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Re: Re: EMS profession

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Education is the answer, don't get me wrong. But until EMS establishes

itself as a profession, and the insurance industry catches up and starts

reimbursing, no one will want to have an MBA for 30k a year. Start from the

begining, and work with what we have, I think we need to crawl before we

walk.

Re: EMS profession

See my post under ems leadership. I will summ it up in one phrase

about the management of EMS. Masters of Business Administration!

-- In @y..., " jeriami stclair " <medicsntx@h...> wrote:

> If you could change something about the way EMS is what would it

be? (e.i.

> cooperation between ems people, salaries, job satisfaction, EMS

workers

> having pride in what we do, wanting to be more productive and

invovled, why

> we and other peolpe dont consider EMS a profession like

nursing......you get

> the idea.)

>

> I am in the process of writing a paper and would like the list

opinion.

>

> Thanks

> Jeriami

>

>

> _________________________________________________________________

> Join the world's largest e-mail service with MSN Hotmail.

> http://www.hotmail.com

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Guest guest

Following on importance of education is also the need for research to prove

what is done in the field makes a difference. Having you own body of

research (which can stand up to the rigors of academic level peer review)

also helps to prove the point that EMS is a profession in and of itself and

not a subpart of another field, i.e. emergency medicine which is a domain of

physicians. This research also leads into furthering the education of those

in the profession, which in turn makes the profession stronger.

Re: EMS profession

See my post under ems leadership. I will summ it up in one phrase

about the management of EMS. Masters of Business Administration!

-- In @y..., " jeriami stclair " <medicsntx@h...> wrote:

> If you could change something about the way EMS is what would it

be? (e.i.

> cooperation between ems people, salaries, job satisfaction, EMS

workers

> having pride in what we do, wanting to be more productive and

invovled, why

> we and other peolpe dont consider EMS a profession like

nursing......you get

> the idea.)

>

> I am in the process of writing a paper and would like the list

opinion.

>

> Thanks

> Jeriami

>

>

> _________________________________________________________________

> Join the world's largest e-mail service with MSN Hotmail.

> http://www.hotmail.com

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That's an interesting statement considering that the conceptual and

legal basis for EMS is that it is the delegated practice of emergency

medicine. How would a non physician construct a randomized controlled

trial that would withhold treatment from a control population, or render

experimental treatment to a targeted population without physician

authorization?

Barry Sharp wrote:

> Following on importance of education is also the need for research to

> prove

> what is done in the field makes a difference. Having you own body of

> research (which can stand up to the rigors of academic level peer

> review)

> also helps to prove the point that EMS is a profession in and of

> itself and

> not a subpart of another field, i.e. emergency medicine which is a

> domain of

> physicians. This research also leads into furthering the education of

> those

> in the profession, which in turn makes the profession stronger.

>

>

>

>

> Re: EMS profession

>

>

> See my post under ems leadership. I will summ it up in one phrase

> about the management of EMS. Masters of Business Administration!

> -- In @y..., " jeriami stclair " <medicsntx@h...> wrote:

> > If you could change something about the way EMS is what would it

> be? (e.i.

> > cooperation between ems people, salaries, job satisfaction, EMS

> workers

> > having pride in what we do, wanting to be more productive and

> invovled, why

> > we and other peolpe dont consider EMS a profession like

> nursing......you get

> > the idea.)

> >

> > I am in the process of writing a paper and would like the list

> opinion.

> >

> > Thanks

> > Jeriami

> >

> >

> > _________________________________________________________________

> > Join the world's largest e-mail service with MSN Hotmail.

> > http://www.hotmail.com

>

>

>

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Good points Bob. For the clinical research aspects, there would have to be

physician participation along with the ever present Internal Review Boards

for research involving human subjects. However, there could also be

historical data which could look at the prehospital care/hospital outcomes

utilizing differing protocols, levels of care, transport times, etc. for

various types of health problems which could then be compared. In addition,

there are also non-clinical aspects of EMS operations and activities which

could be studied to determine best-practices. This could even lead to a

change in the education needs for EMS, expanding from the technical

operations to more of management and epidemiology. (This, of course, is

still a long way off.)

