told me that this would be a great way to get our foot in the door with local fire departments and ease the usual tensions between organizations. I also got the departments to agree to let our employees attend these trainings so that they could meet their own CEU requirements. And so the CEU program was born. Within two months, we were providing CEUs to three different shifts on three different departments. This made a total of nine trainings per month on various days and times. Now, we had a situation where none of our employees could claim that there were not enough continuing education offerings.
However, the same manager who told me to set up this system was starting to question my timesheets as I submitted them. He would point to the two hour blocks and angrily ask what I was doing.
“Those are the monthly trainings that you approved. Remember…the marketing and good will campaign towards the local fire departments that also benefits us by providing multiple opportunities for our own employees to get CEUs. Remember…the project you ASSIGNED to me?”
He looked at me like he was confused and bewildered. Every time I turned in a time sheet he would ask the same questions, until finally I just said, “What the hell is wrong here? You ask me to do something, and then you question me like I made this all up. What’s wrong?” He informed me that he was having trouble justifying the expenses to his superiors, and that he was surprised the program was going well. It wasn’t long before I was told to cancel classes for two of the fire departments, making me look like a jackass.
Meanwhile, remember the office furniture I had ordered. It never came. I was then brought into the office and asked why I needed furniture. Bewildered, I just asked if I was expected to sit cross-legged on the floor to do my work. I was never given an answer, and it was suggested that I improvise something. So during the weekend, I brought in an old desk that was in my basement. It was pretty ugly, but so was the bare office. I thought that I would benefit by getting the thing out of my house and I would at least have a horizontal surface to work on.
At this point, I started to realize that a rough dynamic existed between the Regional Manager, and the Operations Director that hired me. Many of the strategy meetings that I attended consisted of the Operations Director and myself pitching ideas to the Regional Manager. He would agree and say that the ideas sounded great. We would adjourn. I would go implement the ideas, and the Regional Manager would later come and angrily ask me what I was doing. This became a recurring theme that was almost comical. Meeting, idea, approval, implementation, angry inquisition. The entire process was maddening. The Regional Manager started to question me why my office looked so crappy. He said it was an eye sore. I then told him that he had denied my request for furniture, so I was just bringing something from home to work on until the budget allowed them to furnish my office. He just stared at me blankly.
It wasn’t long before I began to realize I had made a huge mistake. Three or four months went by and I was never taken off a truck. I was allowed to come in for my two days of office overtime, but I was constantly questioned about it and had to defend it. I quickly learned that getting people to agree to things by email was useful. I could print the old email and take it into the Regional Manager’s office and point out what he had agreed to. He promptly stopped answering my email.
For months I was promised a computer. It never came. So I used my own laptop. Then I was asked why I was bringing my own computer to work. I was promised a cell phone. It never came. So I purchased my own smart phone and began to use it. When I pulled it out during a meeting I was told, “Why did you get a cell phone? I told you that we would issue you one.” I told him that they had promised that four months ago, and I had given up. But the worst was yet to come.
Very early on, I was asked to apply to the state to become a training institution and create a paramedic program. This was the main reason I was hired. I started on this project right away. You can’t just create a paramedic program out of thin air. Many relationships have to exist. Schedules made, budgets approved. Lessons to be planned. Equipment to be acquired. And man did I deliver. My reputation as an educator followed me to my new job, and there was a big buzz and interest over the upcoming paramedic class. I submitted a budget, and it was approved by both the Regional Manager, and the Operations Director. I pulled the trigger and started to advertise and send out announcements.
It was a home run. In all, 32 people signed up for the course. Twenty-six would be paying customers. Eight would be employees of the company attending the course for free. The money earned was going to be more than enough to purchase quality equipment and pay over half of my first year’s salary. I was walking tall around the building, beaming with pride. My first attempt at management was a resounding success, and I accomplished everything with absolutely no resources. Who wouldn’t be impressed by that? I figured it was only a matter of time before I was taken off my truck to coordinate all of the educational offerings that were going on. At this point, we were still doing CEUs at three fire departments, so in total my department was providing over 50 hours of instruction each month and I was the only person in my department. It was obvious that I couldn’t do that and work on a truck, and do quality assurance, and write new protocols, and develop an upcoming EMT program. Right? RIGHT?
The turning point came when I ordered over $10,000 worth of books from Brady Publishing. (You’re welcome Dr. Bledsoe.) I had collected a pile of $300 checks from all the students written out to the company and took them to the Regional Manager. “Here you go,” I said as I handed him the checks along with the invoice for the books. At that point he looked at me, said “Oh crap, close the door,” and the madness began.
