October 24, 2007: Frequently Asked Questions
We have provided below the responses to questions we are asked frequently by town selectmen and residents concerning the capabilities and performance of McGregor.
- How many calls did McGregor respond to in 2006?
- How many EMTs do you have?
- How many ambulances do you operate?
- I like the idea of a volunteer organization, but I have a few questions:
- I've heard that for most major problems, it's important to have a paramedic:
- Are your volunteer paramedics and EMTs highly skilled?
- How do your volunteer paramedics and EMTs maintain their skills? How do they compare to other paramedics?
- All of this sounds expensive. I thought one of the benefits of a volunteer organization was low cost?
- I live in Lee (or Madbury or Durham). Don't we need to have our own EMS agency and ambulance?
- I thought our fire department also has EMTs. What role do they play?
- How long has McGregor been providing service to the community?
- What do your "customers" (i.e. Town residents) say about your services?
- Is McGregor entirely volunteer? I thought you had a few paid EMTs?
- I understand some of your EMTs are UNH students. Are brand new EMTs taking care of my family?
- What other benefits does McGregor provide to our community?
-
How many calls did McGregor respond to in 2006?
1257 Total (500 in Durham, 359 at UNH, 247 in Lee, 71 in Madbury and 79 to other towns). We foresee an increase of approx. 5% per year in call volume, although there have been signs that the rate of increase is accelerating.
How many EMTs do you have?
We have over 50 active volunteer members. Nearly half are advanced life support (ALS) providers, including Paramedics and EMT-Intermediates.
How many ambulances do you operate?
We have two Advanced Life Support ambulances available 24 hours a day, 7 days a week. A third, older reserve ambulance is maintained for special events and ambulance maintenance.
- I like the idea of a volunteer organization, but I have a few questions:
If you have to rely on volunteers, are your ambulances really "available" 24 x 7?
We have an enviable record of 99% availability. This compares well with the best services in the state. For the rare times when we are unavailable, Dover and other towns are ready with an ambulance.
How long does it take the ambulance to begin responding when there is a call?
1 minute 45 seconds is the average time until an ambulance rolls out the door (at night and on weekends, the average time is approx. 2:20). Again, these times compare favorably with the best in the state.
How long does it take the ambulance to get to the scene of the emergency?
6 minutes 20 seconds is the average time until an ambulance arrives on scene (from when we are first notified) (in Durham/UNH, the average time is approx. 5 min.). This is among the fastest ambulance response times in the state, including both paid and volunteer services. Not surprisingly, this time is mostly affected by how far we have to travel.
Our EMTs live in the communities they serve; often one of our EMTs, outfitted with life-saving equipment, arrives and begins care prior to the arrival of an ambulance or fire department vehicle.
- I've heard that for most major problems, it's important to have a paramedic:
Does McGregor have paramedics?
McGregor has 7 active paramedics.
This allows us to make available a paramedic virtually every time one is required (98% availability). Indeed, we are often able to deliver two paramedics for major calls (e.g. cardiac arrest) or when two calls occur at the same time.Locally, over 50% of ambulance transports require a paramedic. In part, this is because only a paramedic can perform the vast majority of advanced procedures and medications.
Paramedics are only one component of a successful EMS response. Other essential components include a first responder (usually not a paramedic) who arrives on scene rapidly and provides stabilization, as well as other EMTs who are part of the ambulance crew. McGregor has 15 EMT Intermediates. EMT Intermediates can also perform certain advanced life support procedures, but have a more limited scope of practice than Paramedics.
Are there other paramedics available locally?
Unfortunately, the local availability of paramedics is limited. While the local fire departments have excellent advanced life support providers, they have very few paramedics and, unlike hospitals in other areas, Wentworth-Douglass Hospital does not offer paramedic service.
Durham Fire Dept. has 5 paramedics, but only one on duty at any given time; Madbury Fire Dept. and Lee Fire & Rescue do not have providers operating at the paramedic level. Although there are other, more distant agencies that have paramedics, they are farther away and have little excess capacity to serve our communities.
Are your volunteer paramedics and EMTs highly skilled?
Many of our senior "volunteers" are seasoned emergency medical professionals who work (or recently worked) for some of the most highly-regarded EMS agencies and Emergency Rooms in the area, including:
- Frisbie Hospital EMS
- Exeter Hospital ALS Intercept Services
- Wentworth Douglass Hospital Emergency Dept.
- Greater Lowell Paramedic Intercept
- Exeter Hospital Emergency Dept.
- Portsmouth Hospital Emergency Dept.
- UNH EMT Instructor
Our paramedics have participated in over 1777 McGregor calls (on average), and often hundreds or thousands of calls with other services.
How do your volunteer paramedics and EMTs maintain their skills? How do they compare to other paramedics?
To remain highly-skilled, paramedics and EMTs must do two things: (i) perform a high volume of skills, and (ii) attend continuing medical education.
Four factors ensure that our providers remain highly-skilled:
- We cover four communities rather than just one, yielding a high volume of calls (e.g. 1257).