My intent in using the emergency medicine example is to point out the need

for prehospital EMS to have their own body of research/education rather than

to be a subset of the overall " emergency medicine " which can cover

prehospital and hospital by providers ranging from bystanders doing CPR to

the full physician, nurses and allied health compliment at a Level I Trauma

Center. From what I've seen, most of the research in " emergency medicine "

has had a physican and/or emergency room viewpoint rather than the viewpoint

of the street medic. (I haven't seen recent copies, so things may have

changed and if they have I apologize for my oversight.)

Health Education has been doing that same thing for the past several decades

breaking away from " clinical patient education " on one side and " physical

education/PE coach " on the other, particularly in the area of public health.

Health Education is now at the point with it's own journals, educational

requirements, individual certification requirements (which are required by

law in some states), professional associations and is recognized as a stand

alone profession by the U.S. Department of Labor. But to get there, it took

time, effort and lots of work by a number of individuals with vision for

lots of years.

Re: EMS profession

>

>

> See my post under ems leadership. I will summ it up in one phrase

> about the management of EMS. Masters of Business Administration!

> -- In @y..., " jeriami stclair " <medicsntx@h...> wrote:

> > If you could change something about the way EMS is what would it

> be? (e.i.

> > cooperation between ems people, salaries, job satisfaction, EMS

> workers

> > having pride in what we do, wanting to be more productive and

> invovled, why

> > we and other peolpe dont consider EMS a profession like

> nursing......you get

> > the idea.)

> >

> > I am in the process of writing a paper and would like the list

> opinion.

> >

> > Thanks

> > Jeriami

> >

> >

> > _________________________________________________________________

> > Join the world's largest e-mail service with MSN Hotmail.

> > http://www.hotmail.com

>

>

>

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Well, as long as EMS is a MONEY driven industry then we will get no respect

you have all of these transfer services that live off of the name EMERGENCY

MEDICAL SERVICES well they are not.......they are medical transfer

services.....EMS should be reserved for 911 ONLY!!! We are supposed to be

part of the public safety services....well when was the last time your Police

Dept. or Sheriff Dept. sent you a bill for arresting you for stealing the

candy bar from K-Mart or asked you if you had homeowners insurance before

they stooped the person from breaking into your house, or when you house was

on fire and you called 911 were you asked if you have insurance first /

before they sent you a fire truck.....well try calling an ambulance and tell

them you need to have your mother transported to the hospital because she is

not feeling well the first thing the AMR's, RURAL METRO's, MOM AND POP EMS

is if you have insurance....and if you don't have government assistance well

then they ask do you have a credit card, or how about the cash rate...well if

the answer is no...then the tell you well you need to call 911....it is just

like some of the nursing homes with EMS services right down the street will

call there transfer service for a patient with active CVA, MI, or other

serious problem and the transfer service will have an ETA of 30 min or more

but because they are a paying client....the will not call the public service

EMS agency unless they have no insurance....that is why we are not respected

among the other public safety services.....as long as we allow private

medical transfers services to act like 911 EMERGENCY MEDICAL SERVICES then we

will be looked at as nothing more that wrecker driver's (AMBULANCE DRIVER'S)

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Sorry to stir you up Steve....I was not talking about 911 services...if AMR

is contracted with a county, city, or other govermental body they still are

demanding a contract price from that agency...and they still bill each and

everyone they transport reguardless if they have insurance or not....they

still send out bills and as far as the fire dept's i have never heard of

sending bills directly to the patient for rescue and extrication they might

bill the auto insurance or health insurance...but they don't ask for the

money first....remember i am only talking about the fact that the public is

confused ....they think that Jack and Bob's ems is the same as City of Austin

EMS, or that is what i am trying to say....transfers services should be just

that...a medical transfer service....not emergency medical services....they

are not the same thing....how can a service that is only in operation from 4

am till 9 pm just to take dialysis patient to and from be called EMERGENCY

MEDICAL SERVICES....DON'T MAKE SENCE.....

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I am not sure where you work as you chose not to sign your post but AMR San

definitely does not demand payment prior to transport. Not only is

this a ridiculous accusation it would present serious med-legal issues.

When a person calls 911 we respond and transport them to the hospital of

their choice regardless of their ability to pay!

Now, if you are in a hospital and you want to be transported to Dallas then

yes you will have to arrange payment but for 911 contact, we transport

regardless of payment or ability to pay. In fact, we have no mechanism in

place to collect prior to transport on 911 call.

Before you make accusation as inflammatory as you are making you need to do

some research and clearly state who you are accusing.

On a side note, many fire departments do charge for EMS transport as well as

rescue and extrication.

Dralle, EMT-P EMSC

CES Specialist

American Medical Response- San

Re: Re: EMS profession

Well, as long as EMS is a MONEY driven industry then we will get no respect

you have all of these transfer services that live off of the name EMERGENCY

MEDICAL SERVICES well they are not.......they are medical transfer

services.....EMS should be reserved for 911 ONLY!!! We are supposed to be

part of the public safety services....well when was the last time your

Police

Dept. or Sheriff Dept. sent you a bill for arresting you for stealing the

candy bar from K-Mart or asked you if you had homeowners insurance before

they stooped the person from breaking into your house, or when you house was

on fire and you called 911 were you asked if you have insurance first /

before they sent you a fire truck.....well try calling an ambulance and tell

them you need to have your mother transported to the hospital because she is

not feeling well the first thing the AMR's, RURAL METRO's, MOM AND POP EMS

is if you have insurance....and if you don't have government assistance well

then they ask do you have a credit card, or how about the cash rate...well

if

the answer is no...then the tell you well you need to call 911....it is just

like some of the nursing homes with EMS services right down the street will

call there transfer service for a patient with active CVA, MI, or other

serious problem and the transfer service will have an ETA of 30 min or more

but because they are a paying client....the will not call the public service

EMS agency unless they have no insurance....that is why we are not respected

among the other public safety services.....as long as we allow private

medical transfers services to act like 911 EMERGENCY MEDICAL SERVICES then

we

will be looked at as nothing more that wrecker driver's (AMBULANCE DRIVER'S)

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And yes i agree about the Fines, and probation fee's....but the Police or

Sheriff dept. does not charge that....that is the courts. anyway you only get

fined if you do something wrong.....if your mother, father, grandparents have

a heart attack....well where is the fault in that...the point i keep trying

to make is we can never be considered as valuable of a service as police,

fire as long as we have companies that are setting up shop just to milk

Medicaid and Medicare and to charge 600.00 + for a 10 min ambulance ride to

your local emergency room....and to top that off a 1000.00 + bill from the

emergency dept.............health care really needs to get a handle on that

problem too....but as far as EMS in which a lot of us work in well I guess

Steve said it.....If we want to be a profession we need to police ourselves!

Steve I could not agree with you more.....

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They can't be an EMS. TO be MICU licensed they must operate 24/7. Report

them to TDH!

If we want to be a profession we need to police ourselves!

Steve Dralle

Re: Re: EMS profession

Sorry to stir you up Steve....I was not talking about 911 services...if AMR

is contracted with a county, city, or other govermental body they still are

demanding a contract price from that agency...and they still bill each and

everyone they transport reguardless if they have insurance or not....they

still send out bills and as far as the fire dept's i have never heard of

sending bills directly to the patient for rescue and extrication they might

bill the auto insurance or health insurance...but they don't ask for the

money first....remember i am only talking about the fact that the public is

confused ....they think that Jack and Bob's ems is the same as City of

Austin

EMS, or that is what i am trying to say....transfers services should be just

that...a medical transfer service....not emergency medical services....they

are not the same thing....how can a service that is only in operation from 4

am till 9 pm just to take dialysis patient to and from be called EMERGENCY

MEDICAL SERVICES....DON'T MAKE SENCE.....

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Guest guest

They can't be an EMS. TO be MICU licensed they must operate 24/7. Report

them to TDH!

If we want to be a profession we need to police ourselves!

Steve Dralle

Re: Re: EMS profession

Sorry to stir you up Steve....I was not talking about 911 services...if AMR

is contracted with a county, city, or other govermental body they still are

demanding a contract price from that agency...and they still bill each and

everyone they transport reguardless if they have insurance or not....they

still send out bills and as far as the fire dept's i have never heard of

sending bills directly to the patient for rescue and extrication they might

bill the auto insurance or health insurance...but they don't ask for the

money first....remember i am only talking about the fact that the public is

confused ....they think that Jack and Bob's ems is the same as City of

Austin

EMS, or that is what i am trying to say....transfers services should be just

that...a medical transfer service....not emergency medical services....they

are not the same thing....how can a service that is only in operation from 4

am till 9 pm just to take dialysis patient to and from be called EMERGENCY

MEDICAL SERVICES....DON'T MAKE SENCE.....

