Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort Worth

[Guest guest]

Neither does critical thinking nor any higher-level reading ability, such as the

ability to detect either tone or sarcasm.

God bless technical educashun! (Yes, dimwits, that was an intentional

misspelling.)

-Wes Ogilvie

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

>

>

>

>

>

>

> Well I have stayed out of this discussion as everyone knows my side, but here

I go again. Many if not most 911 callers would suffer no harm not going by

ambulance. Some would not suffer any harm not even ever going to the doctor

about their present complaint. In fact my 13 year old with no medical education

could determine many of the ones I have suggested not transporting.

>

> If the people working for a service do not have enough common sense to be able

to safely examine then assist patients to get where they really need to go

perhaps the service should hire better people. Everyone keeps throwing out that

standards have lowered, well those that hire are the reason lowered standards

have become the norm. If services refused to hire those warm body's with a pulse

standards could rise, so perhaps we need to re-look at where the real problem

is.

>

> Again you would still transport 95% of all callers that want to go but for

some you would do them more benefit helping them find a way to get the care they

actually need. We are not saying they are not sick and yes they may even need to

spend time in the hospital but that does not make it an emergency ( immediate

life threat ). Helping educate patients improves customer relations and in the

future helps ambulances be available to respond to immediate life threats.

>

> I could go on and on as can those that oppose so I will stop now. My main

point in my rant is just because you disagree with someones opinion does not

mean you have a right to belittle them. Perhaps if everyone got off the only

opinion that is right is mine attitude maybe we could move EMS forward.

>

> No disrespect meant in my frustrated response. Have a great day.

>

> Renny

>

>

>

>

>

>

>

>

[Guest guest]

Let's just keep doing what we're doing and fuggetaboutit.

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

To: texasems-l

Date: Monday, November 2, 2009, 7:56 AM

 

Out of the Box is right. People that think like this need to be off the box. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw. com/news/ local-beat/ Call-An-Ambulanc e-Get-a-Taxi-

66723887.

html

>

>

>

------------ --------- --------- --------- --------- --------- -

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

Common sense is less the issue then reality, simply because health

care is a business. Employers hire to the minimum standard because

that is the requirement. If they were to hire above the minimum

standard, that would be good, but it would cost them money and cut

into profits. If it were a major employer, it could also set off a

spiral in the industry of competition for the " better qualified "

applicants, which would result in our salaries coming up dramatically.

While you and I may think that's a great idea, the guys in suits

running the businesses disagree (and for good reason: reimbursements

wouldn't pay for the expenditure and now ambulances are going to run

at a loss...) Even if it could somehow get paid for, it's still a bad

idea to business people because paying someone more then you must

means your profit margin is reduced by at least that much. It's bad

business, which means it's not going to happen.

Asking employers to hire better people isn't a strategy that's going

to work on any scale that matters, unless you have some real " juice "

behind it (I think of somewhere like Boston, or King County.) That to

me implies some sort of governmental connection, where you can keep

competitors out of your sandbox (creating a regulatory monopoly, which

is good for business.) If you can't do that, then someone with cheaper

labor and lower standards is just going to kick your feet out come

first contract time.

If you want improvement, you need to focus first on education and

second on some sort of quality assurance/quality improvement system.

You focus on bringing everyone up to the standard that you're looking

for out of the box, then force them to stay there. You will always

have slackers who try to drag dog and go-getters that are going to

exceed the standard, but in the United States of America, the minimum

standard is where it's at. Whether you like it or not, if you want

real change, real improvement, that's the measure you need to adjust.

Austin

> Well based on that response I guess it is obvious common sense has

> no place in EMS.

>

>

>>

>>

>> **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

>>

>> Renny --

>>

>> Your posts no longer require my reply as a paramedic and a

>> lawyer. You'd be much better off talking to an ECA who's watched

>> a couple of episodes of Boston Legal. I'll send you their

>> direction instead.

>>

>> -Wes Ogilvie

>>

>>

>> Re: Call an Ambulance, Get a Taxi | NBC

>> Dallas-Fort Worth

>>

>>

>>

>>

>>

>>

>> Well I have stayed out of this discussion as everyone knows my

>> side, but here I go again. Many if not most 911 callers would

>> suffer no harm not going by ambulance. Some would not suffer any

>> harm not even ever going to the doctor about their present

>> complaint. In fact my 13 year old with no medical education could

>> determine many of the ones I have suggested not transporting.

>>

>> If the people working for a service do not have enough common sense

>> to be able to safely examine then assist patients to get where they

>> really need to go perhaps the service should hire better people.

>> Everyone keeps throwing out that standards have lowered, well those

>> that hire are the reason lowered standards have become the norm. If

>> services refused to hire those warm body's with a pulse standards

>> could rise, so perhaps we need to re-look at where the real problem

>> is.

>>

>> Again you would still transport 95% of all callers that want to go

>> but for some you would do them more benefit helping them find a way

>> to get the care they actually need. We are not saying they are not

>> sick and yes they may even need to spend time in the hospital but

>> that does not make it an emergency ( immediate life threat ).

