Guest guest Posted April 9, 2007 Report Share Posted April 9, 2007 Why did you let them go ahead and fly her? Why did she consent? Assuming she had the present mental capacity to understand what was happening, she was the person in charge of her destiny absent a clearly communicated message to the contrary. So, you and the patient had the power to stop the transfer but consented to its continuation. That will be the physician's defense. See a lawyer to get legal advice on this situation; however, do not be surprised if s/he tells you you're hooked for the bill. Gene G. > > Here is a situation that occured several weeks ago with a family member. > You have a 38 y/o female who is c/o chest pain to the center of the chest > with pressure in addition to the pain. They go to one of the local ER's > that does not handle anything over a stumped toe. They do the typical > cardiac work up, 12 lead, etc. Lab showed only a slight elevation in Trop > maybe .4, not change in 12 lead that should indicate any MI. I'm called by > another family member about this entire situation. I speak with the nurse > who says that she is going to Abilene since she is cardiac...WRONG. I > instruct the nurse that she is to be taken to either Baylor All Saints in > Ft. Worth, Providence or Hillcrest in Waco. I provide names of the > cardiologist that I have worked with at all three locations. The nurse > tells me that she will work on getting a place. After get off the phone, > the nurse then ask the pt what she wants, and is told by the nurse that she > is to do what I have told them. > > As I'm returning back to the city from Dallas, I called the hospital back > and they have secured Baylor Ft. Worth. I had ask the nurse to let me know > before they left the ER. No call. When I arrive, I find out that the doc > in the box has decided to fly her out instead of going by ground. I > question the nurse, and ask if there was a change in the pts condition, and > I'm told no. Why are you flying her out then? Because the doc wanted it > done. Great no prior consent from me, as the family thought that I > knew...WRONG. I tell the ER nurse that this is a waste of air medical > services for someone with no major status change. > > I'm in luck, the crew is still on the ground, so I make contact with them > and find out that there is no change, and they again that it could have been > sent by ground. As I told the crew, I could have got an ambulance from > either place where I work and it would not have cost them anything. I came > within a hair of pulling them off the bird and ground pounding it to Ft. > Worth. > > To make long story short, a cath was done and no blockage was found of any > kind. Maybe a muscle spasm that cause Trop to become elevated to a 4.5, but > no heart damage. > > So, is this unnecessary use of air medical transport or not? Should the doc > be billed for this? To me, the pt was stable enough to go by ground and > would have saved $7,000. > > -- > > Wayne Dennis, EMTP > EMS & Clinical Supervisor > Life Care Plus EMS > Member, Injury Prevention - GETAC > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2007 Report Share Posted April 9, 2007 Send him the bill (or to the transferring facility). That is the only way this crap will stop. From: texasems-l [mailto:texasems-l ] On Behalf Of Wayne Dennis Sent: Monday, April 09, 2007 8:23 AM To: Texas EMS-l Subject: Fly or No Fly Here is a situation that occured several weeks ago with a family member. You have a 38 y/o female who is c/o chest pain to the center of the chest with pressure in addition to the pain. They go to one of the local ER's that does not handle anything over a stumped toe. They do the typical cardiac work up, 12 lead, etc. Lab showed only a slight elevation in Trop maybe .4, not change in 12 lead that should indicate any MI. I'm called by another family member about this entire situation. I speak with the nurse who says that she is going to Abilene since she is cardiac...WRONG. I instruct the nurse that she is to be taken to either Baylor All Saints in Ft. Worth, Providence or Hillcrest in Waco. I provide names of the cardiologist that I have worked with at all three locations. The nurse tells me that she will work on getting a place. After get off the phone, the nurse then ask the pt what she wants, and is told by the nurse that she is to do what I have told them. As I'm returning back to the city from Dallas, I called the hospital back and they have secured Baylor Ft. Worth. I had ask the nurse to let me know before they left the ER. No call. When I arrive, I find out that the doc in the box has decided to fly her out instead of going by ground. I question the nurse, and ask if there was a change in the pts condition, and I'm told no. Why are you flying her out then? Because the doc wanted it done. Great no prior consent from me, as the family thought that I knew...WRONG. I tell the ER nurse that this is a waste of air medical services for someone with no major status change. I'm in luck, the crew is still on the ground, so I make contact with them and find out that there is no change, and they again that it could have been sent by ground. As I told the crew, I could have got an ambulance from either place where I work and it would not have cost them anything. I came within a hair of pulling them off the bird and ground pounding it to Ft. Worth. To make long story short, a cath was done and no blockage was found of any kind. Maybe a muscle spasm that cause Trop to become elevated to a 4.5, but no heart damage. So, is this unnecessary use of air medical transport or not? Should the doc be billed for this? To me, the pt was stable enough to go by ground and would have saved $7,000. -- Wayne Dennis, EMTP EMS & Clinical Supervisor Life Care Plus EMS Member, Injury Prevention - GETAC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2007 Report Share Posted April 9, 2007 Here's my question -- why hasn't the managed care industry required some sort of determination of medical necessity? -Wes Ogilvie Fly or No Fly Here is a situation that occured several weeks ago with a family member. You have a 38 y/o female who is c/o chest pain to the center of the chest with pressure in addition to the pain. They go to one of the local ER's that does not handle anything over a stumped toe. They do the typical cardiac work up, 12 lead, etc. Lab showed only a slight elevation in Trop maybe .4, not change in 12 lead that should indicate any MI. I'm called by another family member about this entire situation. I speak with the nurse who says that she is going to Abilene since she is cardiac...WRONG. I instruct the nurse that she is to be taken to either Baylor All Saints in Ft. Worth, Providence or Hillcrest in Waco. I provide names of the cardiologist that I have worked with at all three locations. The nurse tells me that she will work on getting a place. After get off the phone, the nurse then ask the pt what she wants, and is told by the nurse that she is to do what I have told them. As I'm returning back to the city from Dallas, I called the hospital back and they have secured Baylor Ft. Worth. I had ask the nurse to let me know before they left the ER. No call. When I arrive, I find out that the doc in the box has decided to fly her out instead of going by ground. I question the nurse, and ask if there was a change in the pts condition, and I'm told no. Why are you flying her out then? Because the doc wanted it done. Great no prior consent from me, as the family thought that I knew...WRONG. I tell the ER nurse that this is a waste of air medical services for someone with no major status change. I'm in luck, the crew is still on the ground, so I make contact with them and find out that there is no change, and they again that it could have been sent by ground. As I told the crew, I could have got an ambulance from either place where I work and it would not have cost them anything. I came within a hair of pulling them off the bird and ground pounding it to Ft. Worth. To make long story short, a cath was done and no blockage was found of any kind. Maybe a muscle spasm that cause Trop to become elevated to a 4.5, but no heart damage. So, is this unnecessary use of air medical transport or not? Should the doc be billed for this? To me, the pt was stable enough to go by ground and would have saved $7,000. -- Wayne Dennis, EMTP EMS & Clinical Supervisor Life Care Plus EMS Member, Injury Prevention - GETAC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2007 Report Share Posted April 9, 2007 >>So, is this unnecessary use of air medical transport or not? Should the doc be billed for this? To me, the pt was stable enough to go by ground and would have saved $7,000.<< In a word, yes. -- Grayson, CCEMT-P, etc. MEDIC Training Solutions http://www.medictrainingsolutions.com/ Quote Link to comment Share on other sites More sharing options...
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