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EMS, EMS 2.0, Patient Care

Get it out now

I have decided too many in this field use the phrase
“You call, we haul, that’s all.”
So I have declared that today, January 22, 2010 is the last day we are allowed to say that, unless you have a side job in the refuse industry or possibly driving a tow truck.

Your new slogan is
“You hurt, we flirt. You lyin’, someone might be dyin’.”
It is not against the law, nor outside of your responsibilities to inform persons when their injuries or illnesses are untreatable by you and your staff.  Nor is it against the law or outside your responsibilities to tell the truth when they ask if they should have called you.

I have been known to remind clients that a baby could be choking nearby but they will die because their paramedic resource is here putting your swollen wrist in a towel from your kitchen and frozen vegetables from your freezer while all your college buddies watch from the couch.

“I didn’t know what to do so I called you guys, is that wrong?”

“Yes.”  Odd look.  “An emergency and an injury are two remarkably different things.  Sometimes they overlap, but not as much as you might think.  Your ambulance will be here shortly, they’re coming from far away, busy night tonight.”

“A lot of sick people huh?”

“No.”

“Do you think I need an ambulance?”

“No.”

“What should I do?”

“Goto a doctor.  But as you can see I’ve taken the pain away and reduced the swelling in your wrist using common household items.  I learned this in the cub scouts.  This is as much pre-hospital care as we can give, so from this point on everything is else is just a ride. A very expensive ride.”

“Can my friends take me instead?  I mean I thought you guys could get me in quicker.”

“Sure your friends can take you, let me help you to the car.  Sign this release form first and assume liability for the bill.”

“What bill?’

“The bill from us coming here to help you.  As much as your politicians would like you not to know, this tax payer funded service is not fully funded to the point we can provide service for everyone calling 911, so we bill for our service.”

“Oh.”

OMG happy, what are you doing?  If he’s insured that’s an easy ALS billing transport, we need that money!

No, I just freed up one of your precious ambulances to run an actual emergency call and performed vital public education, something our profession fears among all other things.

A well informed and healthy populace generates few billable transports.

Stop lying to your patients by telling them they should always call you when they stub their toe or that there is no fee when there is one.  Lying to them IS against the law and outside your responsibilities.  Telling the truth and refusing transport are two completely different things.

Telling the truth can never get you in trouble.

Carry on.

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0 Comments

  1. PGSIlva January 22, 2010 11:50 am

    Dude…it's not the 1st time I have used all of those arguments in multiple permutations. I also find that the “wow, the ER has to be slammin tonight with this weather/being the weekend/all the clubs/ you'll be lucky to be seen anytime before dawn” Sometimes they even listen…

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  3. Anonymous January 22, 2010 7:50 pm

    Dude…it’s not the 1st time I have used all of those arguments in multiple permutations. I also find that the “wow, the ER has to be slammin tonight with this weather/being the weekend/all the clubs/ you’ll be lucky to be seen anytime before dawn” Sometimes they even listen…

    • the Happy Medic January 22, 2010 8:51 pm

      Indeed they do, but so few folks actually take the time, thinking they can talk for 20 minutes rather than just do the 15 minute transport, not realizing that 5 minutes saved will bite them back countless times over in he future.
      That and the continued need for private companies to, by law, turn a profit on these people keeps them from educating their clientele. Not all, but most.
      Thanks again for reading PG. you coming out to SF for the premiere?

      • PGSilva January 23, 2010 1:43 am

        I would love to head out to SF for the premier but you know how it is…if I’m not at my desk pushing electrons the entire U.S. financial system may become compromised by money launderers and terrorism financiers…yeahhhhh…besides, the weather is much to nice out there.

  4. PGSIlva January 22, 2010 3:50 pm

    Dude…it's not the 1st time I have used all of those arguments in multiple permutations. I also find that the “wow, the ER has to be slammin tonight with this weather/being the weekend/all the clubs/ you'll be lucky to be seen anytime before dawn” Sometimes they even listen…

  5. Anonymous January 22, 2010 9:35 pm

    You know, there have been soooo many times that I could have used those very lines on many of my Taxing Customers/ Taxing Repeat Customers (they are taxing my system). But, if I were to use those lines, I would probably have to come get a job with you, HM. The Powers That Be around these parts would not take to kindly to my speaking the truth.

    • the Happy Medic January 22, 2010 11:25 pm

      That’s the beauty of it. They want you to lie, tell them to do it. Tell the truth. It’s the law.

  6. the Happy Medic January 22, 2010 4:51 pm

    Indeed they do, but so few folks actually take the time, thinking they can talk for 20 minutes rather than just do the 15 minute transport, not realizing that 5 minutes saved will bite them back countless times over in he future.
    That and the continued need for private companies to, by law, turn a profit on these people keeps them from educating their clientele. Not all, but most.
    Thanks again for reading PG. you coming out to SF for the premiere?