>> Helping educate patients improves customer relations and in the

>> future helps ambulances be available to respond to immediate life

>> threats.

>>

>> I could go on and on as can those that oppose so I will stop now.

>> My main point in my rant is just because you disagree with someones

>> opinion does not mean you have a right to belittle them. Perhaps if

>> everyone got off the only opinion that is right is mine attitude

>> maybe we could move EMS forward.

>>

>> No disrespect meant in my frustrated response. Have a great day.

>>

>> Renny

>>

>>

>>

>>

>>

>>

>>

>>

[Guest guest]

I'M WITH HENRY! Also, it seems this discussion has run it's course and has taken

the direction of that NBC show- " Trauma " -------------------DNR!

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

To: texasems-l

Date: Monday, November 2, 2009, 7:56 AM

 

Out of the Box is right. People that think like this need to be off the box. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw. com/news/ local-beat/ Call-An-Ambulanc e-Get-a-Taxi-

66723887.

html

>

>

>

------------ --------- --------- --------- --------- --------- -

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

I'M WITH HENRY! Also, it seems this discussion has run it's course and has taken

the direction of that NBC show- " Trauma " -------------------DNR!

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

To: texasems-l

Date: Monday, November 2, 2009, 7:56 AM

 

Out of the Box is right. People that think like this need to be off the box. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw. com/news/ local-beat/ Call-An-Ambulanc e-Get-a-Taxi-

66723887.

html

>

>

>

------------ --------- --------- --------- --------- --------- -

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

I'M WITH HENRY! Also, it seems this discussion has run it's course and has taken

the direction of that NBC show- " Trauma " -------------------DNR!

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

To: texasems-l

Date: Monday, November 2, 2009, 7:56 AM

 

Out of the Box is right. People that think like this need to be off the box. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw. com/news/ local-beat/ Call-An-Ambulanc e-Get-a-Taxi-

66723887.

html

>

>

>

------------ --------- --------- --------- --------- --------- -

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

My apology's I forgot my after my reply.

As to sarcasm in written form w/o stating sarcasm or adding a smiley it is

obvious even based on your reply that sarcasm can often be missed. Thank

goodness that people waste money and years in college so us uneducated idiots

can make the same amount of money in a life time. 8)

> >

> >

> > **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

> >

> > Renny --

> >

> > Your posts no longer require my reply as a paramedic and a lawyer. You'd be

much better off talking to an ECA who's watched a couple of episodes of Boston

Legal. I'll send you their direction instead.

> >

> > -Wes Ogilvie

> >

> >

> > Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

> >

> >

> >

> >

> >

> >

> > Well I have stayed out of this discussion as everyone knows my side, but

here I go again. Many if not most 911 callers would suffer no harm not going by

ambulance. Some would not suffer any harm not even ever going to the doctor

about their present complaint. In fact my 13 year old with no medical education

could determine many of the ones I have suggested not transporting.

> >

> > If the people working for a service do not have enough common sense to be

able to safely examine then assist patients to get where they really need to go

perhaps the service should hire better people. Everyone keeps throwing out that

standards have lowered, well those that hire are the reason lowered standards

have become the norm. If services refused to hire those warm body's with a pulse

standards could rise, so perhaps we need to re-look at where the real problem

is.

> >

> > Again you would still transport 95% of all callers that want to go but for

some you would do them more benefit helping them find a way to get the care they

actually need. We are not saying they are not sick and yes they may even need to

spend time in the hospital but that does not make it an emergency ( immediate

life threat ). Helping educate patients improves customer relations and in the

future helps ambulances be available to respond to immediate life threats.

> >

> > I could go on and on as can those that oppose so I will stop now. My main

point in my rant is just because you disagree with someones opinion does not

mean you have a right to belittle them. Perhaps if everyone got off the only

opinion that is right is mine attitude maybe we could move EMS forward.

> >

> > No disrespect meant in my frustrated response. Have a great day.

> >

> > Renny

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

My apology's I forgot my after my reply.

As to sarcasm in written form w/o stating sarcasm or adding a smiley it is

obvious even based on your reply that sarcasm can often be missed. Thank

goodness that people waste money and years in college so us uneducated idiots

can make the same amount of money in a life time. 8)

> >

> >

> > **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

> >

> > Renny --

> >

> > Your posts no longer require my reply as a paramedic and a lawyer. You'd be

much better off talking to an ECA who's watched a couple of episodes of Boston

Legal. I'll send you their direction instead.

> >

> > -Wes Ogilvie

> >

> >

> > Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

> >

> >

> >

> >

> >

> >

> > Well I have stayed out of this discussion as everyone knows my side, but

here I go again. Many if not most 911 callers would suffer no harm not going by

ambulance. Some would not suffer any harm not even ever going to the doctor

about their present complaint. In fact my 13 year old with no medical education

could determine many of the ones I have suggested not transporting.

