Thursday, February 5, 2009

EMS is getting busier and busier.

The problem:

EMS systems are being overrun by frequent flyers, people with non-emergent complaints, and prank calls. The reporters in the above video suggest that cities adopt a system where non-emergent calls are offered transportation to other services or doctors. I do not think this system will work for two main reasons:

1 The frequent flyers will figure out how to game the system, and will claim to have a life threatening complaint so they can get to the ER, the the reduction in ER runs will be minimal.

2 The first time a patient dies because an emergent patient was sent a cab instead of an ambulance, there will be a huge lawsuit.

The problem is that with our current legal system, there is no way for any ER or EMS system to refuse service to anyone without legal repercussions, and there will always be people who take advantage of the system. There is one patient that I see frequently, let's call her Jenny, that I have run on as many as 5 times on a single day. Other patients are just as bad. There are 10 patients in my area who are alone responsible for nearly 5% of our call load. That's right- 10 people are being run on over 1,000 times a year. Add in the 10 nursing homes that give us another 5,000 calls a year, and you see that 30% of our time is being used up by a very small minority.

I would say that less than 15% of our runs are true medical emergencies. Our collection rates run at about 40%, with most of those being Medicaid and Medicare. Some of our most ardent frequent flyers are carriers of the Medicaid 'gold card' and call us because they know they can do so without having to worry about paying.

Our medical system is only going to deteriorate as more and more people realize that today's house calls are made by Paramedics, and help is just a phone call away. What is the solution? I have no idea, but I do know that the nation's EMS systems are only going to get busier. At least that gives me job security.

No comments: