Where are our priorities?
Picture yourself driving home from a friend’s house after a little get together for a birthday. It is dark out but with the street lights you can see just fine. The weather is beautiful, the temperature, perfect. You roll down the street with your windows down and the stereo playing something relaxing. The tunes fit right into the night air. You blink and find yourself on the pavement looking up at the sky. You feel cold and have no idea how you got on your back like this but you do know that whatever happened, it can't be good. You hear sirens and then strangers begin to appear over you. The first stands over you. He is wearing a badge. He looks you up and down, and then winces. You realize that the feeling that 'this can't be good' must be an understatement. Then the pain begins to take hold and you can only surmise that you were in a wreck. You hear panic in the voices around you. Then you hear more sirens. Two new faces appear. They seem almost unfazed by your plight. They are talking to you but you can hardly hear them over the pain in your... well your everything! They move you around and then onto a flat board. Great the pain isn't enough they have found the most uncomfortable thing possible to lay you on... Then they strap you to it! This is just getting better and better. They are clearly hurrying. You must be in need of a doctor right now. They place you into the back of an ambulance; you can only see the ceiling and a bunch of stuff hanging in a nylon pocket on the wall. You hear the crackle of a two-way radio. "Medic 075 to telemetry, checking status of Ben Taub General Hospital" says one of the strangers standing over you, while the other checks your vital signs. The radio comes to life "Telemetry to Medic 75, Ben Taub is on diversion due to Emergency Room saturation". Hmmm... You think. They must feel that Ben Taub is the best place for you to go, but evidently they don't have room for you. You hear them over the radio again. "Medic 075 to telemetry, checking status of Memorial Hermann Hospital?" Sounds like they have got a plan. The radio comes to life "Telemetry to Medic 75, Hermann is on ER diversion as well". Suddenly, you realize that you need help now and it seems that it's not available. This was never a concern for you before but it sure as hell is now! Meanwhile, at Ben Taub General. There is a line of 73 people waiting to get into the ER. Hmmm... let's see now, four cut fingers, 23 people with flu like symptoms that they have had for 3 weeks but decided tonight was the night to go into the Emergency room, and a host of other problems, most of which are far from emergencies. Turns out you have to travel a longer distance to get to a hospital that has room for you. Unfortunately, this hospital is less prepared for your injuries. The end result, you live. Sadly, you do loose part of your right arm.
Why? Well there are a number of reasons. First, there are lots of patients who go in for ailments that require a general physician not an emergency room. Lots of patients use the fact that an ER legally can't turn them away to be how they get all of their medical treatment. Many of these people do not pay for the services rendered. The hospital pays for doctors but gets no compensation from many patients. As a result the hospital keeps the smallest possible number of doctors around. This isn't immoral; it is the only way for the hospitals to survive.
Rest assured EMS providers are faced with this same problem. What you didn't know in the above scenario is that the medics that arrived to help you were the fifth unit away but the only ones not already in use for non-emergent calls.
The Institute of Medicine (IOM) and the American College of Emergency Physicians released three studies today. They are The Future of Emergency Care series include: Emergency Care Services at the Crossroads, Emergency Care for Children: Growing Pains and Hospital-Based Emergency Care: At the Breaking Point.
The results???
The IOM, which is part of the National Academies, reported that:
• Insufficient funding and uncompensated care have taken a toll on the capacity of the emergency medical system. Significant cuts in federal funds for emergency medical response in the early 1980s left first-responder services to develop haphazardly across the country. Many ambulance services use out-of-date communications equipment that hinders their ability to coordinate with hospitals and other first-responders in their areas.
• In 2003, emergency departments saw nearly 114 million patients -- a 26 percent increase over the previous decade -- but during the same 10 years the United States lost 703 hospitals and 425 emergency departments, one report noted.
• A growing number of uninsured Americans are looking to emergency departments as their health care "safety net," and much of this care is never paid for.
