Buffing Calls @ Private NYC Ambulances

adamNYC

adamNYC

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Anyone here buff calls while working at a private NYC ambulance? I'm curious because I've heard rumours about guys who are doing it at more than one private company. I would like to know about your experiences, if its worth doing, what the risks are, etc. Me personally I know I am SAFEST doing it at my Volly. At a private service where one is expected to be doing dispatched Txp or SNF emergencies, I can see how it would be a problem if a particular unit or person(s) are coincidentally always getting "flag downs". I would prefer not to risk my job over some buffing action.
 
As in generating calls you happen to run across? I see no problem with it, many patients do not enter the heath care system through 911. Follow local regulations and you'll be fine.
 
As in listening to PD/EMS radio and lights and sirens to that call before 911 EMS gets there
 
If you aren't called, don't respond. Your private employer won't like the fact that they are paying you to respond to other people's calls that they aren't getting paid for. If you are that desperate for an adrenaline rush, there are plenty of vollies out on the island that could use some extra hands.
 
This coming from a guy with a NY State Buff patch :)

If you read my post or my signature, you would know that I do volunteer.

If you have ever worked a private, you would know that we do collect insurance information. Of course there will be the homeless or those without insurance.
 
You seem to miss the sarcasm in my patch. I know you volunteer but that doesn't seem to be enough for you. I am just recommending that instead of buffing other people's calls when they don't need the help that you find someone else that does need the help and put your enthusiasm to good use. I worked privates for just under a decade (quite possibly for the same company you work for) so I am well aware of how it works. I also vollied for a bit longer. I could PM you a few agencies that are very busy (and have fairly active knife and gun clubs), they might even be willing to pay for your train ticket out to Suffolk. Be careful taking your volley ambulance out to buff calls. Things may have changed since I was there but NYS was a home rule state and each company had its own operating certificate that defined the area it was allowed to operate in. Taking you ambulance out of your approved area to buff calls (without being mutual aided) can tweak some noses and get you in trouble with the state. Not to mention your district is now not covered.
 
I suggest you don't do that. I differ to those who know the area as the EMS culture in NYC may be different, but here in Los Angeles they have specific rules against. Although I've heard of guys doing it out here, it's a great way to get chewed out by an FD Captain.

I'll run still alarms, observed incidents, or other public initiated calls all day, but I'm not jumping calls. The thrill isn't worth the headache if or when you finally step into a steaming pile of uh oh.
 
ERDoc said:
Your private employer won't like the fact that they are paying you to respond to other people's calls that they aren't getting paid for.
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That's not how it works. They will hear the call on the scanner, and get there before the 911 ambulance arrives. They will often pick up the patient and transport them to the ER (while charging the patient and collecting insurance, just like the 911 ambulance). When the 911 ambulance arrives, they will frequently take a cancellation, as there is already an ambulance on location.

Many employers won't object, as long as you aren't late to your scheduled pickups. after all, it's extra revenue for them.

But I wouldn't do it if it could get you in trouble at work. No need to lose your job over that type of crap.

a better plan would be to get a job with one of the agencies within the FDNYEMS 911 system.
 
When I worked private ambulance here in LA, the company launched an internal investigation on a crew who still alarmed enough calls that they were accused of listening to a scanner and conveniently choosing routes that would put them on scene of traffic collisions and the like prior to the 911 service providers arriving on scene...last I heard it was determined to be merely a coincidence. Out here that will get not just your employer, but you personally as well in trouble with the county EMSA. Very frowned upon here. As Mufasa said, I don't know how different NYC area EMS culture in this regard is, but I find it difficult to imagine that it's officially condoned. So unless you have a specific "Yes it is OK to listen to the scanner and jump on a call some other agency is actively dispatched too and does not know, much less agree to, you taking it from them" in writing on official letterhead (like an official policy or protocol) I simply would not do it if I were you.
 
DrParasite said:
That's not how it works. They will hear the call on the scanner, and get there before the 911 ambulance arrives. They will often pick up the patient and transport them to the ER (while charging the patient and collecting insurance, just like the 911 ambulance). When the 911 ambulance arrives, they will frequently take a cancellation, as there is already an ambulance on location.

Many employers won't object, as long as you aren't late to your scheduled pickups. after all, it's extra revenue for them.