- Many of our senior providers work for multiple medical services.
- Our continuing education efforts are dedicated to improving our medical skills; we do not divide our attention by focusing on other emergency disciplines.
- Our providers often pursue advanced-level courses beyond the minimum requirement. For example, while all paramedics are required to be certified in ACLS (Advanced Cardiac Life Support), several of our providers are certified at the ACLS-Experienced Provider level and two of our paramedics are ACLS Instructors.
All of this sounds expensive. I thought one of the benefits of a volunteer organization was low cost?
High-quality EMS is not cheap. Nonetheless, McGregor is extremely cost effective for several reasons:
- Cost to Taxpayers is Low- Most of the cost is paid by insurance companies.
The communities collectively pay less than 20% of the cost. - Four communities share the cost, keeping the cost reasonable for all.
This point is key, as the costs for two ambulances are the same whether covering one community or four. - Private donations fund a portion of our capital costs.
- Volunteer Organizations are Inherently Cost Effective
- Thousands of free volunteer hours annually.
- No dedicated administrative staff.
- Overhead is exceptionally low
McGregor Total Cost (2007)
$88,000 McGregor Costs (in excess of EMS revenue)
Durham $37,245 UNH $25,820 Lee $20,032 Madbury $5,103Full-Time Paid Cost Model
$675,000 Annual Operational Cost: Full-Time Paid (in excess of EMS revenue)- This would be the cost of having a full-time paid service (for two ambulances).
- Volunteers thus save the communities over $590,000 per year. Capital costs excluded.
McGregor is careful with your tax dollars. Over the last twenty-years, McGregor has never asked the communities for additional appropriations.
- Most of the cost is paid by insurance companies.
I live in Lee (or Madbury or Durham). Don't we need to have our own EMS agency and ambulance?
We ARE your hometown ambulance service. Our volunteers are residents of Durham, Lee, and Madbury and students at UNH. We are an independent, not-for-profit organization and we serve all of our communities equally. While we have historically been known as "Durham Ambulance Corps," we are not an agency of the Town of Durham and we are not part of the Durham Fire Department.
Working together, Durham, UNH, Lee and Madbury have built a first-class EMS system that is extremely cost-effective. This system—in which a local first responder service (your fire department) is coupled with a separate "regional" agency (McGregor) providing primary EMS transport and treatment—is the prevalent model used across the United States. Standing alone, without a significant increase in cost, it would be very difficult for any of the communities to operate a high-quality, paramedic-level EMS transport system.
I thought our fire department also has EMTs? What role do they play?
McGregor and your fire department are both integral parts of your town's EMS solution. While we work closely together to provide care to the patient, the roles we play are quite distinct.
McGregor's primary role is providing medical care prior to and during transport to the hospital. Our ambulances are outfitted with the latest advanced life support equipment. For many life threatening emergencies--including cardiac arrest, lethal heart rhythms, severe breathing emergencies, severe allergic reactions, and seizures—we can "bring the ER to you," performing many of the procedures that would be performed in the hospital emergency room.
Your local fire department performs several roles at EMS calls. The primary roles of the fire department at major EMS scenes include responsibility for safety, fire, rescue and hazardous materials issues. For example, at a car accident, the fire department may be engaged in extricating the patient from the wreckage, addressing fire and explosion hazards, and performing traffic control. In addition, firefighters that have been cross-trained as EMTs provide outstanding EMS first responder care.
-
How long has McGregor been providing service to the community?
McGregor was founded in 1968 in memory of "Doc" McGregor, who sought to improve EMS in Durham and surrounding communities. New Hampshire towns have historically enjoyed a strong ethic of community service. Our volunteer fire and EMS organizations are a fundamental part of the "core fiber" that helps preserve and maintain our central character. McGregor Memorial Ambulance, with nearly four decades of volunteer service to the community, exemplifies this ethic.
What do your "customers" (i.e. Town residents) say about your services?
Here's what our customers had to say in written survey responses:
- "When the ambulance arrived they were professional but more importantly compassionate and explained every move they had to make. They made me feel safe when they moved me. Each and everyone who was there talked to me and calmed me with their concern. I can't say enough for the care I received. God bless you all." McGregor Patient, January 2005, Lee NH
What recent patients said about the quality of their care:
99+% Strongly Agree or Agree that the crew was "skillful and competent."- "[S]uch competent volunteers"
- "All who responded did an excellent job of caring for me..."
- "I suggest a ride in a simulated injury situation for every one of [the town's leaders] to experience the excellence of care."
- "Always excellent"
- "Very professional, competent, and compassionate (ambulance crew)."
- "Excellent job."
- "I felt completely comfortable that I was being treated by professionals."
- "I feel honored to have been in your care.... I was very impressed by the expertise."
What recent patients said about our attitude and compassion:
99+% Strongly Agree or Agree that the crew was "polite and compassionate."- "Thank you to the ambulance crew! I have always heard good things about you, and now I know they are true."
- "Crew was professional, competent, very kind and caring."
- "[A]bsolutely wonderful working as a caring, and wonderful team...."