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Guest guest

BE CAREFUL WHAT YOU ASK FOR...

for instance, anyone over the age of 45, syncopal episode... they want to be

transported... would you put them on monitor? would you do glucose check? IV?

Lab draw? IF NOT, are you giving TOP quality pre-hospital care?

Just a thought...

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BE CAREFUL WHAT YOU ASK FOR...

for instance, anyone over the age of 45, syncopal episode... they want to be

transported... would you put them on monitor? would you do glucose check? IV?

Lab draw? IF NOT, are you giving TOP quality pre-hospital care?

Just a thought...

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Guest guest

OK...so what about your grandfather or mine that is in abc nursing

home.....and they have that syncopal episode....and the nursing home calls

abc ems..(transfer service) with the county 911 service down the

street....because they know that when the transfer service arrives they will

be bringing candy, pizza, cookies, pens, pads, etc....and if they have a 30

min eta or longer well that is ok..we will just put gramps on a nasel canula

and he will be ok till they arrive...and they send the 2 emt-b crew to

transport him to the hospital....that is what i don't understand and that is

why there should be MEDICAL TRANSFER SERVICES not EMERGENCY MEDICAL

SERVICES....EMERGENCY MEANS JUST THAT....NOT 45 MIN ETA.....AND WE HAVE

GOODIES FOR YOU IF YOU CALL US....

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Also, if you are arrested and found guilty there are

hefty fines and / or court costs associated with such

prosecution. Law enforcement does charge money for

their services. Have you ever paid a traffic ticket?

E. Tate, LP

Tyler, Texas

--- " Dralle, Steve " wrote:

> I am not sure where you work as you chose not to

> sign your post but AMR San

> definitely does not demand payment prior to

> transport. Not only is

> this a ridiculous accusation it would present

> serious med-legal issues.

> When a person calls 911 we respond and transport

> them to the hospital of

> their choice regardless of their ability to pay!

>

> Now, if you are in a hospital and you want to be

> transported to Dallas then

> yes you will have to arrange payment but for 911

> contact, we transport

> regardless of payment or ability to pay. In fact,

> we have no mechanism in

> place to collect prior to transport on 911 call.

>

> Before you make accusation as inflammatory as you

> are making you need to do

> some research and clearly state who you are

> accusing.

>

> On a side note, many fire departments do charge for

> EMS transport as well as

> rescue and extrication.

>

> Dralle, EMT-P EMSC

> CES Specialist

> American Medical Response- San

>

>

> Re: Re: EMS profession

>

>

> Well, as long as EMS is a MONEY driven industry then

> we will get no respect

> you have all of these transfer services that live

> off of the name EMERGENCY

> MEDICAL SERVICES well they are not.......they are

> medical transfer

> services.....EMS should be reserved for 911 ONLY!!!

> We are supposed to be

> part of the public safety services....well when was

> the last time your

> Police

> Dept. or Sheriff Dept. sent you a bill for arresting

> you for stealing the

> candy bar from K-Mart or asked you if you had

> homeowners insurance before

> they stooped the person from breaking into your

> house, or when you house was

>

> on fire and you called 911 were you asked if you

> have insurance first /

> before they sent you a fire truck.....well try

> calling an ambulance and tell

>

> them you need to have your mother transported to the

> hospital because she is

>

> not feeling well the first thing the AMR's, RURAL

> METRO's, MOM AND POP EMS

> is if you have insurance....and if you don't have

> government assistance well

>

> then they ask do you have a credit card, or how

> about the cash rate...well

> if

> the answer is no...then the tell you well you need

> to call 911....it is just

>

> like some of the nursing homes with EMS services

> right down the street will

> call there transfer service for a patient with

> active CVA, MI, or other

> serious problem and the transfer service will have

> an ETA of 30 min or more

> but because they are a paying client....the will not

> call the public service

>

> EMS agency unless they have no insurance....that is

> why we are not respected

>

> among the other public safety services.....as long

> as we allow private

> medical transfers services to act like 911 EMERGENCY

> MEDICAL SERVICES then

> we

> will be looked at as nothing more that wrecker

> driver's (AMBULANCE DRIVER'S)

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

>

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Guest guest

Also, if you are arrested and found guilty there are

hefty fines and / or court costs associated with such

prosecution. Law enforcement does charge money for

their services. Have you ever paid a traffic ticket?

E. Tate, LP

Tyler, Texas

--- " Dralle, Steve " wrote:

> I am not sure where you work as you chose not to

> sign your post but AMR San

> definitely does not demand payment prior to

> transport. Not only is

> this a ridiculous accusation it would present

> serious med-legal issues.

> When a person calls 911 we respond and transport

> them to the hospital of

> their choice regardless of their ability to pay!

>

> Now, if you are in a hospital and you want to be

> transported to Dallas then

> yes you will have to arrange payment but for 911

> contact, we transport

> regardless of payment or ability to pay. In fact,

> we have no mechanism in

> place to collect prior to transport on 911 call.

>

> Before you make accusation as inflammatory as you

> are making you need to do

> some research and clearly state who you are

> accusing.

>

> On a side note, many fire departments do charge for

> EMS transport as well as

> rescue and extrication.

>

> Dralle, EMT-P EMSC

> CES Specialist

> American Medical Response- San

>

>

> Re: Re: EMS profession

>

>

> Well, as long as EMS is a MONEY driven industry then

> we will get no respect

> you have all of these transfer services that live

> off of the name EMERGENCY

> MEDICAL SERVICES well they are not.......they are

> medical transfer

> services.....EMS should be reserved for 911 ONLY!!!

> We are supposed to be

> part of the public safety services....well when was

> the last time your

> Police

> Dept. or Sheriff Dept. sent you a bill for arresting

> you for stealing the

> candy bar from K-Mart or asked you if you had

> homeowners insurance before

> they stooped the person from breaking into your

> house, or when you house was

>

> on fire and you called 911 were you asked if you

> have insurance first /

> before they sent you a fire truck.....well try

> calling an ambulance and tell

>

> them you need to have your mother transported to the

> hospital because she is

>

> not feeling well the first thing the AMR's, RURAL

> METRO's, MOM AND POP EMS

> is if you have insurance....and if you don't have

> government assistance well

>

> then they ask do you have a credit card, or how

> about the cash rate...well

> if

> the answer is no...then the tell you well you need

> to call 911....it is just

>

> like some of the nursing homes with EMS services

> right down the street will

> call there transfer service for a patient with

> active CVA, MI, or other

> serious problem and the transfer service will have

> an ETA of 30 min or more

> but because they are a paying client....the will not

> call the public service

>

> EMS agency unless they have no insurance....that is

> why we are not respected

>

> among the other public safety services.....as long

> as we allow private

> medical transfers services to act like 911 EMERGENCY

> MEDICAL SERVICES then

> we

> will be looked at as nothing more that wrecker

> driver's (AMBULANCE DRIVER'S)

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

>

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Guest guest

There are many fly-by-night services that are unscrupulous at best, however,

just because the service charges a reasonable rate for transport does not

make them unscrupulous. The reality is that the hospitals charge for the

services they provide, Fire Department EMS typically charge for services

(two ways, taxes and fee for service). Law Enforcement receives money from

the tax base as well as ticket revenue (though admittedly this usually goes

to the city " slush " fund) and drug seizures.

The ugly reality is that all of these services require money to provide and

a lot of it (do some research and see how much it costs to provide 24/7 MICU

coverage for 365 days). The public is used to and willing, in most cases,

to support law enforcement and fire service with tax dollars, they are not

usually that supportive of EMS. Many communities just do not have the

resources to provide the level of service necessary. That is where

companies such as AMR, that usually provide quality EMS and transportation

services, can help the communities by charging a subsidy less than it would

cost them to provide the service. This is a win-win situation because the

citizens get far more service than they could otherwise afford and we get

the increase in business.

With regards to the interfacility transports, very few taxpayers would

support interfacility transportation with their tax dollars. So, who is

going to pay for it???? The reality is that someone has to pay for the

service, no matter what, it takes money to make things run, no matter who

provides the service or what type of service you are talking about.

No to agree with you, EMS will always have trouble gaining respect when we

as a industry allow services to operate in unscrupulous manners. If you

work for a service that is in the practice of deep discounting contracts to

get Medicare business, you should be reporting it. If you are in a service

that routinely under staff their units, you should report it. Too many

times EMS personnel turn their head because they want to just " cash their

check " and not worry about those issues. That is what I meant by policing

ourselves!

Dralle, EMT-P EMSC

CES Specialist

American Medical Response- San

Re: Re: EMS profession

And yes i agree about the Fines, and probation fee's....but the Police or

Sheriff dept. does not charge that....that is the courts. anyway you only

get

fined if you do something wrong.....if your mother, father, grandparents

have

a heart attack....well where is the fault in that...the point i keep trying

to make is we can never be considered as valuable of a service as police,

fire as long as we have companies that are setting up shop just to milk

Medicaid and Medicare and to charge 600.00 + for a 10 min ambulance ride to

your local emergency room....and to top that off a 1000.00 + bill from the

emergency dept.............health care really needs to get a handle on that

problem too....but as far as EMS in which a lot of us work in well I guess

Steve said it.....If we want to be a profession we need to police ourselves!

Steve I could not agree with you more.....

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Guest guest

They may not be MICU-capable. Many of the " mom-and-pop " transfer services

have made the decision to not staff 24 hrs a day and not be MICU-capable.

On the other hand, most 24-hour non-911 services I know of are MICU-capable.

I think most are " BLS with MICU capability. "

Mike ;)

>

>Reply-To:

>To:

>Subject: RE: Re: EMS profession

>Date: Tue, 21 May 2002 07:21:23 -0600

>

>They can't be an EMS. TO be MICU licensed they must operate 24/7. Report

>them to TDH!

>

>If we want to be a profession we need to police ourselves!

>

>Steve Dralle

>

> Re: Re: EMS profession

>

>

>Sorry to stir you up Steve....I was not talking about 911 services...if AMR

>is contracted with a county, city, or other govermental body they still are

>demanding a contract price from that agency...and they still bill each and

>everyone they transport reguardless if they have insurance or not....they

>still send out bills and as far as the fire dept's i have never heard of

>sending bills directly to the patient for rescue and extrication they might

>bill the auto insurance or health insurance...but they don't ask for the

>money first....remember i am only talking about the fact that the public is

>confused ....they think that Jack and Bob's ems is the same as City of

>Austin

>EMS, or that is what i am trying to say....transfers services should be

>just

>

>that...a medical transfer service....not emergency medical

>services....they

>

>are not the same thing....how can a service that is only in operation from

>4

>

>am till 9 pm just to take dialysis patient to and from be called EMERGENCY

>MEDICAL SERVICES....DON'T MAKE SENCE.....

>

>

>

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Share on other sites

Guest guest

They may not be MICU-capable. Many of the " mom-and-pop " transfer services

have made the decision to not staff 24 hrs a day and not be MICU-capable.

On the other hand, most 24-hour non-911 services I know of are MICU-capable.

I think most are " BLS with MICU capability. "

Mike ;)

>

>Reply-To:

>To:

>Subject: RE: Re: EMS profession

>Date: Tue, 21 May 2002 07:21:23 -0600

>

>They can't be an EMS. TO be MICU licensed they must operate 24/7. Report

>them to TDH!

>

>If we want to be a profession we need to police ourselves!

>

>Steve Dralle

>

> Re: Re: EMS profession

>

>

>Sorry to stir you up Steve....I was not talking about 911 services...if AMR

>is contracted with a county, city, or other govermental body they still are

>demanding a contract price from that agency...and they still bill each and

>everyone they transport reguardless if they have insurance or not....they

>still send out bills and as far as the fire dept's i have never heard of

>sending bills directly to the patient for rescue and extrication they might

>bill the auto insurance or health insurance...but they don't ask for the

>money first....remember i am only talking about the fact that the public is

>confused ....they think that Jack and Bob's ems is the same as City of

>Austin

>EMS, or that is what i am trying to say....transfers services should be

>just

>

>that...a medical transfer service....not emergency medical

>services....they

>

>are not the same thing....how can a service that is only in operation from

>4

>

>am till 9 pm just to take dialysis patient to and from be called EMERGENCY

>MEDICAL SERVICES....DON'T MAKE SENCE.....

>

>

>

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Guest guest

In a word: YES

Is there some reason somebody would NOT do it? I can't think of any...

