This is a message to some of my clients who seem to think every bump and scrape requires a 911 ambulance ride to the emergency room. In case you’re new and not sure what client means, a client is a person who perceives themselves to be a patient even though, based on a thorough assessment, they have no condition that warrants even a BLS ambulance.
You were sitting at your desk and felt a sharp pain in your wrist while typing. Instead of rubbing the wrist and taking a break, making an appointment with your doctor, you’ve called 911 and reported an odd tingling. You also decide to mention you’re sleepy and overworked, hoping your boss is listening so you can have the rest of the day off. My dispatchers combine sleepy and tingling arm and (magically) dispatch a full medical assignment to a possible stroke. 6 lives are put at risk driving lights and sirens (A whole other debate) to your wrist.
When I arrive you are alert, oriented and all your vital signs are normal for you. I examine your wrist and find no edema, discoloration, decreased range of motion or anything else indicating an injury, let alone an emergency.
Then you say my new favorite line:
“I think I should go in and get it checked out.”
When I take a deep breath and say, “Can you drive or call a friend to take you” while screaming in my head “What do you think I just did?” you reply that no, you know your rights and have insurance so you’ll be going in the ambulance.
Riding your bike in the park can be nice. When you miss that crack in the sidewalk and fall off your bike, scraping your elbow, you should get back up and ride along. Instead you’ve called 911. The magic dispatch computer is once again sending the world because you used the words bike accident and headache. When I get there you’re on the phone with your brother who is telling you to go in and get checked out. I check you out and give you the self adhesive bandage common in most homes and tell you to be more careful. Then you hand me the phone and the brother tells me all about the actress who hit her head and died the next day, then demands you go in to get checked out.
“Did you hit your head?” I ask the rider.
“No, just landed on my elbow, but do you think my head might be hurt anyways? You never can be too careful.” He replies. Then removes his pristine helmet.
“You can be too careful actually.”
“I want to go with you and get checked out.”
You are a Medical Doctor. You run a successful practice here on the 5th floor of the medical building across the street from the ER. 911 was activated when one of your patients arrived with a rash on her ankle and wanted a cream or salve to help with the irritation. It was 5 minutes after 5 PM and you called 911 from the elevator lobby to get her transported to the hospital across the street.
“Is this a transfer, Doc, or is this a 911 activation for a rash?” I thought it was a perfectly fair question.
“Do your job and take her over to get checked out.” Was his answer. I didn’t have the confidence back then to remind him that checking her out was actually HIS job in the first place. I also later learned that driving people to the hospital is not my job.
“Do I really need to get in the ambulance? I can just cross the street on my own.” The woman told us. And we didn’t stop her. I know now we would advise her that if she can, come back to the doctor’s office in the morning with a big smile on your face and ask to be “checked out.”
Point being, friends outside the business, is that what I do when I arrive on the scene of your “emergency” is check you out. When I take a deep breath, stand up and ask you what you think you should do, that is your cue to say, “I guess I don’t need an ambulance.” Because if you did, I’d have you at the hospital by now.
Want to go get checked out? What do you think I just did?
Also on The Happy Medic…
- From the Archives…for the heart attack… – February 9, 2010
- Oh No. Not Again – October 8, 2009
- What do you know? – January 21, 2010
- Where’d who go? – March 23, 2010
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