Chilmark hires ambulance chief; hospital ER head has concerns
Over the strong objections of Dr. Jeffrey Zack, Martha's Vineyard Hospital director of emergency services, but with strong support from ambulance leaders, Chilmark selectmen Tuesday voted unanimously to appoint Paul "Zeke" Wilkins to be the new chief of the Tri-Town Ambulance service.
Prior to the vote, Dr. Zack told selectmen he does not think Mr. Wilkins has the necessary qualifications for the job. "Personally I question the logic of hiring someone who cannot completely fulfill the requirements of the position that was laid out," he told town leaders. "However if it is your intention to move forward, I will work diligently with Mr. Wilkins in an attempt to create an ambulance service that will provide the safest and most effective care to your constituents."
But ambulance leaders that included Chilmark police chief Brian Cioffi pointed to the stable leadership Mr. Wilkins had provided to a fractured organization.
Tri-town ambulance provides coverage for the towns of Chilmark, West Tisbury and Aquinnah, which share the costs of the mostly volunteer service equally.
Mr. Wilkins has served as interim chief since February, following the unexpected departure of former chief Robert Bellinger, who stepped down in December after only seven months on the job. A longtime EMT, Mr. Wilkins completed his training to become a paramedic last year.
The Tri-Town ambulance committee conducted an extensive search to find a permanent replacement for Mr. Bellinger. After one of two finalists selected for the position withdrew his name at the 11th hour, the committee voted to recommend Mr. Wilkins be appointed the new permanent chief.
Because the town of Chilmark handles the finances for the ambulance service, the board of selectmen are responsible for personnel decisions. The vote Tuesday was to endorse the ambulance committee's recommendation.
As head of the hospital emergency room, Dr. Zack is on the front lines of emergency care and works closely with Island EMTs. He is also the architect of a plan unveiled in December (Feb. 9, "Hospital moves to cure ER ills") designed to improve emergency room service and capabilities.
Tuesday night, Dr. Zack expressed strong reservations about the choice of Mr. Wilkins. "In the weeks since the Tri-Town ambulance committee nominated him for the full-time position I had time to ponder whether I agree or not with that decision," he told selectmen. "I do not."
Dr. Zack said he didn't feel Mr. Wilkins was qualified to oversee quality assurances and provide training to other ambulance staff. "While Mr. Wilkins may meet the needs of the position from an administrative and morale standpoint, he is not qualified for the role that is more sorely needed on this service; and that is quality assurance and training," he said.
Dr. Zack said Mr. Wilkins could receive the necessary training, but it would come at a financial cost
"This is not to say the situation is untenable, nor would I say I am not willing to work with Mr. Wilkins to develop a system to satisfy my needs from a quality and safety standpoint. Understand, however, that arrangement will come with a financial price," he said.
Chairman Frank Fenner said the plan was to have the deputy chief of the ambulance handle much of the training and quality assurance protocols, but that plan was jeopardized when the Aquinnah selectmen decided to cut their assessment for Tri-Town by approximately $26,000.
Despite questions about training resources, Mr. Fenner said he fully supported the appointment. "The ambulance staff has gone on far too long without having stable leadership, we really need to advance here in some way," he said.
Selectman Warren Doty said the board was compelled to follow the ambulance committee's recommendation. "I think in many ways that this development in just the last two minutes puts this board in an awkward position, because we are not the board of directors of Tri-Town," he said.
"We are here as a financial vehicle for the Tri-Town ambulance … we don't make policy for the ambulance," he added. "So suddenly saying we have an appointment and now there is a question about that appointment, that's not really for this board to decide."
Chilmark police chief Brian Cioffi, also a member of the ambulance committee, said he shared some of Dr. Zack's reservations about the appointment at first. But after some thought, he said he came to the conclusion that hiring Mr. Wilkins was the right decision.
"The way I look at it we have a fractured ambulance service that hasn't functioned very well for an extended period of time. I look at February until now and say the ambulance service has started to come full circle. We passed our state inspection, morale is up, and my phone isn't ringing," he said.
Mr. Cioffi also said time was of the essence. He said if no action was taken, Tri-town would need to look at entering into contracts with other municipalities, or begin another search in the midst of the summer.
"He may not meet the criteria that the hospital emergency director is looking for. But that is just one part of the total picture. The reality is the service has come around … the momentum is still there, and the ship is still sailing forward as opposed to being pushed back like it has been," he said.
Mr. Wilkins said he was willing to do whatever it takes to meet quality assurances, including working closely with Dr. Zack. "We already have a system in place where we have some off-Island people coming to do some education. So whatever Dr. Zack wants us to do I am 100 percent willing," he said.
Mr. Wilkins had high praise for Dr. Zack.
"He has actually done a lot for this service, much more than any other director of emergency services we've had before. He is on top of it; he understands what it is like to be up here, and what it takes to respond. Because we are the furthest towns away from the hospital … we need to be the best we can," Mr. Wilkins said.
Dr. Zack offered a final thought.
"I don't want to be the negative nanny in the group, and this is not about throwing [Mr. Wilkins] under the bus … he has done a great job, I have no argument with that … but my goal is to have the Tri-Town ambulance service be better than other towns, because they have to," he said.
"Medicine is about practice. The less you do, the weaker your skills get and you have to compensate that with better training … you have a great young group that are going to be stellar meds, but they have some learning to do, and that needs to be done under certain guidelines."
Bret Stearns, a longtime volunteer member of the ambulance squad and director of the Wampanoag Natural Resources Department, closed the discussion on an upbeat note.
"I have been very happy with him as leader of Tri-Town, which as you know can be very difficult because of the volunteers, but I think he has done an exceptional job. We are at the point we need to commit to an investment, and I think [Mr. Wilkins] is a solid long-term investment," he said.
After selectmen unanimously voted to appoint Mr. Wilkins, the audience burst into applause.
June 9, correction:
This story has been corrected from the print version to reflect that only one of two finalists was offered the job.