Iíve always said that I love EMS and that Iíve taken from it far more than I could ever give back to it. The same is true with this blog. From my readers and people who comment, I learn more than I can teach and enjoy more than I can entertain.
This weekend proved all of those facts quite well.
If you didnít read the blog over the weekend, you missed an amazing discussion on my last post. The post, ďA Weighted Issue, The Fire Service Helping Private EMSĒ discussed the case of a private ambulance requesting a fire department for assistance in carrying a bariatric patient back into her home on a long-distance hospital discharge. The private ambulance was 5 or 6 hours out of their area of operations and the Fire Department was a full-time municipal department.
I linked to the stories that had popped up on www.JEMS.com and also on www.EMS1.com. I wrote my feelings on the issue, explored the case a bit, and then opened up the floor to the readers for their comments.
And what happened floored me, just knocked me over.
Predictably, I started getting comments on the postÖ Then some moreÖ then more.. then a LOT more.. then a TON more. The post spread like wildfire and attracted some of the most intelligent discussion Iíve ever had here. Itís by far my most commented post with 86 at the time I write this.
And I read them all. I love comments, they come to my BlackBerry. Really. I read the discussion, the back and forth, and the wide spectrum of opinions as they came in, sometimes two and three at a time.
And my opinion has been swayedÖ my original perception that the Fire Department was Evil has been tempered. My original perception that the Private Ambulance could have dropped a dime and handled the issue with a phone call before the incident has not changed. However, I now focus my ire on the system that caused this issue.
The reimbursement structure holds the ambulance service hostage. No private ambulance would be reimbursed for hauling the patient with extra people. The service wouldnít have been reimbursed for a 2nd rig and the patient had to be taken home. My guess, as was stated by a handful of commenters, is that the service was taking the patient as a favor to garner more business from the rehab hospital. I have no way of knowing that for sure, but it makes sense to me.
Not only did I get a TON, just a ton of great discussionÖ but the post spawned a few others as well.
- http://thesocialmedic.net/2010/09/supersized-challenges/ – David Konig on The Social Medic
- http://firecritic.com/2010/09/to-assist-or-not-should-fds-be-responsible-to-help-private-transport-companies/ – The FireCritic on The Fire Critic
- http://rescuingprovidence.com/2010/09/20/need-a-lift/ – Lt. Michael Morse on Rescuing Providence
- http://noambitionbutone.wordpress.com/2010/09/20/should-fds-assist-private-ambulances/#comment-97 Ė Josh over at No Ambition but One (Can I call him NABO? Please? It sounds cooler that wayÖ Nay Bo)
- http://www.everydayemstips.com/?p=3736 Ė My Jedi Master (or is it Sith Lord?) Greg Friese posted this very poignant piece over at Everyday EMS tips.
This event has taught me something that should be the takeaway for us all. That is this: Issues like this are not going away. In fact, theyíre only going to get more common. Private EMS isnít evil and the ďPrivate Transport IndustryĒ is necessary for the functioning of our healthcare system. Fire-Based EMS will have to help and could never handle the strain of not having private EMS.
Sorry to both parties here, weíre all needed in the current system. Healthcare needs us all.
So play nice and help each other out. Remember the Golden Rule.
And remember the five Pís: ďProper Planning Prevents Poor PerformanceĒ
I shall leave you with two things:
http://lifeunderthelights.com/2010/09/a-weighted-issue-the-fire-service-helping-private-ems/ – A link to the post for you to wade into the comments if you havenít (you should. Bring a snack)
And this, a† video that this experience has brought to my mind. “The Hats of Incident Management” It’s about highway incidents… but you’ll get the point. It’s a classic.
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