Just Plain Ruff Posted June 6, 2007 Share Posted June 6, 2007 Lee, I'm worried about your future career at that service. Any service that will fire you because the people who you transport cannot pay is a service that is a craphole of a service. To put it bluntly, your service sucks on that aspect. You have no control over what patients you transport will pay or not. How can they fire you for their inability to collect from patients. What I am gathering from your posts is that (and this is an assumption) some in your service will no service or try to push a refusal on a patient who they know can't pay. Sure you can say that never happens but if your job relies on the collection rate from patients then I can see how you might be tempted(not saying "you" in particular - just generalizing You) to push a refusal on someone. this is dangerous. Plain and simple. If you wish to move to missouri, I'm sure I can help you get a job here that won't fire you because they cannot collect on patients. Link to comment Share on other sites More sharing options...
RedZone Posted June 28, 2007 Share Posted June 28, 2007 I didn't get a chance to read all the replies. I am basing this on the original scenario, with pt met at curb. I am in NYC. If the person has NO complaint, then they are not a patient. I am justified marking the call unfounded and going about my business. But if they pick up the phone and call 911 again and say, "Send me a different ambulance, that last one refused to take me!" then the dispatcher will likely send a boss who might demand written reports and request an investigation. At the very least, the boss will say, "Just transport the dude." Chances are though, Mr. Lunch Special will just make up a complaint. I'm sure some might even nitpick and argue that "I'm hungry" is a complaint. Now he's a patient. TECHNICALLY, I can call medical control and request not to transport the patient because his condition doesn't warrant it. There is still a disposition code on the books for "patient triaged out at scene." As far as I know, it's just not done anymore here. I guess I would be forced to say... "Hop on." Link to comment Share on other sites More sharing options...
KY-2393P Posted June 29, 2007 Share Posted June 29, 2007 Our policy is to stage for police before entering any unknown scene, and some of us take that to extremes sometimes. And someone pointed out that most frequent fliers know what to say to play the system, "My asthma is getting me" is what one of mine says 2 to 3 times a day. I can almost fill out his run form before we get to his house. (one day he's gonna surprise us with an actual complaint. ha) We try to get there before fire so we can cancel them. Because of liability, "you call, we haul". For some reason, they all believe they get into the ER quicker when they come in on a stretcher. Besides, it takes just as long to write a refusal as it takes to get 'em to the ER, check their vitals and talk to 'em as you ride. -NOTE- MY PERSONAL OPINION - IT COSTS YOU ABSOLUTELY NOTHING TO BE NICE TO THESE PEOPLE FOR 30 MINUTES OF YOUR DAY!!! MOST PEOPLE HAVE A NEED TO BE CATERED TO BY SOMEONE, AND THESE HAVE CHOSEN YOU AND THE ER STAFF TO BE THEIR VALIDATION FOR LIVING. SMILE, BE POLITE, AND GET ON WITH IT. Please excuse my "yelling", and thanks to all of you guys/gals for being out there. Link to comment Share on other sites More sharing options...
Dustdevil Posted June 29, 2007 Share Posted June 29, 2007 Our policy is to stage for police before entering any unknown scene, and some of us take that to extremes sometimes. No doubt. Can you better define for us what you mean by "unknown scene?" Do you mean a run that is dispatched as an "unknown medical emergency" or "unknown situation?" Or do you mean any run, no matter how it was dispatched, that you feel unsure about the safety of? Or something entirely different maybe? You're right; without definition, these things can be taken to extremes. Besides, it takes just as long to write a refusal as it takes to get 'em to the ER, check their vitals and talk to 'em as you ride. Exactly. I agree. Get on with it. Link to comment Share on other sites More sharing options...
KY-2393P Posted June 29, 2007 Share Posted June 29, 2007 911 hangups, any assault/GSW type scenes, any and all drug/ETOH type calls, and man-downs, (though we will go on in and wake up the sleepers, citizens just won't let the homeless sleep in). I have waited over 20 minutes for the PD to even be dispatched because we usually stage a block or so away, then wait for them to "clear" the scene. Stay safe... Link to comment Share on other sites More sharing options...
RomeViking09 Posted September 10, 2007 Share Posted September 10, 2007 Per state law I would transport (all 911s get transport in GA) but I would call the Police and I have a gut feeling he would be brought up on charges for abuse of the 911 System Link to comment Share on other sites More sharing options...
spenac Posted September 11, 2007 Author Share Posted September 11, 2007 Per state law I would transport (all 911s get transport in GA) but I would call the Police and I have a gut feeling he would be brought up on charges for abuse of the 911 System That bites. While we do transport most callers that request it, it is nice to be able to say no to the lunch trip, stubbed toe, one sneeze last week, etc. Link to comment Share on other sites More sharing options...
spenac Posted October 22, 2008 Author Share Posted October 22, 2008 Are there actually state laws that say you must transport all callers even when they really do not need the ambulance? Proof please. I sure like telling patients no when they can safely go private car to ER or their own doctor. Link to comment Share on other sites More sharing options...
RomeViking09 Posted October 22, 2008 Share Posted October 22, 2008 "The patient shall be transported by the ambulance service to the hospital of his/her choice providing that the hospital chosen is within reasonable distance of the patient's location and is capable of meeting the patient's immediate needs. The ambulance service medical director will establish a reasonable distances for rendition of prehospital emergency care for each ambulance service. In the event of exigent circumstances on-line medical control may override the established reasonable distances. If the patient's choice of hospital is not within a reasonable distance, medical control will determine the closest hospital capable of meeting the patient's immediate needs. If the patient's choice of hospital is within a reasonable distance but medical control (or the medic, if the medic is unable to communicate with medical control) determines that 1) the patient's condition is too critical to risk excessive time necessary to reach the hospital chosen and a nearer hospital is capable of meeting the patient's immediate needs, or 2) the hospital chosen is unable to meet the patient's immediate needs, or 3) the hospital chosen by the patient has notified the medic that it is unable to receive the patient, THEN medical control and/or the medic should make a reasonable effort to convince the patient that a hospital other than the one chosen is more capable of meeting the patient's immediate needs. If the patient continues to insist on being transported to the hospital he/she has chosen then the patient shall be transported to that hospital. If the patient does not, cannot, or will not express a choice of hospitals, the ambulance service shall transport the patient to the nearest hospital bel ieved capable of meeting the patient's immediate medical needs without regard to other factors, (e.g., patient's ability to pay, hospital charges, county or city limits, etc.). Reference: DHR Public Health Rule 290 -5-30-.05(8)(k) Destination of Prehospita l Patients." GA Statewide Prehopspital Care Protocols 2007 In short, you must take them if they want to go and where they want to go if it is "within reasonable distance of the patient's location and is capable of meeting the patient's immediate needs." Link to comment Share on other sites More sharing options...
spenac Posted October 22, 2008 Author Share Posted October 22, 2008 In short, you must take them if they want to go and where they want to go if it is "within reasonable distance of the patient's location and is capable of meeting the patient's immediate needs." Actually those comments only deal with patients choice of hospital to be transported to. It does not say all callers must be transported. Not trying to argue just saying. I really want to see a law that says you must transport all callers whether they have a true emergency or not. Link to comment Share on other sites More sharing options...
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