So, after a long weekend, I am wondering to myself about how your EMS service is utilized. Are you primarily a 911 transport service, do you do interfacility transports the majority of the time, or do you do a smattering of both? We do quite a few of both here in rural Iowa. Transport times to one of the local facilities runs about 20 minutes either way. The closest trauma facility is about 45 minutes or so and the closest 24/7 cath lab runs about that far too.
How often do you deal with people misusing your ambulance service? It appears, after reading many articles in both JEMS and online at emsworld.com that this is becoming a growing problem. Obviously this has been a common occurrence for many for some time, but my question is this: How has it changed in the past year? It seems as though in the local communities that it has become worse. People appear to not be concerned about a) the amount of money EMS transport truly costs, and b) the fact that it takes away resources. So the age old question then becomes; “What do we do about it?”
In my experience over the past few years working in EMS in general, nothing will change unless we start contemplating how we are going to rectify the situation. Some services have taken things to the point of charging a fee to respond to a frequent offender’s home, while others contact medical control to get the ok for a treat and release. That last bit opens up a whole new can of worms, especially when you are dealing with someone that has legit underlying medical issues. How do you decipher what is real from what isn’t in terms of patient complaint? We’ve all had those calls where someone is complaining of chest pain or abdominal pain, and they are able to sit and answer all of your questions without appearing to be in any acute distress. And this is the 3rd time they’ve called you today. How do you justify the transport when the patient tells you that they aren’t having chest pain “really”, but they want some antibiotics to help with the sinus infection they’ve been dealing with, and they knew that by calling the ambulance, they would get into the ER faster and be seen quicker. With no regard to how they will be getting home (a real issue when the hospital is in another town in many cases here in Iowa) or that they have taken an ambulance out of service for basically a cab ride, while someone else has to wait 15 minutes for another service to come from another town to respond for their emergency. How do you take care of these people with compassion and concern, like we are called to do every day, without becoming jaded?
Something to ponder…
(a reminder that all situations expressed on this blog are fictional and are in no way a call to specific incidents experience by this provider.)