> >

> > If the people working for a service do not have enough common sense to be

able to safely examine then assist patients to get where they really need to go

perhaps the service should hire better people. Everyone keeps throwing out that

standards have lowered, well those that hire are the reason lowered standards

have become the norm. If services refused to hire those warm body's with a pulse

standards could rise, so perhaps we need to re-look at where the real problem

is.

> >

> > Again you would still transport 95% of all callers that want to go but for

some you would do them more benefit helping them find a way to get the care they

actually need. We are not saying they are not sick and yes they may even need to

spend time in the hospital but that does not make it an emergency ( immediate

life threat ). Helping educate patients improves customer relations and in the

future helps ambulances be available to respond to immediate life threats.

> >

> > I could go on and on as can those that oppose so I will stop now. My main

point in my rant is just because you disagree with someones opinion does not

mean you have a right to belittle them. Perhaps if everyone got off the only

opinion that is right is mine attitude maybe we could move EMS forward.

> >

> > No disrespect meant in my frustrated response. Have a great day.

> >

> > Renny

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

The term " common sense " suggests that yours represents a plurality opinion.

That sounds like a great defense before a " jury of your peers. " Today,

we've also learned that society benefits through denial of services. Wow,

I wish I would have thought of that one.

So, now we can learn and spend more and more on EMS education and medical

technologies for fewer and fewer patients, until eventually we'll be able to

do everything - for no one. I got it!

Bob

>

>

> Well based on that response I guess it is obvious common sense has no place

> in EMS.

>

>

> >

> >

> > **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

> >

> > Renny --

> >

> > Your posts no longer require my reply as a paramedic and a lawyer. You'd

> be much better off talking to an ECA who's watched a couple of episodes of

> Boston Legal. I'll send you their direction instead.

> >

> > -Wes Ogilvie

> >

> >

> > Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

> Worth

> >

> >

> >

> >

> >

> >

> > Well I have stayed out of this discussion as everyone knows my side, but

> here I go again. Many if not most 911 callers would suffer no harm not going

> by ambulance. Some would not suffer any harm not even ever going to the

> doctor about their present complaint. In fact my 13 year old with no medical

> education could determine many of the ones I have suggested not

> transporting.

> >

> > If the people working for a service do not have enough common sense to be

> able to safely examine then assist patients to get where they really need to

> go perhaps the service should hire better people. Everyone keeps throwing

> out that standards have lowered, well those that hire are the reason lowered

> standards have become the norm. If services refused to hire those warm

> body's with a pulse standards could rise, so perhaps we need to re-look at

> where the real problem is.

> >

> > Again you would still transport 95% of all callers that want to go but

> for some you would do them more benefit helping them find a way to get the

> care they actually need. We are not saying they are not sick and yes they

> may even need to spend time in the hospital but that does not make it an

> emergency ( immediate life threat ). Helping educate patients improves

> customer relations and in the future helps ambulances be available to

> respond to immediate life threats.

> >

> > I could go on and on as can those that oppose so I will stop now. My main

> point in my rant is just because you disagree with someones opinion does not

> mean you have a right to belittle them. Perhaps if everyone got off the only

> opinion that is right is mine attitude maybe we could move EMS forward.

> >

> > No disrespect meant in my frustrated response. Have a great day.

> >

> > Renny

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

And how often is common sense common in Nything let alone EMS?

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos

(Cell)

LNMolino@...

> Well based on that response I guess it is obvious common sense has

> no place in EMS.

>

>

> >

> >

> > **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

> >

> > Renny --

> >

> > Your posts no longer require my reply as a paramedic and a lawyer.

> You'd be much better off talking to an ECA who's watched a couple of

> episodes of Boston Legal. I'll send you their direction instead.

> >

> > -Wes Ogilvie

> >

> >

> > Re: Call an Ambulance, Get a Taxi | NBC

> Dallas-Fort Worth

> >

> >

> >

> >

> >

> >

> > Well I have stayed out of this discussion as everyone knows my

> side, but here I go again. Many if not most 911 callers would suffer

> no harm not going by ambulance. Some would not suffer any harm not

> even ever going to the doctor about their present complaint. In fact

> my 13 year old with no medical education could determine many of the

> ones I have suggested not transporting.

> >

> > If the people working for a service do not have enough common

> sense to be able to safely examine then assist patients to get where

> they really need to go perhaps the service should hire better

> people. Everyone keeps throwing out that standards have lowered,

> well those that hire are the reason lowered standards have become

> the norm. If services refused to hire those warm body's with a pulse

> standards could rise, so perhaps we need to re-look at where the

> real problem is.

> >

> > Again you would still transport 95% of all callers that want to go

> but for some you would do them more benefit helping them find a way

> to get the care they actually need. We are not saying they are not

> sick and yes they may even need to spend time in the hospital but

> that does not make it an emergency ( immediate life threat ).

> Helping educate patients improves customer relations and in the

> future helps ambulances be available to respond to immediate life

> threats.

> >

> > I could go on and on as can those that oppose so I will stop now.