And before I do any of the " fancy stuff " , I'd probably put the patient on a

little oxygen.

Barry E. McClung, Paramedic/Crew Chief

North Blanco County EMS

City, Texas

Re: Re: EMS profession

BE CAREFUL WHAT YOU ASK FOR...

for instance, anyone over the age of 45, syncopal episode... they want to be

transported... would you put them on monitor? would you do glucose check? IV?

Lab draw? IF NOT, are you giving TOP quality pre-hospital care?

Just a thought...

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Guest guest

Two concerns with your post;

1) It would be considered a kickback to provide food to an agency in return

for Medicare patient. Report this activity to CMS.

2) I know our local TDH personnel are very concerned with the use of

" private " services that have long eta's for emergent responses to nursing

homes. I am sure if I reported a case that I witnessed or involved my

family it would be investigated and addressed by TDH. You should contact

your local TDH representatives concerning this type of activity.

Steve Dralle

Re: Re: EMS profession

OK...so what about your grandfather or mine that is in abc nursing

home.....and they have that syncopal episode....and the nursing home calls

abc ems..(transfer service) with the county 911 service down the

street....because they know that when the transfer service arrives they will

be bringing candy, pizza, cookies, pens, pads, etc....and if they have a 30

min eta or longer well that is ok..we will just put gramps on a nasel canula

and he will be ok till they arrive...and they send the 2 emt-b crew to

transport him to the hospital....that is what i don't understand and that is

why there should be MEDICAL TRANSFER SERVICES not EMERGENCY MEDICAL

SERVICES....EMERGENCY MEANS JUST THAT....NOT 45 MIN ETA.....AND WE HAVE

GOODIES FOR YOU IF YOU CALL US....

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Actually, if I recall correctly, any " goodies " given to entice business, is

considered BRIBERY under Federal Medicare statues.

Gene, am I correct on this, or am I hallucinating again?

When my Grandmother was still alive, and living in a nursing home (not MY idea,

mind you... my Aunt did it), I was able to put in my 2 cents worth, and we

advised the Nursing Home that we only wanted my Grandmother transported by the

local 911 provider, in the event of ANY emergency or urgent-care situation.

Routine stuff via Mom-n-Pop Ambutaxi, Inc. was fine.

We NEVER had any problems with them violating our wishes, but i suppose some

folks down here may NOT be that scrupulous.

Barry E. McClung, Paramedic/Crew Chief

North Blanco County EMS

City, Texas

Re: Re: EMS profession

OK...so what about your grandfather or mine that is in abc nursing

home.....and they have that syncopal episode....and the nursing home calls

abc ems..(transfer service) with the county 911 service down the

street....because they know that when the transfer service arrives they will

be bringing candy, pizza, cookies, pens, pads, etc....and if they have a 30

min eta or longer well that is ok..we will just put gramps on a nasel canula

and he will be ok till they arrive...and they send the 2 emt-b crew to

transport him to the hospital....that is what i don't understand and that is

why there should be MEDICAL TRANSFER SERVICES not EMERGENCY MEDICAL

SERVICES....EMERGENCY MEANS JUST THAT....NOT 45 MIN ETA.....AND WE HAVE

GOODIES FOR YOU IF YOU CALL US....

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To Mr. Mystery,

That is very interesting... the nursing homes in our COUNTY are able to call

WHO they want... I can recall of ONLY one that calls someone other than our

service [excluding the serious medical events]. From what I have been told,

we have NO contracts with ANYONE in our county to provide medical transport

services.

So, why is it we can do this without candy, pizza, and all the other goodies?

We have broken it down to 3 things - #1) GREAT COSTUMER SERVICE [we do what

is BEST for the patient... our medical director will back us 110% if we are

thinking about the patients well being]. #2) EXCELLENT MEDICAL CARE [we not

look at whether you can pay... what you can pay... nursing home patient...

teenager... excellent medical treatment is excellent medical treatment] #3)

COMMUNICATION [if we cannot make it when they want... we tell them... they

can wait for us or call someone else... they normally wait... if they don't

wait, they normally call for HELICOPTER *hmmm*].

Now, I am not sure where you are working... what your regional EMS providers

are like... but I have been here for 4+ years... and I am working under the

system that has been in place YEARS prior to my arrival. MAYBE there is a

problem with the area you are working in... sounds like there is nothing but

NEGATIVE situations where you are at.