  7. MarkUK January 22, 2010 10:12 pm

    “Telling the truth can never get you in trouble.”

    Justin, where DO you live? Earth, ot Planet Zog?

    • the Happy Medic January 22, 2010 11:28 pm

      Mark, I live life by asking a simple question whenever someone thinks I’m being insensitive: “True or false?”
      They often answer, “True, but…”
      Patient doesn’t need ambulance, tell them. Patient does need ambulance, tell them. Cook made your order wrong, tell them. Wife looks fat in those pants, tell her. Even that last one. you’d be amazed how far the truth can take you into a happy and stress free life.

      The more you lie or withhold the truth, the worse off everyone is.
      True or false?

  8. 9_ECHO_1 January 22, 2010 5:35 pm

    You know, there have been soooo many times that I could have used those very lines on many of my Taxing Customers/ Taxing Repeat Customers (they are taxing my system). But, if I were to use those lines, I would probably have to come get a job with you, HM. The Powers That Be around these parts would not take to kindly to my speaking the truth.

  9. MarkUK January 22, 2010 6:12 pm

    “Telling the truth can never get you in trouble.”

    Justin, where DO you live? Earth, ot Planet Zog?

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  11. the Happy Medic January 22, 2010 7:25 pm

    That's the beauty of it. They want you to lie, tell them to do it. Tell the truth. It's the law.

  12. the Happy Medic January 22, 2010 7:28 pm

    Mark, I live life by asking a simple question whenever someone thinks I'm being insensitive: “True or false?”
    They often answer, “True, but…”
    Patient doesn't need ambulance, tell them. Patient does need ambulance, tell them. Cook made your order wrong, tell them. Wife looks fat in those pants, tell her. Even that last one. you'd be amazed how far the truth can take you into a happy and stress free life.

    The more you lie or withhold the truth, the worse off everyone is.
    True or false?

  13. MsParamedic January 23, 2010 1:52 am

    See, I get in trouble for telling the truth…very often. But it’s worth it. I hold healthcare to a higher standard. Lead by example, Happy… You’re doing it. I’m doing it.

    *revolution*

  14. Anon January 23, 2010 2:37 am

    I don’t know about that flirting suggestion. All you hot paramedics could get yourself into a whole other pot of hot water by flirting (that goes for both sexes). Not that I would complain, you know, I’m just sayin’….. then again pretty sure I would never get this “talking to” so maybe it doesn’t matter. boo hoo.

  15. PGSilva January 22, 2010 9:43 pm

    I would love to head out to SF for the premier but you know how it is…if I'm not at my desk pushing electrons the entire U.S. financial system may become compromised by money launderers and terrorism financiers…yeahhhhh…besides, the weather is much to nice out there. </end sarcasm>

  16. Anonymous January 23, 2010 2:49 am

    I like to refer to that as a “Catch and release” A very informative and educational way of letting the public knowhow the system works. Many times they (Joe Public) appreciates the Honesty when we put us into their same situation and refer back to it as “Off the record, this is what I would do in your situation, I do not think that this warrants a $1000 bill…”

  17. msparamedic January 22, 2010 9:52 pm

    See, I get in trouble for telling the truth…very often. But it's worth it. I hold healthcare to a higher standard. Lead by example, Happy… You're doing it. I'm doing it.

    *revolution*

  18. Anon January 22, 2010 10:37 pm

    I don't know about that flirting suggestion. All you hot paramedics could get yourself into a whole other pot of hot water by flirting (that goes for both sexes). Not that I would complain, you know, I'm just sayin'….. then again pretty sure I would never get this “talking to” so maybe it doesn't matter. boo hoo.

  19. delrosa January 22, 2010 10:49 pm

    I like to refer to that as a “Catch and release” A very informative and educational way of letting the public knowhow the system works. Many times they (Joe Public) appreciates the Honesty when we put us into their same situation and refer back to it as “Off the record, this is what I would do in your situation, I do not think that this warrants a $1000 bill…”

  20. First Due Medic January 23, 2010 10:01 am

    As much as I would LOVE to tell some of our customers/clients the truth….I’m not sure just how long my employment might last. You see, there is a big difference in for profit and need based care, i.e. private v. municipal. While some of the higher ups would NEVER admit it, we must transport if at all possiable.

    I couldn’t imagine what would happen if I noted on my call sheets all the times that a patient was ambulatory and walked to the truck with no problems. What’s even worse is going to a nursing home and not transporting a resident who has fallen; this patient is usually CA/Ox4 and doesn’t want to go anywhere. Too many of these would surely get some unwanted attention.

    So the rock and hard place gets even tighter as I try to maintain professional integrity and stay gainfully employed.

    O woe is me!!

    • the Happy Medic January 23, 2010 5:13 pm

      Do you mean to say your service transports those who do not need it? When you mention not noting that a person ambulated to your rig, why is that not included? Because it’s hard to bill ALS on an ambulatory patient?
      If your service is instructing you to omit information related to patient care they are committing fraud. Your report is a legal document and under the law can only be edited by the author and the person about which it is written.