> My main point in my rant is just because you disagree with someones

> opinion does not mean you have a right to belittle them. Perhaps if

> everyone got off the only opinion that is right is mine attitude

> maybe we could move EMS forward.

> >

> > No disrespect meant in my frustrated response. Have a great day.

> >

> > Renny

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

And how often is common sense common in Nything let alone EMS?

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos

(Cell)

LNMolino@...

> Well based on that response I guess it is obvious common sense has

> no place in EMS.

>

>

> >

> >

> > **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

> >

> > Renny --

> >

> > Your posts no longer require my reply as a paramedic and a lawyer.

> You'd be much better off talking to an ECA who's watched a couple of

> episodes of Boston Legal. I'll send you their direction instead.

> >

> > -Wes Ogilvie

> >

> >

> > Re: Call an Ambulance, Get a Taxi | NBC

> Dallas-Fort Worth

> >

> >

> >

> >

> >

> >

> > Well I have stayed out of this discussion as everyone knows my

> side, but here I go again. Many if not most 911 callers would suffer

> no harm not going by ambulance. Some would not suffer any harm not

> even ever going to the doctor about their present complaint. In fact

> my 13 year old with no medical education could determine many of the

> ones I have suggested not transporting.

> >

> > If the people working for a service do not have enough common

> sense to be able to safely examine then assist patients to get where

> they really need to go perhaps the service should hire better

> people. Everyone keeps throwing out that standards have lowered,

> well those that hire are the reason lowered standards have become

> the norm. If services refused to hire those warm body's with a pulse

> standards could rise, so perhaps we need to re-look at where the

> real problem is.

> >

> > Again you would still transport 95% of all callers that want to go

> but for some you would do them more benefit helping them find a way

> to get the care they actually need. We are not saying they are not

> sick and yes they may even need to spend time in the hospital but

> that does not make it an emergency ( immediate life threat ).

> Helping educate patients improves customer relations and in the

> future helps ambulances be available to respond to immediate life

> threats.

> >

> > I could go on and on as can those that oppose so I will stop now.

> My main point in my rant is just because you disagree with someones

> opinion does not mean you have a right to belittle them. Perhaps if

> everyone got off the only opinion that is right is mine attitude

> maybe we could move EMS forward.

> >

> > No disrespect meant in my frustrated response. Have a great day.

> >

> > Renny

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

And how often is common sense common in Nything let alone EMS?

Louis N. Molino, Sr. CET

FF/NREMT/FSI/EMSI

Typed by my fingers on my iPhone.

Please excuse any typos

(Cell)

LNMolino@...

> Well based on that response I guess it is obvious common sense has

> no place in EMS.

>

>

> >

> >

> > **DISCLAIMER -- SARCASM THROUGHOUT THIS REPLY**

> >

> > Renny --

> >

> > Your posts no longer require my reply as a paramedic and a lawyer.

> You'd be much better off talking to an ECA who's watched a couple of

> episodes of Boston Legal. I'll send you their direction instead.

> >

> > -Wes Ogilvie

> >

> >

> > Re: Call an Ambulance, Get a Taxi | NBC

> Dallas-Fort Worth

> >

> >

> >

> >

> >

> >

> > Well I have stayed out of this discussion as everyone knows my

> side, but here I go again. Many if not most 911 callers would suffer

> no harm not going by ambulance. Some would not suffer any harm not

> even ever going to the doctor about their present complaint. In fact

> my 13 year old with no medical education could determine many of the

> ones I have suggested not transporting.

> >

> > If the people working for a service do not have enough common

> sense to be able to safely examine then assist patients to get where

> they really need to go perhaps the service should hire better

> people. Everyone keeps throwing out that standards have lowered,

> well those that hire are the reason lowered standards have become

> the norm. If services refused to hire those warm body's with a pulse

> standards could rise, so perhaps we need to re-look at where the

> real problem is.

> >

> > Again you would still transport 95% of all callers that want to go

> but for some you would do them more benefit helping them find a way

> to get the care they actually need. We are not saying they are not

> sick and yes they may even need to spend time in the hospital but

> that does not make it an emergency ( immediate life threat ).

> Helping educate patients improves customer relations and in the

> future helps ambulances be available to respond to immediate life

> threats.

> >

> > I could go on and on as can those that oppose so I will stop now.

> My main point in my rant is just because you disagree with someones

> opinion does not mean you have a right to belittle them. Perhaps if

> everyone got off the only opinion that is right is mine attitude

> maybe we could move EMS forward.

> >

> > No disrespect meant in my frustrated response. Have a great day.

> >

> > Renny

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

On Monday, November 2, 2009 08:08, " , Rick " rick.moore@...>

said:

> Business runs on productivity when the suits look at the

> productivity numbers they don't distinguish between the " real " calls and

> the " BS " calls. Like it or not, " BS " calls are a part of the business,

> in fact they are essential to the business.

