EMS is getting busier and busier.

The problem:

EMS systems are being overrun by frequent flyers, people with non-emergent complaints, and prank calls. The reporters in the above video suggest that cities adopt a system where non-emergent calls are offered transportation to other services or doctors. I do not think this system will work for two main reasons:

1 The frequent flyers will figure out how to game the system, and will claim to have a life threatening complaint so they can get to the ER, the the reduction in ER runs will be minimal.

2 The first time a patient dies because an emergent patient was sent a cab instead of an ambulance, there will be a huge lawsuit.

The problem is that with our current legal system, there is no way for any ER or EMS system to refuse service to anyone without legal repercussions, and there will always be people who take advantage of the system. There is one patient that I see frequently, let’s call her Jenny, that I have run on as many as 5 times on a single day. Other patients are just as bad. There are 10 patients in my area who are alone responsible for nearly 5% of our call load. That’s right- 10 people are being run on over 1,000 times a year. Add in the 10 nursing homes that give us another 5,000 calls a year, and you see that 30% of our time is being used up by a very small minority.

I would say that less than 15% of our runs are true medical emergencies. Our collection rates run at about 40%, with most of those being Medicaid and Medicare. Some of our most ardent frequent flyers are carriers of the Medicaid ‘gold card’ and call us because they know they can do so without having to worry about paying.

Our medical system is only going to deteriorate as more and more people realize that today’s house calls are made by Paramedics, and help is just a phone call away. What is the solution? I have no idea, but I do know that the nation’s EMS systems are only going to get busier. At least that gives me job security.

Security theater

I just returned from a two week vacation in the Caribbean. For obvious reasons, I kept the number of people who knew I would be gone to a minimum, but now that I have returned, I would like to share a few of my observations.

On the day that I left, I had to fly to Puerto Rico to catch the cruise ship that would carry me for the journey. I try not to fly, but the fact that Puerto Rico is an island over 1,100 miles from my home made flying a necessity.

We arrived at the airport two hours early, so that we could deal with the effects of the security theater put in place by our government. The ticketing procedures were efficient: the ticket agent asked for my ID and credit card, weighed in our bags, and issued our boarding passes. We then proceeded to the security gates, and that is where things took a turn for the worse.

The first thing you notice is the long lines. After waiting in line for about 5 minutes, you come to the first security post. At this station, the TSA official examines your papers to make sure of what, I do not know. She looked over my boarding pass and my Photo Identification and, deciding that I was worthy of flying, allowed me to pass on to the next line.

This line requried me to remove my shoes, and place all of my belongings in a plastic tote. This tote was x-rayed, and inspected for contraband. Mrs Street Pharmacist was also required to remove her belt, and had to submit to a frisking. I felt so incredibly violated being searched in such a fashion. I was afraid to make eye contact with any of the security personnel, for fear that they would somehow deem me a troublemaker or miscreant, and place me on some sort of a list that would forever brand me to be a terrorist. Once on this government list, who knows what other liberties I will have taken from me?

To those who think that these searches are needed in order to keep us safe, I would point this out: the 9/11 hijackings were carried out by a handful of determined men who carried nothing more than a few small knives. Have you ever seen these before?

Completely undetectable, and they can be bought for less than $10 on websites like this one. Our Government cannot even keep weapons and drugs out of the prisons, so what makes you think that they can do any better with any other venue?

What has happened here is that our Fourth Amendment has been totally destroyed. The rest of our Bill of Rights are soon to follow.

The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.