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Flu Shots in the Firehouse

How to Survive Our Doctor Shortage

Welcome to The Laboratory, an occastional New Republic series where we celebrate policy solutions that should be getting far more attention than they've gotten so far.

We imagine firefighters charging into burning buildings, not swabbing for strep throat. But we're going to have to expand our thinking. With the country growing older and 30 million more people getting health insurance from Obamacare, we're facing a severe shortfall of primary care providers. At the same time, fire incidence in the United States has been at historic lows, thanks to improved prevention. Firefighters—most of whom have basic medical training—already respond to more calls for health emergencies than for fires, anyway. So let's turn firehouses into walk-in medical clinics.

In fact, it's already happening. During the H1N1 scare, firefighters in Alameda County, California, provided immunizations, helping to make sure the low-income, uninsured people living in and around Oakland were protected from the disease. It worked out so well that Alex Briscoe, the director of the county's health care services agency, has proposed creating firehouse clinics staffed full time by rescue workers and outside health professionals. The clinics would serve as "portals" to the county health system, introducing residents with chronic disease like diabetes, asthma, and hypertension to the facilities and services they need to keep them from getting sicker. The plan awaits final approval, but a similar program has been underway in Colorado Springs, Colorado, for about a year. Officials there hope that, by providing basic care and promoting prevention, the fire department might actually reduce the volume of 911 calls–particularly from severely ill people who end up in emergency rooms several times a month. Not a bad play in an age of austerity.