Taxi um... ambulance driver or Professional

[spenac]

Thanks for the link. Abuse will continue as long as we are not allowed to say no to the guy that just wants lunch at the hospital. The you call we haul attitude is destroying EMS as much if not more so than the uneducated people coming into our profession. Perhaps if we didn't burn everybody out that is worth a darn by hauling all callers things could be improved.

[AnthonyM83]

In fact, I have seen some sharp paramedics become medical control and become sh*tty at it. Restricitng medications and procedures, that they as medics would had fought for. The reason, now the risks is on their license.

Wouldn't that translate to not wanting to risk harm to patients? Even though in their mind, they're hesitant for fear of risking their license, they have the fear because there's a chance something might go wrong...so in essence it's protecting the patient more?

It just reminds me of how EMTs want more meds until they become medics....

[renelsonnremtp]

If you cant use good judgement and make decisions based on YOUR assessment then you are not doing your job at any level of EMS. The fact that we transport every patient regardless of need has more to do with revenue generation that medical nessesity. Whether you are county, city, hospital, or private, patients need to be hauled to produce revenue to pay your wages.

BOTTOM LINE!

[spenac]

If you cant use good judgement and make decisions based on YOUR assessment then you are not doing your job at any level of EMS. The fact that we transport every patient regardless of need has more to do with revenue generation that medical nessesity. Whether you are county, city, hospital, or private, patients need to be hauled to produce revenue to pay your wages.

BOTTOM LINE!

That is a joke, that is one of the great unsupported EMS lies we all seem to love to quote. Most patients do not pay. If they do not need an ambulance medicaid, medicare, insurance do not pay unless you are committing fraud.

Sorry we need to educate the public by denying transport when it is not needed.

[mstovall]

I am frustrated by some of the misuse of our service, but in the end it is us training the individuals that they can misuse the system. We had a regular drunk who would be transported across town from wherever he ended up to the ER on a 2-3 times a week cycle. Then he would refuse treatment in the ER and walk the half-block to his house. He was on disability and was utilizing us as his private taxi. This stopped when a newer medic to our service called LE to have the guy arrested and pressed charges for false reporting of an emergency. The guy was jailed on a misdemeanor. Another tactic we use is triage. Many people were using us to jump the line of the ER. Once they realized they would go to triage anyway, we reduced our run volume on other calls.

My only suggestion is to do a thorough assessment if you are going to refuse transport. Too many times we are so frustrated by being called out 3 times in one night by a transport Tom that we don't adequately assess the individual. True professionalism is defined when you give the person the same level of treatment when you know it is BS to rule out any possibility of a health issue instead of just dismissing something cause of who it is.

One final thought;

At least most of your services are right beside the main taxi cab service in your town.

Yellow Ambulance

Yellow Taxi Cab

I already see the eyes rolling as you feel my pain.

[Richard B the EMT]

I will presume your "Transport Tom" is also known as my "Frequent Flyer".

[ERDoc]

Look at it from a medical director's point of view. You are relying on a large number of people (most of whom you have never met) that are working under your medical license to be able to judge what is and is not an emergency. With the system the way it is now, you will not see that happen very soon. Think of some of the people you work with and decide if you would trust them with your license. I think a more likely approach is to allow the crews to call medical control and get permission to refuse transport.

[irme]

You are never going to get rid of the frequent flyers, they are here to stay. They quickly learn an appropriate way to get/demand your attention; what symptoms they need to complain of and how to tug at your emotional strings.

As for your average Joe public there are those that listen! What if instead of telling them they get no ride you put it foward as an idea... For instance I ask how the family member is planning on getting to hospital, they usually say follow behind in the car. Now a perfect opportunity to put foward the idea they don't really need to be transported by ambulance.

I have always found the key to this is to make them think they have done the right thing in calling us but now the appropriate transport method would be by car. Of course you are always going to have those pt's who refuse and want to go by ambulance but at least you are going some way in reducing maybe a quater to half of the bull that doesn't need an ambulance!

[spenac]

I AM HEARBY STARTING A NEW CAMPAIGN " JUST SAY NO ". Now that will solve more problems than anything else.

[CBEMT]

Think of some of the people you work with and decide if you would trust them with your license. I think a more likely approach is to allow the crews to call medical control and get permission to refuse transport.

I think I'd rather a service medical director be allowed to make policies based on his relationship with myself and my co-workers than having to roll the dice with some resident who doesn't know me on the other end of a phone while he's trying to do 46 other things.