Ask anyone who works in EMS, and they can tell you a hundred stories of people who abuse the EMS system. I have seen my share, and the stories have infinite variety:

The thermostat:
It was 2 o’clock in the morning when we went to this woman’s house for a complaint of “difficulty breathing.” When we got there, the “patient” didn’t want to go to the hospital, she just wanted help. Having just moved into her house, she didn’t know how to program her electronic thermostat and wanted us to show her how. It wsa 82 degrees in her house, nowhere near being a medical emergency.

People fake seizures, unconsciousness, chest pains, you name it, in the belief that they will not be arrested if they go to the hospital. The sad fact is that they are sometimes right. The officer sometimes doesn’t want to sit around the hospital for several hours, waiting for his prisoner to be discharged for minor misdemeanors. Felony arrests? Forget it, you are going to jail as soon as the hospital is done with you.

A variation of this was one morning’s call:
A man was required to be in court at 8 o’clock in the morning for a child support hearing. He walked from his home towards the courthouse 10 miles away. (Why he didn’t take the bus is a mystery.) He made it about 3 miles, and then called 911 with reported shortness of breath and chest pain at about 10 after 7. When we arrived, he wanted to go to the hospital that, coincidentally, was two blocks from the courthouse. When we arrived and asked him what was going on, his first words were, “I am trying to get to court because my wife…”

We all knew that this was a fake call intended to get him to the hospital closest to the courthouse, so that he could walk out and be in court faster. Since there is no penalty for failure to pay for the ambulance ride OR the ER bill, this is the equivalent of a free taxi. We decided that the best thing for this patient was to go to a different hospital. Why? Well, if he really was having chest pain, the patient would be less likely to walk out of that one, opting instead to use the ER bill to show the court why he had a medical reason for missing court. IF he wasn’t really having chest pains, then he didn’t need to go anyhow. Besides, to reach the hospital he wanted, we would have had to pass another, closer one, and there was no medical reason to pass a perfectly good hospital to go to the other one.

Lest anyone think that we were being mean or lazy, he still got a complete workup. His vitals were: SaO2 98% on room air, 100% on 2 lpm of O2. HR 82, RR24, BP 142/94. Monitor showed SR, and 12 lead showed nothing important. He was hot and sweaty, but that is unsurprising considering that he was about 60 pounds overweight, and it was 82 degrees with 80% humidity. He still got 325 mg of aspirin, NTG spray x2, and transport to the closest hospital (rather than the one he wanted)

People abuse the system every day. This is why universal, “free” health care will never work.

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1 Comment

TOTWTYTR · September 30, 2010 at 7:22 pm

When you give someone something for free, they rarely appreciate it and will often abuse the crap out of it. Housing, food, health care, even training, it's all the same.

In this case you were doing the correct thing for the patient from a medical standpoint. Far be it for us to decide if someone is faking, right? This guy gave a Hx that suggested some sort of cardiac event, so you treated him thusly.

Too bad for him that the correct treatment just happens to preclude taking him to the hospital that is near the court.

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