- "I would recommend the care from them again...."
- "I really feel safe having them close to us knowing that they really care."
- "Their response and concern was exemplary!"
Click here for more Patient Experiences.
-
Is McGregor entirely volunteer? I thought you had a few paid EMTs?
We have two paid EMTs on-duty from Monday through Friday 7a to 7p. They are all Paramedics or Intermediates. Note that, although they are not required to do so, all of the paid folks also volunteer when off-duty.
They respond to EMS calls (when volunteers are unavailable). In addition, they perform double-duty, performing administrative tasks, maintaining the operational readiness of the ambulances and providing training. Like most non-profit organizations, McGregor requires a small number of employees to facilitate the work of the volunteers.
We have NO paid receptionist or administrative assistant.
Our executive officers are all volunteer.
Most administrative tasks are performed by volunteers (e.g. our secretary is a volunteer).
I understand some of your EMTs are UNH students. Are brand new EMTs taking care of my family?
Patient care is always in the hands of one of our senior "crew chief" EMTs. McGregor crew chiefs have, on average, participated in over 1000 McGregor calls and have years of experience. In addition, they must have completed over a year of rigorous training and passed a "crew chief" promotional examination.
McGregor ambulance crews meet standards that far exceed the state minimum requirements for ambulance crews, and, to our knowledge, are as rigorous as any in the state.
Bear in mind that even a new EMT must have completed a state-certified course, passed a national written and practical examination and be licensed by the State of New Hampshire. Even with these qualifications, however, a new EMT cannot qualify as even a junior McGregor crew member without performing additional McGregor training and passing a McGregor written and practical examination. It would thus be impossible for any new McGregor EMT to be in charge of patient care.
We are proud of our student EMTs, which today comprise approx. 30% of our volunteers.
-
What other benefits does McGregor provide to our community?
- Experienced Board of Advisors Provides Long Term Stability and Planning
- Positive Relationship between University, UNH Students and Towns
- Preparedness for Large Scale / Mass Casualty Incidents
- Core Feeder Organization for EMS, Hospital and Fire Organizations in the Seacoast
- Low Cost Public CPR, First Aid & Defibrillator Education
Experienced Board of Advisors Provides Long Term Stability and Planning
Our strong Board of Advisors includes experienced business people, residents and medical professionals who provide long term stability and strategic planning to McGregor. The current outside members are:
- Richard Houghton (businessman and Madbury Town Moderator)
- William Cote (former Durham Fire Dept. Captain / Deputy Chief and public safety expert with Primex)
- Kathryn Lynch (Advanced Cardiac Life Support AHA National Faculty and former UNH Professor of Nursing)
- Arthur P. Boutin, III (former McGregor President and EMT-I)
- Dana Smith (McGregor member, Secondary, firefighter)
Positive Relationship Between the University, University Students and Towns
Every day, the commitment of our student volunteers enhances the positive image of UNH and its students. Moreover, it is one of the key ways in which the University gives back to the surrounding communities. McGregor provides initial medical training for scores of UNH students who have gone on to become doctors, nurses and other healthcare professionals.
UNH offers EMT-Basic and EMT-Intermediate courses to students and New Hampshire residents. These courses act as a crucial "feeder" for new McGregor volunteers. Many of the instructors for these courses are also McGregor members.
Preparedness for Large Scale / Mass Casualty Incidents
In today's environment, prudence requires that we be prepared in the event that a large scale incident—whether accidental or deliberate—occurs at any of the large sports, entertainment, educational or transportation venues located in our communities. With our large group of medical volunteers, we can rapidly deploy the EMS personnel required to begin treating the ill and injured. A large, dedicated EMS capability frees our dedicated firefighters to focus on the fire, rescue and haz mat aspects of such an incident.
Core Feeder Organization for Seacoast EMS, Fire and Hospital Organizations
With its unique focus on training and continuing education, hundreds of McGregor’s members have gone on to careers as EMTs, doctors, nurses, firefighters and police officers in the Seacoast area and beyond. McGregor alumni include:
- Dr. Lukas Kolm, EMS Medical Director and ER Doctor at WDH
- Dr. Joseph Mastromarino, EMS Medical Director and ER Doctor at Exeter Hospital
- Dr. Dave Heller, ER Doctor at Portsmouth Hospital
McGregor maintains one of the most active EMS training programs in the State of NH. We provide training to our own members and help coordinate training for other EMS providers in the Seacoast area.
- extensive weekly and monthly training in-house
- one of the top EMS educators in NH is a member
- key sponsor of EMT education in the Seacoast
- EMT Refreshers
- EMT Basic
- EMT Intermediate
- Emergency Vehicle Operations
- Pre-hospital Trauma Life Support
McGregor Provides Public CPR, First Aid and Defibrillator Instruction
Studies show that teaching CPR citizens and teachers saves lives!- Public outreach and education is a key component of McGregor's service to the community.
- McGregor offers frequent CPR, first aid and defibrillator classes in the community and in Oyster River schools
- McGregor has approx. 15 AHA Certified CPR Instructors.
