As the NAEMD and Medical Priority Consultants began to engage in more assertive, if not aggressive growth and marketing strategies in the 1990’s, I grew apprehensive about actions such as the development of “model legislation” that favored their products, establishing questionable “strategic alliances” with trade groups such as NENA as well as the managed care industry, and offering consulting services that were little more than complex sales pitches. The impressive Clawson juggernaut regularly toes the fine line between a non-profit standards and training organization (now the IAED) and the for-profit Priority Dispatch Corporation.

Dr. Clawson and his group are also aggressive in identifying and addressing what they perceive as infringement on their copyrights, or misuse of the materials that they license to agencies such as LAFD. The tone of Dr. Clawson’s letter, and Dr. Eckstein’s response to it, are illustrative of their mutual backgrounds in Emergency Medicine, and the passion with which they pursue their vision of it.

I use Dr. Clawson’s protocols every day as I continue to ply my trade in the dispatch profession. I must agree with the LAFD’s assertions that some of the protocols are overkill – this word has defined my gut feelings about what the MPDS has become over the last 3 decades. I disagree with LAFD, however, that the correct application of these protocols creates inherent delays that can impact the efficacy of response where true time/life priority conditions exist. Other reporting indicates that the LAFD’s approach to the essential functions of their entire mission need to catch up with the times – perhaps this is also true of their EMS system, and the means to access it.

The latest LA Times story stated that “the agency’s medical director has said the current system is too cumbersome and contributes to delays in getting rescuers to emergency scenes”. Dr. Eckstein further asserts that “we’re not the only system that’s looking at this”. I’ve seen the evolution of the EMS system driven by knowledgeable, trained dispatchers who know how to get information and move resources in a safer fashion through the use of EMD programs.

I hope that the LAFD continues their evolution into 21st century operations with an EMD system that addresses their unique needs, but exercises caution on two fronts – the potential for a de-evolution of their entire EMS delivery program, and attracting the attention of Dr. Clawson’s lawyers, who will undoubtedly be watching closely.