He explained to me that there was no way to pay for these books. I looked at him and said, “I don’t think you understand. They are paid for. See? I have $10,000 worth of checks, and I need $10,000 worth of books. You have not lost any money. Now stop jacking with me and let’s get this done.” What ensued was this bizarre conversation where he tried to explain to me that the accounting department would hate this arrangement, and that he would get in trouble for allowing this to happen. He asked why the students didn’t pay the publisher directly. I told him that since I was ordering in volume I was getting a 20% discount which I was passing along to the students. Also, students are notoriously lazy about ordering books. If I handled the order, everything was done on time, it would be cheaper, and better organized. He told me that there was no way in hell that this was happening, and that’s where I had my first knock-down drag-out with him. “Then why in the hell did you approve all this? Do you remember the meetings? Do you remember the budget I submitted? Do you remember the emails that by the way I have copies of? What in the hell is wrong with you?”
What followed was about three days of intense negotiations and phones calls. During our ridiculously unnecessary brainstorming sessions to get this resolved, it came out that I had once owned my own educational company. It was something I had started, but it never took off. However, it was still on the books and all I had to do was start a business checking account to become active again. He suggested that I do the class through my own company.
I should have just walked away. I wish I could go back in time and tell myself, “Look dummy, this is the Ghost of Christmas Future and nothing but ruin lies ahead of you on this path. Just walk away.” But I didn’t. I did the math and saw the outrageous profits that could be made from this class, and that I could start this company while getting paid by my other job. What was there to lose? Right? RIGHT? So I tore up all the checks, had a meeting with the students, and told them to please write checks to the new company. Overnight, my own education company was born.
Okay, so let’s do a recap. I was still working on a truck. I had an office with no furniture. I had no computer and no phone. I was coordinating tons of educational offerings with zero resources. And now I was starting my own company, which by the way is a tad more complicated than what it seems. It was a freaking blur of accountants and lawyers and operating agreements that had me up till 1am or 2am on a regular basis. But it all came together and the class launched on time. Now, you would think this would be a great setup, right? Well it would have been except for the rape accusation. Yep. You heard me right.
One day while I was making a PowerPoint, I got a cryptic phone call from one of our EMT’s. “Buck, something horrible has happened, please come up to the hospital.”
I arrived shortly afterwards to find one of our EMT’s in the ER claiming to have been raped by our Operations Director. Now just to keep the people in this story straight, this was the guy from Texas who got me hired. He was the guy who usually defended me from the strange interactions I had with the Regional Manager. But now the only guy who was backing me up and playing blocker from my moves had just been accused of rape. For legal reasons I am not going to discuss the outcome of any of this. All I can say is that I was in no way involved. I don’t know if he did it or he didn’t. I don’t really care, and it is for a court to decide. All I know is that he was immediately removed from his position and the cops came to clean him out of the building pretty quick.
So there I was, in an office full of garage sale furniture. I was trying so hard to do my job at this company that I actually started another company to get it done. Odd, but true. And then the weird stuff began. The Operations Director was more responsible for my loose leash more than I realized, because when he was gone from the picture, I quickly learned that the Regional Manager did not want me working there. Six months into my job I had no computer, but I was asked why I wasn’t on the email system. I was never allowed to access the run forms, but I was asked why wasn’t doing QA. I was asked to start training neighboring fire departments, and was told to stop. I was told to start a paramedic class and I was actually having trouble being released from street duty to go teach it.
It all came to a head on day during orientation class. I was asked to revamp the orientation class and expand it to include many classes required by OSHA which were simply not being covered. I called the head office, looked at the orientation classes for other divisions, designed something similar, and launched the program. Again, there was a meeting. I was given this task. I turned in a schedule. It was approved. A sane person would think this would work. Right? RIGHT?
Orientation usually lasted two days. Our new expanded program was to last for five. On the third day, the Regional Manager walked by the classroom and saw that students were still being trained. He interrupted the lesson, took the podium, and sent everyone home. He told them that there had been a mistake and that orientation was only to last two days. They were to meet with the scheduler on the way out to be immediately assigned to trucks.
That was the last straw. From that moment on I was planning my exit. I let monthly payments to the paramedic class build up for a couple of months and turned in my two weeks’ notice. I have been supporting my family with my company ever since. Well, that is until it folded recently. But that is the subject of my next post. After my company failed I was forced to find a really quick job to make ends meet. Where do you think is the easiest place to find a job in Kentucky? Yep. You guessed it. To feed my family I went back and ate shovel’s full of crow and pride and did what I needed to do to support my family. What happened during that misadventure will be detailed in the next post in this series.
But for now, I will leave you with this horrible taste in your mouth. My first EMS management job…if only I had a time machine.
I can’t wait for the next installment! This might be one of the most riveting blog posts that I’ve ever read.