As cities undergo the transformation and gentrification you will see a change in run volume and the continued battle of runs versus work. Medical calls in many areas are wearing out personnel and equipment. In the southern part of the US, we are still seeing PD's and Garden Style Apartments as the source of work. Real estate is still hot here but people are still people and will continue to be the source of Job security for the fire service.
We have seen the addition of a pickup truck or SUV staffed with 1-2 FF's that respond as an independent unit to medical calls to relieve the wear and tear on the Engines and Trucks. We have them in our city and county departments and I know that Nashville will be adding them at certain companies where the run volume warrants.
"CFDMarshal", Rev., you are CORRECT.
They did a survey here where I live in CT., and one of the things they recommended was to get a pickup truck or SUV with two FF/EMTs to handle most of the medical calls, rather than an engine (or a Truck) when needed.
So far it hasn't been done, but I can see it happening.
Also, you and I were on this web sites last zoom meeting when we heard about buying new apparatus that could take up to 48-60 months.
Plus the very high price tag
As was mentioned also was trying to get parts for some apparatus even 8 years old or so, might be impossible to get.
Or if you can it, the huge cost factor.
I think for many places - changes are coming related to the fire service on a nationwide basis.