While I fully accept that I may be grossly overestimating the intelligence of

MedStar's bean counters, it seems to me that if they were making money off of

those patients, they wouldn't be trying to dump them. That leads me to believe

that, despite the obvious assumption you have made (which is indeed logical), in

reality, it's not working out. They aren't getting paid for those runs. Heck,

there's no medical justification for half of the Priority 5 transfers they make

all day long either, but you don't see them trying to get out of doing them.

Rob

[Guest guest]

Well the patient I was referring to as " BS " were the patients who choose not to

go to, or do not have, a gp to visit when they have an ankle sprain. They want

an evaluation and choose to use Medic 1 Cab Co. so they can move to the front of

the line in the ER, or something similarly " un emergent " (if there is such a

term).

Citizens such as these often present their " insurance card " ....you know the 8

1/2 x 11 piece of paper that the State of Texas issues Medicaid reciepients.

(Don't get me started about that little burden to the Health Care system in this

country.)

Perhaps your evaluation skills are not strong enough to differentiate between

what is an emergency and what is not, however my skills are honed enough to

distinguish between the two.

Now while I agree that my previous post is an opinion, I disagree that it is BS.

I am offended that, when I venture to express an opinion in an open forum for

the third time in the six years, it is met with an inflammatory retort.

So insert raspberry here!

L. Gaines

jlgatc@...

To: texasems-l

From: hbarber@...

Date: Mon, 2 Nov 2009 07:56:44 -0600

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Out of the Box is right. People that think like this need to be off the box. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw.com/news/local-beat/Call-An-Ambulance-Get-a-Taxi-66723887.

html

>

>

>

----------------------------------------------------------

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

Well the patient I was referring to as " BS " were the patients who choose not to

go to, or do not have, a gp to visit when they have an ankle sprain. They want

an evaluation and choose to use Medic 1 Cab Co. so they can move to the front of

the line in the ER, or something similarly " un emergent " (if there is such a

term).

Citizens such as these often present their " insurance card " ....you know the 8

1/2 x 11 piece of paper that the State of Texas issues Medicaid reciepients.

(Don't get me started about that little burden to the Health Care system in this

country.)

Perhaps your evaluation skills are not strong enough to differentiate between

what is an emergency and what is not, however my skills are honed enough to

distinguish between the two.

Now while I agree that my previous post is an opinion, I disagree that it is BS.

I am offended that, when I venture to express an opinion in an open forum for

the third time in the six years, it is met with an inflammatory retort.

So insert raspberry here!

L. Gaines

jlgatc@...

To: texasems-l

From: hbarber@...

Date: Mon, 2 Nov 2009 07:56:44 -0600

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Out of the Box is right. People that think like this need to be off the box. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw.com/news/local-beat/Call-An-Ambulance-Get-a-Taxi-66723887.

html

>

>

>

----------------------------------------------------------

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

I agree , Good point.

Subject: Re: Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

To: texasems-l

Date: Monday, November 2, 2009, 7:56 AM

 

Out of the Box is right. People that think like this need to be off the box.. It

is only your opinion that it is BS. What about your patient?

Henry

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw. com/news/ local-beat/ Call-An-Ambulanc e-Get-a-Taxi-

66723887.

html

>

>

>

------------ --------- --------- --------- --------- --------- -

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

Easy easy there Austin,

As an employer of paramedics, I must disagree with you here. EMS agencies are

the customer of the Education system...and honestly an education system that has

been painfully harmed by a " allow anyone in to be taught by anyone who wants to

teach with nothing more important than getting people through the program...not

getting them prepared to work on the streets " mentality by way too many people

in EMS Education. EMS Education is NO different than the issues we have with no

limits on how many transfer services that can be in an area...and that hurts

because programs that want to appropriately prepare medics gets undercut by

those merely trying to move people through.

When I have to test over 50 paramedics to find 1 or 2 that can work a simple

mega-code (not a bunch of drips and complications but CPR, defib, Epi, Amio,

etc) without someone walking them through the process...I fail to see how that

is my fault as an EMS Provider.

You want to increase the minimum standard? Let's do 3 things:

1. Work from Washington D.C. on down to develop a system to pay EMS providers

for doing other things beside transporting and to pay all these services at the

COST plus a percentage that it takes to provide them.

2. Develop a method where Counties can regulate who provides services within

their county borders and who cannot so that the market can be controlled how

that county desires to control it.

3. Develop an educational system in Texas that limits who can conduct classes

yet provides the appropriate number of slots in locations around the state in a

way to insure that there are an appropriate number of well trained and prepared

EMT's and Paramedics.

Fix these three problems around this state...and then we can talk about trying

to determine how we can or cannot determine who needs to go to the hospital.

There are some really interesting projects being done around the country

currently along these lines...but our system is sending them down limited growth

or even death because there is no way to fund them.

Dudley

Re: Call an Ambulance, Get a Taxi | NBC

>> Dallas-Fort Worth

>>

>>

>>

>>

>>

>>

>> Well I have stayed out of this discussion as everyone knows my

>> side, but here I go again. Many if not most 911 callers would

>> suffer no harm not going by ambulance. Some would not suffer any

>> harm not even ever going to the doctor about their present

>> complaint. In fact my 13 year old with no medical education could

>> determine many of the ones I have suggested not transporting.