      If your service instructs you to lie to your patients and default to transport, indeed the private service model has failed, putting profits ahead of proper care.

      Do what you can to be an advocate for your patients. Do what is right, tell the truth, and be honest with them. If you are fired for telling someone who doesn’t need you just that you will own that company and make your own decisions.

      Email me gate keeper, ASAP

  21. The Gate Keeper January 23, 2010 6:01 am

    As much as I would LOVE to tell some of our customers/clients the truth….I'm not sure just how long my employment might last. You see, there is a big difference in for profit and need based care, i.e. private v. municipal. While some of the higher ups would NEVER admit it, we must transport if at all possiable.

    I couldn't imagine what would happen if I noted on my call sheets all the times that a patient was ambulatory and walked to the truck with no problems. What's even worse is going to a nursing home and not transporting a resident who has fallen; this patient is usually CA/Ox4 and doesn't want to go anywhere. Too many of these would surely get some unwanted attention.

    So the rock and hard place gets even tighter as I try to maintain professional integrity and stay gainfully employed.

    O woe is me!!

  22. the Happy Medic January 23, 2010 1:13 pm

    Do you mean to say your service transports those who do not need it? When you mention not noting that a person ambulated to your rig, why is that not included? Because it's hard to bill ALS on an ambulatory patient?
    If your service is instructing you to omit information related to patient care they are committing fraud. Your report is a legal document and under the law can only be edited by the author and the person about which it is written.

    If your service instructs you to lie to your patients and default to transport, indeed the private service model has failed, putting profits ahead of proper care.

    Do what you can to be an advocate for your patients. Do what is right, tell the truth, and be honest with them. If you are fired for telling someone who doesn't need you just that you will own that company and make your own decisions.

    Email me gate keeper, ASAP

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  24. Anonymous January 24, 2010 8:22 pm

    Really…. Seriously…..??!!!! You call we haul is openly the policy from the top. I would get fired for thinking out loud about disagreeing with this “brilliant” approach to patient care. They have our FTOs call back any patient we 93 the next day in an effort to “catch” us not following the haul policy. Horrific adventure for this week—morbidly obese paramedic unable to get down and provide patient care–saveable arrest and the guy is dead!! Guess who is in serious job jeopardy for going to the top and complaining (almost)? So no I haven’t turned in the written official complaint yet and they immediately told her what was up. She’s my asst. supervisor so I’m going to probably be job hunting soon. Adventures in the deep south continue stay tuned….lol. Y’all hiring?

  25. carolinagrl January 24, 2010 4:22 pm

    Really…. Seriously…..??!!!! You call we haul is openly the policy from the top. I would get fired for thinking out loud about disagreeing with this “brilliant” approach to patient care. They have our FTOs call back any patient we 93 the next day in an effort to “catch” us not following the haul policy. Horrific adventure for this week—morbidly obese paramedic unable to get down and provide patient care–saveable arrest and the guy is dead!! Guess who is in serious job jeopardy for going to the top and complaining (almost)? So no I haven't turned in the written official complaint yet and they immediately told her what was up. She's my asst. supervisor so I'm going to probably be job hunting soon. Adventures in the deep south continue stay tuned….lol. Y'all hiring?

  26. MarkUK January 24, 2010 11:54 pm

    You ain’t met my missus!

    • MarkUK January 24, 2010 11:57 pm

      Justin, you ain’t met my missus!

  27. the Happy Medic January 24, 2010 6:55 pm

    As a matter of fact, we are.
    http://38.106.4.187/index.aspx?page=7

  28. MarkUK January 24, 2010 7:54 pm

    You ain't met my missus!

  29. MarkUK January 24, 2010 7:57 pm

    Justin, you ain't met my missus!

  30. carolinagrl January 24, 2010 8:22 pm

    Really…. Seriously…..??!!!! You call we haul is openly the policy from the top. I would get fired for thinking out loud about disagreeing with this “brilliant” approach to patient care. They have our FTOs call back any patient we 93 the next day in an effort to “catch” us not following the haul policy. Horrific adventure for this week—morbidly obese paramedic unable to get down and provide patient care–saveable arrest and the guy is dead!! Guess who is in serious job jeopardy for going to the top and complaining (almost)? So no I haven't turned in the written official complaint yet and they immediately told her what was up. She's my asst. supervisor so I'm going to probably be job hunting soon. Adventures in the deep south continue stay tuned….lol. Y'all hiring?

  31. the Happy Medic January 24, 2010 10:55 pm

    As a matter of fact, we are.
    http://38.106.4.187/index.aspx?page=7

  32. MarkUK January 24, 2010 11:54 pm

    You ain't met my missus!

  33. MarkUK January 24, 2010 11:57 pm

    Justin, you ain't met my missus!

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