The medical director of D.C.’s fire department resigned in a scathing letter to Mayor Muriel Bowser, charging that “people are dying needlessly” in “a highly toxic” culture where reform is impossible.
Poor response times plague the District fire department. Bowser hired Dr. Jullette Saussy seven months ago for the specific purpose of reforming the department. Confirmed in November and named EMS Medical Director and Assistant Fire Chief, Saussy is already fed up with the D.C. system. In her resignation letter to the Mayor dated January 29 she rips the culture of a department that she argues values bureaucratic structure over meaningful medical reforms, reports WTOP.
“The culture of the DC Fire and EMS Department is highly toxic to the delivery of any semblance of quality pre-hospital patient care,” Saussy writes in her letter. “EMS reform, even attempts to make basic changes, are met with resistance from the top down.”
Saussy accuses the fire department of fostering a “feel good” environment which relies on manipulated or incomplete data that serves as their measure of performance. She says it creates a false reality within the department, where people are not properly overseen and issues fail to ever be addressed.
“You cannot fix what you do not measure honestly and this is one main reason the system continues to fail the people we are here to serve,” Saussy said. “A lack of accountability at all levels has created a workforce that is undisciplined and unchecked. Major infractions result in virtually no discipline and the ‘practice of medicine’ is ‘overseen’ by people with no authority, no medical expertise or teeth to drive change.”
The poor deployment of resources by the D.C. fire department draws criticism every year. In 2013 the department operated with roughly half the number of paramedics as fire departments with similar call volumes around the country, reports WUSA9.
Paramedic competency is another major issue plaguing the department and a key point of frustration in Saussy’s resignation. The National Registry of Emergency Medical Technicians and the District Department of Health asked her for “skill competency” reports on the 700 medics employed by the department. She notes that this requires her to personally attest to their abilities, possibly putting her medical license at risk.
“In an attempt to hold this system accountable, lawyers have sued the last several medical directors over the providers’ lack of competency, lack of training and poor medical decision-making,” writes Saussy. “Not only can I not verify competency, there is no valid indication that they have received any form of real training or continuing education.”
When Saussy started at the fire department she immediately saw how changes in their deployment could boost production and save lives that were being lost by a slow moving system. Saussy cites the example of a 35 year old man who died in a late January stabbing. She argues the wounds could have been managed and a life may have been saved had the response time not taken over 18 minutes. After numerous attempts at change and being told she was at the department for medical purposes, not policy, she feels she can no longer morally stand with the district fire department.
“When I see something that can make a difference between life and death, and yet it is ignored, I must distance myself from that system,” Saussy said in her resignation. “Complicity kills and I will not be a party to that behavior.”
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