>>

>> If the people working for a service do not have enough common sense

>> to be able to safely examine then assist patients to get where they

>> really need to go perhaps the service should hire better people.

>> Everyone keeps throwing out that standards have lowered, well those

>> that hire are the reason lowered standards have become the norm. If

>> services refused to hire those warm body's with a pulse standards

>> could rise, so perhaps we need to re-look at where the real problem

>> is.

>>

>> Again you would still transport 95% of all callers that want to go

>> but for some you would do them more benefit helping them find a way

>> to get the care they actually need. We are not saying they are not

>> sick and yes they may even need to spend time in the hospital but

>> that does not make it an emergency ( immediate life threat ).

>> Helping educate patients improves customer relations and in the

>> future helps ambulances be available to respond to immediate life

>> threats.

>>

>> I could go on and on as can those that oppose so I will stop now.

>> My main point in my rant is just because you disagree with someones

>> opinion does not mean you have a right to belittle them. Perhaps if

>> everyone got off the only opinion that is right is mine attitude

>> maybe we could move EMS forward.

>>

>> No disrespect meant in my frustrated response. Have a great day.

>>

>> Renny

>>

>>

>>

>>

>>

>>

>>

>>

[Guest guest]

On Monday, November 2, 2009 23:35, THEDUDMAN@... said:

> Yet, when people do exactly as we have told them to do over the last 20 to 30

> years...it is now somehow something they are doing to abuse the very system

that

> WE have set up.

This would be especially true in Fort Worth, the system which is the subject of

this thread. MedStar is a monopoly. Citizens have zero choice on who they

call. No other provider -- emergency or non-emergency -- is allowed within the

city of Fort Worth. If MedStar doesn't transport you, then nobody transports

you. To take that kind of monopolistic authority and then abuse it by refusing

anyone is a serious breech of their fiduciary trust.

Rob

[Guest guest]

On Monday, November 2, 2009 23:35, THEDUDMAN@... said:

> Yet, when people do exactly as we have told them to do over the last 20 to 30

> years...it is now somehow something they are doing to abuse the very system

that

> WE have set up.

This would be especially true in Fort Worth, the system which is the subject of

this thread. MedStar is a monopoly. Citizens have zero choice on who they

call. No other provider -- emergency or non-emergency -- is allowed within the

city of Fort Worth. If MedStar doesn't transport you, then nobody transports

you. To take that kind of monopolistic authority and then abuse it by refusing

anyone is a serious breech of their fiduciary trust.

Rob

[Guest guest]

On Monday, November 2, 2009 23:35, THEDUDMAN@... said:

> Yet, when people do exactly as we have told them to do over the last 20 to 30

> years...it is now somehow something they are doing to abuse the very system

that

> WE have set up.

This would be especially true in Fort Worth, the system which is the subject of

this thread. MedStar is a monopoly. Citizens have zero choice on who they

call. No other provider -- emergency or non-emergency -- is allowed within the

city of Fort Worth. If MedStar doesn't transport you, then nobody transports

you. To take that kind of monopolistic authority and then abuse it by refusing

anyone is a serious breech of their fiduciary trust.

Rob

[Guest guest]

,

I don't think that anyone thought your right to post on this list was BS.

However, everyone here has the right to their own opinion. The Flame bites us

all from time to time. You yourself can do a little Bar B Q yourself see example

( " Perhaps your evaluation skills are not strong enough to differentiate

between what is an emergency and what is not, however my skills are honed enough

to distinguish between the two. " )

People call 911 because of their perceived need not ours. That is a reality that

we must accept, respond and take care of that need. 90% of our calls could fit

into your definition of BS. That leaves only 10% for the real Paramedics to do

their life saving magic. I think the real problem here is that (my perception

only) you believe that the 90% is beneath you. I assume that you are paid for

your shift to respond so what is the big deal. Go deal with the BS calls and do

it with a grin.

I have been doing this for 35 years and have found that the longer you do this

the fewer calls you can fit into the BS category.

Henry

P.....S. I do a fair job of patient assessment.

Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

Worth

Great idea. Should be policy at all times not just flu season. They come

do a proper exam. Advise patient what is needed which is not an ambulance,

if patient still insists, instead of saying no like they should, they pay

for the patient to get a real taxi ride rather than an ambulance transport.

Less money lost, as you will not collect from insurance of any type as these

are not emergency's, and you have your units available to go to another call

quicker.

Below is part of the news report.

" Paramedics would still respond to 911 calls and examine every patient, but

would not automatically take everyone to the hospital.

" We'll actually advise them, 'Hey, you don't need to go to the hospital.

We're not going to take you by ambulance to the hospital, because you don't

need to be in the emergency room,' " Zavadsky said.

Those who insist on going would still go -- but not in an expensive

ambulance.

" We'll arrange for transportation for them either by taxi or sedan, " he

said. " We'll pay for that trip. " "

>

>

>

>

> Sorry, but I fully disagree with doing this.

