other 20 percent) were considered "possibly" unnecessary
Reported in J Accid Emerg Med. 1998 Nov;15(6):368-70.
That's a huge waste of time, energy, and money. Since I know that an am- bulance ride generally isn't very cheap, somebody else must be picking up the tab, if it isn’t the patient.
Even Sweden is not without prob- lems. A June 2007 article found a sig- nificant number of EMS transports did not need any pre-hospital interventions, and hence could have arrived safely via many other routes. They recommended that EMS agencies develop clear criteria for dispatch to assist people in the proper utilization of ambulances.
( Eur J Emerg Med. 2007 Jun;14(3):151-6.)
So why is ambulance misuse and abuse a problem? To name a few issues: • Overstaffing of ambulances is needed to weather the burden.
• Patients with real medical problems are forced to wait, and their care gets delayed.
• It is hard on morale for EMS providers if, after years of training, we are relegated to becoming a med- ical taxi. While driving a taxi is a worthy career choice, it does not take the same level of training, and is an inappropriate use of EMS talent.
• Imagine the waste of insurance dol- lars on ambulance charges that are unnecessary, or the loss to ambu- lance companies when/if a patient doesn't pay for their misuse of the system.
HOW DID THIS HAPPEN?
It is my belief that there has been a societal shift over the last 20 years. • As a society, we have weakened our definition of just what is an emer- gency.
• We have a McDonald’s mentality — "I want a cheeseburger, and I want it now" — without any delays.
• We seem unable to say "no," in large part because of fears of legal liability if we say no.
• When there are attempts to place
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reasonable limits of utilization, there seems to be an outcry of "Wait, you can't do that! What about …? It's not fair!"
ARE THERE ANY SOLUTIONS? I hope so, but the real question is will
we have the guts to change things? I think that more than anything else, we want our efforts to "count," and for us to be seen as a value to our community. It does seem to me that ANY service not perceived as valu- able to a person will be used inappropri- ately if the service is "free." I think we will need to find ways to make these services
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