• Emergency departments are also playing key roles in disaster response, but in 2002 and 2003, emergency medical services received just 4 percent of the $3.38 billion doled out for emergency preparedness by the U.S. Department of Homeland Security.
It is time that we educate the population as to the difference between an emergency and a medical problem. It is time that we educate the general populous on the difference between an emergency transport unit (an ambulance) and a taxi cab. It is time that city councils give their EMS providers the ability to refuse to take non-emergent patients seeking only a ride. It is time that the federal government moves some of its Homeland Security money to all of the organizations who secure the homeland. It is time that emergency system abuse becomes unlawful. Notice I said "abuse", not use. Many people do not have insurance; many of them do not have the funds to pay for emergency medical services. This is a fact, and those people should not be punished for their socio-economic standing. Sadly there are a great many who abuse this system. People who go to the hospital by ambulance for a minor headache while there are 2 cars sitting in the driveway and four adults at the house. This costs the tax payer a fortune, when all that was needed was a trip to the store for aspirin. I am all for taking care of the little guy. As a very smart friend of mine put it, "We are the good guys. As the good guys it is our duty, if we are capable, to help those who can't help themselves." That doesn't mean it is our duty to help those who won't help themselves, those who abuse every system they touch.
Why? Well there are a number of reasons. First, there are lots of patients who go in for ailments that require a general physician not an emergency room. Lots of patients use the fact that an ER legally can't turn them away to be how they get all of their medical treatment. Many of these people do not pay for the services rendered. The hospital pays for doctors but gets no compensation from many patients. As a result the hospital keeps the smallest possible number of doctors around. This isn't immoral; it is the only way for the hospitals to survive.
Rest assured EMS providers are faced with this same problem. What you didn't know in the above scenario is that the medics that arrived to help you were the fifth unit away but the only ones not already in use for non-emergent calls.
The Institute of Medicine (IOM) and the American College of Emergency Physicians released three studies today. They are The Future of Emergency Care series include: Emergency Care Services at the Crossroads, Emergency Care for Children: Growing Pains and Hospital-Based Emergency Care: At the Breaking Point.
The results???
The IOM, which is part of the National Academies, reported that:
• Insufficient funding and uncompensated care have taken a toll on the capacity of the emergency medical system. Significant cuts in federal funds for emergency medical response in the early 1980s left first-responder services to develop haphazardly across the country. Many ambulance services use out-of-date communications equipment that hinders their ability to coordinate with hospitals and other first-responders in their areas.
• In 2003, emergency departments saw nearly 114 million patients -- a 26 percent increase over the previous decade -- but during the same 10 years the United States lost 703 hospitals and 425 emergency departments, one report noted.
• A growing number of uninsured Americans are looking to emergency departments as their health care "safety net," and much of this care is never paid for.
• Emergency departments are also playing key roles in disaster response, but in 2002 and 2003, emergency medical services received just 4 percent of the $3.38 billion doled out for emergency preparedness by the U.S. Department of Homeland Security.
It is time that we educate the population as to the difference between an emergency and a medical problem. It is time that we educate the general populous on the difference between an emergency transport unit (an ambulance) and a taxi cab. It is time that city councils give their EMS providers the ability to refuse to take non-emergent patients seeking only a ride. It is time that the federal government moves some of its Homeland Security money to all of the organizations who secure the homeland. It is time that emergency system abuse becomes unlawful. Notice I said "abuse", not use. Many people do not have insurance; many of them do not have the funds to pay for emergency medical services. This is a fact, and those people should not be punished for their socio-economic standing. Sadly there are a great many who abuse this system. People who go to the hospital by ambulance for a minor headache while there are 2 cars sitting in the driveway and four adults at the house. This costs the tax payer a fortune, when all that was needed was a trip to the store for aspirin. I am all for taking care of the little guy. As a very smart friend of mine put it, "We are the good guys. As the good guys it is our duty, if we are capable, to help those who can't help themselves." That doesn't mean it is our duty to help those who won't help themselves, those who abuse every system they touch.
posted by Christopher at 11:39 PM
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