> Ron

>

>

http://www.nbcdfw.com/news/local-beat/Call-An-Ambulance-Get-a-Taxi-66723887.

html

>

>

>

----------------------------------------------------------

----

> New Windows 7: Find the right PC for you. Learn more.

>

>

[Guest guest]

Bottom line is, it doesn't really matter whether the people on this list

who favor paramedic-initiated refusals feel themselves competent to make

those decisions. In fact, they may *be* competent to make those decisions.

The problem is, it won't be just *them* making those decisions. Until

the bottom-tier, least competent turds in every system can be trusted to

accurately make those decisions, the idea of widespread

paramedic-initiated refusals is a non-starter.

By and large, the best clinicians and the people with the best critical

thinking ability I've met in EMS developed that ability *in spite of*

their EMS education, and not *because* of it. They are, by definition,

outliers. They are not a representative example of rank-and-file EMS.

Until EMS education is reformed in such a way as to make the *average*

medic capable of doing this, it just ain't gonna happen. And there is a

ceiling to that knowledge; there are already providers trained to that

level. They call themselves nurses and physician assistants, and they

won't work for the chump change that CMS pays for EMS reimbursement.

Henry Barber wrote:

>

> ,

>

> I don't think that anyone thought your right to post on this list was

> BS. However, everyone here has the right to their own opinion. The

> Flame bites us all from time to time. You yourself can do a little Bar

> B Q yourself see example

>

> ( " Perhaps your evaluation skills are not strong enough to

> differentiate between what is an emergency and what is not, however my

> skills are honed enough to distinguish between the two. " )

>

> People call 911 because of their perceived need not ours. That is a

> reality that we must accept, respond and take care of that need. 90%

> of our calls could fit into your definition of BS. That leaves only

> 10% for the real Paramedics to do their life saving magic. I think the

> real problem here is that (my perception only) you believe that the

> 90% is beneath you. I assume that you are paid for your shift to

> respond so what is the big deal. Go deal with the BS calls and do it

> with a grin.

>

> I have been doing this for 35 years and have found that the longer you

> do this the fewer calls you can fit into the BS category.

>

> Henry

>

> P.....S. I do a fair job of patient assessment.

> Re: Call an Ambulance, Get a Taxi | NBC Dallas-Fort

> Worth

>

> Great idea. Should be policy at all times not just flu season. They come

> do a proper exam. Advise patient what is needed which is not an ambulance,

> if patient still insists, instead of saying no like they should, they pay

> for the patient to get a real taxi ride rather than an ambulance

> transport.

> Less money lost, as you will not collect from insurance of any type as

> these

> are not emergency's, and you have your units available to go to

> another call

> quicker.

>

> Below is part of the news report.

>

> " Paramedics would still respond to 911 calls and examine every

> patient, but

> would not automatically take everyone to the hospital.

>

> " We'll actually advise them, 'Hey, you don't need to go to the hospital.

> We're not going to take you by ambulance to the hospital, because you

> don't

> need to be in the emergency room,' " Zavadsky said.

>

> Those who insist on going would still go -- but not in an expensive

> ambulance.

>

> " We'll arrange for transportation for them either by taxi or sedan, " he

> said. " We'll pay for that trip. " "

>

>

> >

> >

> >

> >

> > Sorry, but I fully disagree with doing this.

> > Ron

> >

> >

> http://www.nbcdfw.com/news/local-beat/Call-An-Ambulance-Get-a-Taxi-66723887.

> http://www.nbcdfw.com/news/local-beat/Call-An-Ambulance-Get-a-Taxi-66723887.>

> html

> >

> >

> >

> ----------------------------------------------------------

> ----

> > New Windows 7: Find the right PC for you. Learn more.

> >

> >

[Guest guest]

One edit: Nurse -practitioners- and physician assistants.

A nurse with no emergency experience has even less business then a new

graduate paramedic with making any decisions like these.

Austin

> Until EMS education is reformed in such a way as to make the *average*

> medic capable of doing this, it just ain't gonna happen. And there

> is a

> ceiling to that knowledge; there are already providers trained to that

> level. They call themselves nurses and physician assistants, and they

> won't work for the chump change that CMS pays for EMS reimbursement.

[Guest guest]

There is more then enough blame to go around for everyone to take

their bite, though I can understand why you'd take offense. If you're

interviewing fifty people for every one that you can offer a job to, I

think you're doing your due diligence and are to be commended. It

doesn't negate basic economic principles, however.

If you have a minimum standard and you are trying to hire someone who

exceeds the minimum standard, they are probably going to cost more,

and they should. Many organizations (particularly the larger or more

profit-driven ones) -want- the more qualified applicants but aren't

willing to pay them any differently. They start at the top of the list

and work their way down to the bottom until they get someone willing

to take the money they offer.

However, the point of my post was not that we should kick EMS

employers in the nuts (though there are a few that I think could use

it) but that it's -unreasonable- to put the blame on them for hiring

" minimum standard " candidates, due to economic (and apparently

practical) reasons.