But I wouldn't do it if it could get you in trouble at work. No need to lose your job over that type of crap.

a better plan would be to get a job with one of the agencies within the FDNYEMS 911 system.
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Like I said, it's been awhile since I was in the field. The company I worked for told us NOT to buff calls because there was no way to know who did and didn't have insurance. If we came up on a scene, we were to stabilize until the vollies came along, unless we could find out if they had insurance.
 
ERDoc said:
. Taking you ambulance out of your approved area to buff calls (without being mutual aided) can tweak some noses and get you in trouble with the state. Not to mention your district is now not covered.
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Yea its called a charter license. We were told at our orientation not to go buff calls outside of our chartered area because other vollies have jurisdiction over that area. Even if someone called us directly we cannot go outside of our area. Doing so will put that charter license at risk. NYC Community EMS I hear can buff calls wherever they want. If anyone has info on them let me know.

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One thing I have personally experienced working a private is legitimate flag downs. Ped hit by a car, MVA, etc. What cracked me up is when FDNY BLS showed up the FD LT told them we "buffed" the call. I responded "We were on our way to a nursing home emergency actually" when everyone waved at us to pull over assuming we were there for them. We called dispatch and they reassigned the emergency to another unit and let us do the flag down job :)
 
adamNYC said:
I responded "We were on our way to a nursing home emergency actually" when everyone waved at us to pull over assuming we were there for them. We called dispatch and they reassigned the emergency to another unit and let us do the flag down job :)
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This is a horrible plan. Over the years on here and in other forums, this has been debated quite frequently with different providers from different areas having drastically different protocols for such a situation.

But think about it this way...You were on your way to an "emergency". The fact that it is a nursing home is irrelevant as they have true emergencies there and you were determined to be the closest unit for that emergency. Because you passed by or were flagged down for a "cooler call" (my words) you elected to stop for this one as opposed to continuing to the original call.

Now, a second unit has to be dispatched to the FIRST emergency. The second unit is presumably farther away than you originally were or they would have been sent to start with. You just delayed that first emergency for who knows how long? The delay very well could have contributed to the person in the home to becoming worse or dying. The truth of the matter is we do not know, it could have been nothing. Regardless, it was your first "emergency" assigned. If it was a routine transport then no worries, but you stated it was an actual emergency. Good job delaying care to the one who called first.

While I understand it is hard to drive past people flagging you down, your duty is to continue to your first assignment. Yes there is another emergency right in front of you, so what....the emergency is not yours.

In general, it is poor policy to abort one emergency over another without all the information to analyze and you simply cannot do that until you have someone on scene most times.
 
Be that as it may, we were specifically instructed at company orientation that we must stop for any flag downs regardless if we had a patient or if we were enroute to an emergency.

Duty to Act

And we didn't buff that one. Legit flag down my first month of EMS.
 
As I said in my first statement...every agency has varying protocols.


So where is your "duty to act" to the first person who called? That goes out the window? I am trying to stimulate logical discussion with you...

And if you stop for a flag down and I or a family member is in back, I will have a lawyer on speed dial as your duty to act is now with whoever is in the truck.
 
What you say makes total sense to me. What I did was based on what we were told to do. If I had an unstable pt in the back however its highly unlikely I would stop for a flag down.
 
Ok, now that we established that basically what I stated is "possibly right" in theory and you are merely following orders....have you taken it upon yourself to inquire as to why these orders exist? Have you asked what happens if you do not follow them? Have you been shown these orders in writing and agreed to them?

Basically, is this a written company policy?

Do you see where I am going with this?

Aside from the legal ramifications of you not being protected, is there not an ethical duty to act to those already in need of your assistance?

I know not everyone is as stubborn as I am, but when I am given directions/orders I have to understand them and I have to see them written down. Do you have this in place?

This discussion is not just about liability, this is about growth, both personal and professional within ourselves. We ask ourselves...am I doing the right thing for my patient? Is this best practice to follow if it is not an absolute corporate policy? Don't I have a duty to act for those who call me first?

I do not think this is a black and white reply as the world to me is about 99% gray. Regardless, what say you?
 
What if the call you buff is uninsured?

Whole idea is rotten.

FWIW, if you tired that here, I would politely, yet firmly, ask you to leave.
 
For all of you guys who are saying, "if you tried that here…" You should know that the New York City EMS system functions very differently than anywhere else. For some strange reason, in the city, whackers seem to be tolerated more so than anywhere else,especially if they call themselves "buffs".
 
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