PITA patients

abckidsmom said:
I hate medics who arrive on every scene trying to figure out a way to avoid transporting the patient even more. For that reason, I'm a big proponent of the you-call-we-haul mentality. Lazy, stupid medics make stupid decisions out of the "you don't need to go to the hospital" mentality.
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Maybe not that far as to say lazy medics, but I do agree with you. Not only does the you-call-we-hall mentality protect the pt, it also protects the medics to. I think it’s a great thing to have in place. I don’t think I would feel right not transporting a pt if they felt they needed it.
 
MrBrown said:
Apparently a lot.
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Yes. It's appalling, actually.
When my oldest was a baby (more than a decade ago), I didn't have insurance for a while. One of her well baby visits with one vaccination cost me close to $500. I don't really want to think about what the same visit would cost me now.
 
DaniGrrl said:
Yes. It's appalling, actually.
When my oldest was a baby (more than a decade ago), I didn't have insurance for a while. One of her well baby visits with one vaccination cost me close to $500. I don't really want to think about what the same visit would cost me now.
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Last time I wanted to see a doctor, a few weeks ago now, I made the decision to see him, got in my car and was talking to him 20 mins later. He ordered an ultrasound, I made an appointment straight after seeing him (at 4:30pm in the afternoon) to get ultrasoundededed at 8:40am the next day, saw my doctor again with ultrasound report/slides in hand at 10am (after a 5 minute wait) cleared me of various problems and we went with a non-emergent dx, and gave me some free medications to start. Total up front cost for three appointments, two assessments, an ultrasounds and a radiologist: $30....25 American? I might add that this is without the private insurance that I retain for more... expensive issues.

Now if I had to pay $500, or even $100 for a visit to the doctor, I would have sat at home with a potentially life threatening illness brewing away. I don't wish to share the full details, but its not a problem that required an ambulance and nor did it present as one, even to a lay person, but the realistic ddx involved a number of life threatening illnesses. However, if my options were free emergency care and a $500 dollar drs appointment, guess which one I would have chosen.

Now factor in the people who sat at home while their $30 primary care issue became a $10,000 major surgical issue while they were waiting around worrying about the cost, and tell me universal healthcare is for commies.
 
jjesusfreak01 said:
Here we have advanced practice paramedics (APPs) that can do redirects. Any medic here can leave people at home if they don't need to go and they don't want to.
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Ive looked at your APP program and protocols. They dont really seem to have much of an expanded scope of practice as they do more responsibility to be able to give orders on scene for post radio medications, and authorize alternative destinations for patients.

We do the same thing here in our agency every single day. I dont understand what makes you an "advanced practice" paramedic or whats more advanced that a regular paramedic.
 
Melclin said:
Last time I wanted to see a doctor, a few weeks ago now, I made the decision to see him, got in my car and was talking to him 20 mins later. He ordered an ultrasound, I made an appointment straight after seeing him (at 4:30pm in the afternoon) to get ultrasoundededed at 8:40am the next day, saw my doctor again with ultrasound report/slides in hand at 10am (after a 5 minute wait) cleared me of various problems and we went with a non-emergent dx, and gave me some free medications to start. Total up front cost for three appointments, two assessments, an ultrasounds and a radiologist: $30....25 American? I might add that this is without the private insurance that I retain for more... expensive issues.
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Oh come on, we all know it's impossible because it can't be true! Everyone knows that in the world of communist socialized medicine everyone has to wait months before seeing a doctor, and can only have any medical interventions performed if the death panel approves them :P
Speaking of which, what are the salaries of physicians is Australia like?
Now, our service has an option for refusing transport even if the patient requests it. However, medical command first has to be contacted for that.
 
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FLEMTP said:
Ive looked at your APP program and protocols. They dont really seem to have much of an expanded scope of practice as they do more responsibility to be able to give orders on scene for post radio medications, and authorize alternative destinations for patients.

We do the same thing here in our agency every single day. I dont understand what makes you an "advanced practice" paramedic or whats more advanced that a regular paramedic.
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I never said they were much more advanced. Thats just what the name is. They have extra training in community preventative medicine. Primarily they visit patients that cause undue strain on the EMS system by calling constantly for non-emergencies. They also have the ability to redirect. They carry cold saline, so either a district chief or an APP goes to all cardiac arrests, since there is no refrigeration on the ambulances. Sometimes they will just show up on scenes to make sure that the primary unit doesn't need any help. They do a lot of stuff, but ultimately, the heads of the system decided that they are useful, so we have them.
 
jjesusfreak01 said:
I never said they were much more advanced. Thats just what the name is. They have extra training in community preventative medicine. Primarily they visit patients that cause undue strain on the EMS system by calling constantly for non-emergencies. They also have the ability to redirect. They carry cold saline, so either a district chief or an APP goes to all cardiac arrests, since there is no refrigeration on the ambulances. Sometimes they will just show up on scenes to make sure that the primary unit doesn't need any help. They do a lot of stuff, but ultimately, the heads of the system decided that they are useful, so we have them.
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Im not saying that they arent useful. I just think that the name is a bit misleading. I feel that EMS needs to start implementing something similar nationwide to deal with the higher risk patients in the community as a rule, not as the exception. I just dont agree with calling them advanced practice if they are not.

I will say that your agency is very good at being out in the forefront of EMS. Ive always had a great respect for Wake EMS, and ive been looking at possibly coming up there to work in recent months. I have family in NC, and moving up there looks better and better every day!
 
Got a new one, except this time it was family., We get called out for BP problems., We get on scene go to the pt and their daughter starts to get real nasty with me and my captain, so nasty to the point of where she threatens to get out a camera and start taking photos, i take care of the pt while my capt calms down the daughter., The daughter tries to convince us that the pt is faking a symptom(mind u she even winked), when the pt was telling the truth., long story short we transport with no further incidents even though i was kinda wishing the daughter got removed until we loaded the pt
 
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