How often do you transport patients to the ED that do not need that level of care?

medic417

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Been saying no to transport for years. I will not transport a patient that does not need it. I will not waste the patients or the tax payers dollars giving a person a taxi ride. I will educate them as to where they can go for the type of help they need. Just because they think it's an emergency does not mean it is an emergency.
 

DesertMedic66

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All the time. Sadly in our system we don't have the choice of saying "we will not transport you". In ours it's "if you wanna go then let's go".

Transported a female from a car accident (small fender binder) who's c/c was "my weave (sp? Hair extension) fell off". We attempted to educate her while in transport but I highly doubt she listened.
 

VCEMT

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Good for you, Spartacus.
 
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medic417

medic417

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Hey where did the post I replied to go? My post is actually the second post of this topic. Topic is not my topic sombody I think they said from Arizona started this discussion.
 
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DesertMedic66

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Hey where did the post I replied to go? My post is actually the second post of this topic. Topic is not my topic sombody I think they said from Arizona started this discussion.

Lies.... :p
 

Veneficus

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I don't transport anymore :)

But when I did, all the time...

In one service I worked at, there was a "paramedic refusal" protocol. However, transport times were so short and the extra paperwork was so time consuming, that it was actually to the benefit of getting in service faster to just transport.

The problem with denying transport, or people who don't require an ED is that many people who don't require the ED still require some form of medical care.

So in effect, when you don't transport, if the caller (let's not call them a patient yet) does not have the means or the ability to seek alternative care, you are denying them care.

I think there needs to be a better way than an ALS ambulance to the ED. Actually I know there is a better way. But US EMS, change, and doing the right thing are just not conducive to it.
 

Sandog

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Hey where did the post I replied to go? My post is actually the second post of this topic. Topic is not my topic sombody I think they said from Arizona started this discussion.

I saw it too. Strange indeed.
 
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medic417

medic417

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I saw it too. Strange indeed.

I only commented because I couldn't wait for someone to say it is illegal to refuse transport.

Wonder what gremlin stole originalonal post. Maybe a virus has attacked the emtlife site?
 

Veneficus

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I only commented because I couldn't wait for someone to say it is illegal to refuse transport.

Wonder what gremlin stole originalonal post. Maybe a virus has attacked the emtlife site?

maybe it was started by a banned user?
 
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medic417

medic417

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Veneficus

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OP
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medic417

medic417

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OP
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medic417

medic417

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EpiEMS

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Been saying no to transport for years. I will not transport a patient that does not need it. I will not waste the patients or the tax payers dollars giving a person a taxi ride. I will educate them as to where they can go for the type of help they need. Just because they think it's an emergency does not mean it is an emergency.

Problem is, the billing model is transport based, not treatment based. Maybe we should try and change the incentive structure, I suppose.
 
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medic417

medic417

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Problem is, the billing model is transport based, not treatment based. Maybe we should try and change the incentive structure, I suppose.

We bill the individual if we are called whether we transport or not. Now medicaid medicare at this time will not cover so it falls the patient to pay.
 

Tigger

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We bill the individual if we are called whether we transport or not. Now medicaid medicare at this time will not cover so it falls the patient to pay.

Do you bill if you do not treat as well?
 

Trashtruck

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In Medic417's defense, I read the OG post, then came back to it minutes later and it was gone.
If I remember correctly, it was 'Mike911' or 'Michael911' or something like that. Said he was from AZ and and EMS administrator with extensive experience on the business/administrative end.

Anywhoooooo...yes, we transport people to the ED ALL THE TIME that absolutely have no need to go there, ie 'I'm hungry' to razor burn to 'F*CK YOU! Take me to the hospital'
They don't even have to have a medical complaint...or a complaint at all, just a desire to go the hospital. I don't agree with the system, but that's how it is.
Like Veneficus said, transport times are short and paperwork(proper, cya paperwork) to leave them there is more timely. Ultimately, we take them, and they sit in the waiting room or walk out when they find out they're going to the waiting room.
When hospitals are on divert, we still take the BS there, since they won't be taking a bed anyway.

As far as billing, I have no idea who/what/how that works. A third-party does our billing.
 
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EpiEMS

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We bill the individual if we are called whether we transport or not. Now medicaid medicare at this time will not cover so it falls the patient to pay.

Considering the bulk of the patient population that deals with EMS on a regular basis (and doesn't actually need *emergency* medical care), I can't imagine the number of bills actually paid is very high.

EMS should be a gateway to the healthcare system, as the national standard curriculum states -- and gateways sometimes need to close to certain people.
 
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