My brother is an engineer. Yes, heís a firefighter and occasionally he still drives the Fire Truck, but Iím not talking about being an engineer as it relates to the fire service. Iím talking about a pocket-protector wearing, slide-rule-sliding Engineer who draws lines on paper and calculates weight to strength ratios and the like. Itís math thatís way over my head and Iím glad that heís the one that has to do that type of work every day and not me. When he explains his job to me my brain starts to overheat and Iím surprised that my hair hasnít caught on fire yet. It started smoking once, but I was able to catch a glimpse of ďThe HillsĒ on the TV and it slowed my mental activity just in time.
My brother, Captain Kaiser, is a volunteer fire captain and he used to be an EMT although he let it lapse due to the fact that it limited time with his family. I guess that I got the EMS genes and he got the ďgo to college and get a real job that pays wellĒ genes. I say more power to him and heís one of my best friends. I donít get to see him as much as I should, but we talk often on the phone. He has always been interested in hearing all of my tales of EMS glory, and I listen to tales of his two daughters. Raising daughters sounds waaaay different than raising my son.
The other day I was talking to him about ďthis blogging stuff I doĒ and I breached the subject of EMS 2.0. I havenít written much about EMS 2.0 by name lately, although the concepts Iíve been bringing forth fit into my model of it, but trust me when I say there has been a lot of behind the scenes activity. It turned into an interesting conversation with my brother. He was an EMT but never got past the volunteering when his community needs him stage. Thatís an honorable place to be, no doubt, but he didnít delve into the level that I take it to. So explaining EMS 2.0 to him was close to explaining it to an educated lay person.
In the conversation, I brought up the scenario that I used to write the post: ďAre We the Gatekeepers to the Emergency Healthcare System?Ē (Unofficially titled, ďDid I do good?Ē) and explained to him how I evaluated a patient in a nursing home, performed a full assessment on her including a 12-lead EKG and a review of her recent lab work, held a telephone conference with her Primary Care Physician and the Nursing staff on scene, and triaged the patient to the Primary Heathcare System as opposed to the Emergency Healthcare System. In the process, I saved the healthcare system (in the form of Medicare) thousands of dollars and provided better care to the patient by deferring her from the emergency room. I explained to him that my ambulance service could not bill the patient for the care I provided her because we did not transport and that the current system needs to recognize the value in having EMS provide such services in terms of cost-savings. If I would have transported, our service would have made the revenue, but Medicare would have paid thousands of dollars in unnecessary care overall. Since I didnít, I saved Medicare thousands, but the service wasnít valued and we didnít receive any compensation for our work.
Basically, the conversation wound up being that he agreed with me that EMS has a powerful position to improve access to primary care and ďsaveĒ healthcare as it were by increasing access to primary care, properly deferring patients from the emergency healthcare system when their care could be more appropriately managed in the primary care setting, and by saving millions of dollars in the overall healthcare setting. He agreed with me that it would require deregulation of the EMS industry to allow us to attempt programs and offer new services outside of our current mold and would require increased education of street-level EMS providers to get this done. He also agreed with me that money weíre already collectively spending should be allocated from inefficient programs and given to efficient high-performance EMS systems to do this in order to realize greater savings.
Remember, heís an engineer. Heís good at math. He may not be a healthcare provider currently schlepping patients around in a shiny red and white bus that makes ďwoo wooĒ sounds, but heís as smart as they comeÖ
And when I told him that heís exactly who we should be getting our message out to, he disagreed. He thinks that we should be out there talking to politicians and Insurance Industry executives. Honestly, he chastised me for not being in my local congresshumanís office to do just that.
So, hereís a shoutout to the politicos out there: ďEMS can Ďsaveí healthcare through a free-market, grass-roots, innovative solution using currently available resources. We can save millions and improve the entire healthcare system just by putting in place a few good ideas and allowing EMS professionals the ability to think outside of the boxĒ.
So do me a favor, yíall. Go tell your local politico to e-mail me at Proems1@yahoo.com. Iíd love to have a talk with them. You should too.