I feel bad... my biggest concern right now is which direction or DWI

Awareness Program is gonna be progressing. *lol* OH YEAH - there is also the

concern of which helicopter service to use... there are 2 privates and 1

municipal to operate in our county. Man, I am not all too sure about this

going home and relaxing all the time either... gonna have to get me part-time

gig or something. *wink*

I do appreciate the other folks for the positive responses.

Junior , EMT-Paramedic

on County EMS Medic 33-Blue

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Gene, while you are pondering this, can you give any guidance or insight to

the difference between " goodies " for bribery that Barry is refering versus

the usual " goodies " used as part of the firm's marketing? I know when my

wife worked in long-term care, it wasn't unusual for the private transfer

companies to stop by and leave off note pads, pens and stickers with their

phone numbers on them. (It also wasn't unusual for the facility's contract

pharmacy to include a few candies in the bags when making drug deliveries to

the nurses station as a way of making nice-nice.)

At the time my wife worked in long-term care, there was a dramatic

difference between the levels, equipment and trucks that the city-regulated

(i.e. franchise) transfer service (BLS, non-emergency, non-standard

ambulance) and the non-regulated services that operated outside of the city

(ALS, Code-3, standard ambulance platform). They made the decision of 9-1-1,

BLS or ALS transfer provider based on the patient's condition and needs.

Re: Re: EMS profession

Actually, if I recall correctly, any " goodies " given to entice business, is

considered BRIBERY under Federal Medicare statues.

Gene, am I correct on this, or am I hallucinating again?

When my Grandmother was still alive, and living in a nursing home (not MY

idea, mind you... my Aunt did it), I was able to put in my 2 cents worth,

and we advised the Nursing Home that we only wanted my Grandmother

transported by the local 911 provider, in the event of ANY emergency or

urgent-care situation.

Routine stuff via Mom-n-Pop Ambutaxi, Inc. was fine.

We NEVER had any problems with them violating our wishes, but i suppose some

folks down here may NOT be that scrupulous.

Barry E. McClung, Paramedic/Crew Chief

North Blanco County EMS

City, Texas

Re: Re: EMS profession

OK...so what about your grandfather or mine that is in abc nursing

home.....and they have that syncopal episode....and the nursing home calls

abc ems..(transfer service) with the county 911 service down the

street....because they know that when the transfer service arrives they

will

be bringing candy, pizza, cookies, pens, pads, etc....and if they have a

30

min eta or longer well that is ok..we will just put gramps on a nasel

canula

and he will be ok till they arrive...and they send the 2 emt-b crew to

transport him to the hospital....that is what i don't understand and that

is

why there should be MEDICAL TRANSFER SERVICES not EMERGENCY MEDICAL

SERVICES....EMERGENCY MEANS JUST THAT....NOT 45 MIN ETA.....AND WE HAVE

GOODIES FOR YOU IF YOU CALL US....

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Guest guest

You're indicting the whole EMS transfer industry based on a narrow and

obviously jaundiced perception of how a few providers behave. I work for a

service that is MICU (not capable.........MICU!) and we do " routine "

transfers, as well as critical care transportation of patients- lots of 'em.

You can't put EMS provision in neat little boxes- it's become too complex an

industry for that kind of generalization. I'm not jumpin' your stuff, but

you need to get a few years under your belt and keep your eyes and brain

circuits open.

Jay Garner, AAS, LP

Re: Re: EMS profession

> OK...so what about your grandfather or mine that is in abc nursing

> home.....and they have that syncopal episode....and the nursing home calls

> abc ems..(transfer service) with the county 911 service down the

> street....because they know that when the transfer service arrives they

will

> be bringing candy, pizza, cookies, pens, pads, etc....and if they have a

30

> min eta or longer well that is ok..we will just put gramps on a nasel

canula

> and he will be ok till they arrive...and they send the 2 emt-b crew to

> transport him to the hospital....that is what i don't understand and that

is

> why there should be MEDICAL TRANSFER SERVICES not EMERGENCY MEDICAL

> SERVICES....EMERGENCY MEANS JUST THAT....NOT 45 MIN ETA.....AND WE HAVE

> GOODIES FOR YOU IF YOU CALL US....

>

>

>

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