Austin

>

> Easy easy there Austin,

>

> As an employer of paramedics, I must disagree with you here. EMS

> agencies are the customer of the Education system...and honestly an

> education system that has been painfully harmed by a " allow anyone

> in to be taught by anyone who wants to teach with nothing more

> important than getting people through the program...not getting them

> prepared to work on the streets " mentality by way too many people in

> EMS Education. EMS Education is NO different than the issues we

> have with no limits on how many transfer services that can be in an

> area...and that hurts because programs that want to appropriately

> prepare medics gets undercut by those merely trying to move people

> through.

>

> When I have to test over 50 paramedics to find 1 or 2 that can work

> a simple mega-code (not a bunch of drips and complications but CPR,

> defib, Epi, Amio, etc) without someone walking them through the

> process...I fail to see how that is my fault as an EMS Provider.

>

> You want to increase the minimum standard? Let's do 3 things:

>

> 1. Work from Washington D.C. on down to develop a system to pay EMS

> providers for doing other things beside transporting and to pay all

> these services at the COST plus a percentage that it takes to

> provide them.

>

> 2. Develop a method where Counties can regulate who provides

> services within their county borders and who cannot so that the

> market can be controlled how that county desires to control it.

>

> 3. Develop an educational system in Texas that limits who can

> conduct classes yet provides the appropriate number of slots in

> locations around the state in a way to insure that there are an

> appropriate number of well trained and prepared EMT's and Paramedics.

>

> Fix these three problems around this state...and then we can talk

> about trying to determine how we can or cannot determine who needs

> to go to the hospital. There are some really interesting projects

> being done around the country currently along these lines...but our

> system is sending them down limited growth or even death because

> there is no way to fund them.

>

> Dudley

>

>

> Re: Call an Ambulance, Get a Taxi | NBC

>>> Dallas-Fort Worth

>>>

>>>

>>>

>>>

>>>

>>>

>>> Well I have stayed out of this discussion as everyone knows my

>>> side, but here I go again. Many if not most 911 callers would

>>> suffer no harm not going by ambulance. Some would not suffer any

>>> harm not even ever going to the doctor about their present

>>> complaint. In fact my 13 year old with no medical education could

>>> determine many of the ones I have suggested not transporting.

>>>

>>> If the people working for a service do not have enough common sense

>>> to be able to safely examine then assist patients to get where they

>>> really need to go perhaps the service should hire better people.

>>> Everyone keeps throwing out that standards have lowered, well those

>>> that hire are the reason lowered standards have become the norm. If

>>> services refused to hire those warm body's with a pulse standards

>>> could rise, so perhaps we need to re-look at where the real problem

>>> is.

>>>

>>> Again you would still transport 95% of all callers that want to go

>>> but for some you would do them more benefit helping them find a way

>>> to get the care they actually need. We are not saying they are not

>>> sick and yes they may even need to spend time in the hospital but

>>> that does not make it an emergency ( immediate life threat ).

>>> Helping educate patients improves customer relations and in the

>>> future helps ambulances be available to respond to immediate life

>>> threats.

>>>

>>> I could go on and on as can those that oppose so I will stop now.

>>> My main point in my rant is just because you disagree with someones

>>> opinion does not mean you have a right to belittle them. Perhaps if

>>> everyone got off the only opinion that is right is mine attitude

>>> maybe we could move EMS forward.

>>>

>>> No disrespect meant in my frustrated response. Have a great day.

>>>

>>> Renny

>>>

>>>

>>>

>>>

>>>

>>>

>>>

>>>

[Guest guest]

Good point. You know, even physicians struggle with the decision whether

to admit someone to the hospital or not, and that is with a wide array

of diagnostic information at their disposal. It smacks of hubris to

assert that paramedics can make these decisions, system-wide. Everyone

on this list has had calls that they *know* didn't need an ambulance,

but that isn't the point. What they don't *know* is how many patients

they've thought that of, who turned out to be ill enough for an admission.

We're talking about implementing a *policy* of paramedic-initiated

refusals, system-wide. That is going to include more than Supermedic

making the decisions, and more than the obvious system abusers that we

all know and loathe. There are so many shades of gray in between " needs

an ambulance " and " bullshit, " and the range so open to education,

experience and interpretation, that to think that EMS systems are

capable of implementing such policies - utilizing the current

educational model - is ludicrous.

To assert otherwise just demonstrates that we don't even know what we

don't know.

A Austin wrote:

>

>

> One edit: Nurse -practitioners- and physician assistants.

>

> A nurse with no emergency experience has even less business then a new

> graduate paramedic with making any decisions like these.

>

> Austin

>

>

>

> > Until EMS education is reformed in such a way as to make the *average*

> > medic capable of doing this, it just ain't gonna happen. And there

> > is a

> > ceiling to that knowledge; there are already providers trained to that

> > level. They call themselves nurses and physician assistants, and they

> > won't work for the chump change that CMS pays for EMS reimbursement.

>

>

--

Grayson

www.kellygrayson.com