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Home > Topics > EMS Management
January 22, 2014
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Behind the Patient: Street Portraits
by Michael Morse

Whose patient is this, anyway?

Dealing with a disrespectful doctor made for an awkward situation on a recent medical call

By Michael Morse

She appeared from the confines of her sanctuary, white robe billowing behind her as she strode toward me, and with the air of authority that 30 years of life and a few years of medical school bestowed upon her demanded her patient be taken where she, the physician, ordered.

I stepped out of the elevator and asked my partner to continue toward the ER, which was 100 yards away, in the same building. My patient was having enough problems and did not need to witness a very unprofessional display.

“My protocols are very specific,” I explained to Daughter of Socrates. “The patient is in sinus tachycardia, and the appropriate facility for this patient is here, not there.”

“Are you a physician?” she gloated, as 20 now extremely uncomfortable people watched the display, some eager for the elevator doors to open and offer an escape, others amused by the spectacle.

“No, I’m the EMT, and she is now my patient.”

“She’s my patient, and you will take her where I tell you.”

The dispute

What’s next, I wondered.

“Is not.”

“Is too.”

“Is not.”

“Is too.”

“Is not.”

“Infinity!”

I couldn’t wait for the elevator doors to open so I could get back to MY patient. The doctor fumed. Had she or an informed representative of hers greeted us and explained the situation, and had a continuation of care form and a copy of the EKG and pertinent history been ready — rather than a curt reply from a secretary stating, “it’s in the computer” when I asked for the reason for our summons — things would have gone differently.

The inquisition

“What is your name?” she demanded.

I told her.

“Who is your supervisor?”

I told her. And for good measure I also told her the name of the director of emergency medical services for the State of Rhode Island.

“I want their phone numbers.”

“I’ve got a patient to take care of, go away.”

“There are plenty of people taking care of her,” she replied, referring to the four firefighters and my driver who responded to the 911 call for a female with a rapid heart rate.

We come to this place a number of times every week; the staff refuses to use the hospital’s transport system or a private ambulance company, preferring the speed with which the 911 responders arrive.

Blessed escape

After an eternity, Moses parted the Red Sea, and the elevator doors opened. I jumped into the full car, behind the other passengers, and waited for the doors to close, separating me from the aggressor.

“What is their phone number!” she demanded.

“Call 911, you have that one on speed dial.”

The doors closed.

Looks like I’ve got some typing to do.

I get more respect from people living on the streets, with nothing, no money, no food and no education than I did from that doctor. I think I’m going to put a little extra effort into my report.

About the author

Michael Morse is a rescue captain with the Providence Fire Department and the author of Rescuing Providence and Responding. He has worked on engine, ladder and rescue companies during his 21-year career. His current assignment is Rescue Company 5. Michael blogs at RescuingProvidence.com.
Comments
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Alan Yates Alan Yates Thursday, January 23, 2014 4:26:02 PM After several similar instances our medical control physicians gave standing orders to get them on the phone with the "doctor" who insisted on taking over at the scene. No interfering "doctor's" ego survived the conversation with our ER Docs to try to pull the same thing twice. In fact, several of them became very easy to get along with after such a talk.
Ken Henke Ken Henke Thursday, January 23, 2014 4:53:13 PM I've stood up to a few "junior docs" in my time. They always backed down because they realized I was right. In Kentucky, if a doctor demands certain care in conflict with our protocals, then that doctor has to accompany the patient all the way and sign the run report.
Dawnn Marie Dawnn Marie Thursday, January 23, 2014 10:20:15 PM Happy to see you back Michael. I've missed your writings. Be well, Stay safe my friend :)
Rescuing Providence Rescuing Providence Friday, January 24, 2014 5:24:06 AM Thanks Alan, similar thing happenned here after the doctor in question filed a complaint. Our state director of EMS, who is also a paramedic and an ER doctor is a great advocate for us in the field and fully supported my actions.
Rescuing Providence Rescuing Providence Friday, January 24, 2014 5:28:50 AM Thanks Ken, I had the option to do just that, but the doctor dissapeared too quickly. Just a bad situation all around, I did a little soul searching after the incident and decided that I did the right thing, even though it may have appeared that I was using the patient to make a point.
Rescuing Providence Rescuing Providence Friday, January 24, 2014 5:29:22 AM Hello Dawn, thanks for that, hope all is well.
Todd Dicker Todd Dicker Sunday, January 26, 2014 8:20:26 AM Similar situation with an RN. In this state, the easy response is, "I do not accept your turndown of this patient's care to a lower level of license, you will be accompanying this patient with us to the ER, you will be calling in the report by radio, and you will be giving the handoff report. I assume your liability insurance also covers your actions in an ambulance as well as any traffic related incidents we may be involved in, because it is now all your responsibility."
Scott Brown Scott Brown Sunday, January 26, 2014 8:24:03 AM Interesting. ...if I behaved that way id be looking for employment.
Kimberly Felder Kimberly Felder Sunday, January 26, 2014 2:04:14 PM which, unfortunately, is the difference between having a supportive management team and medical director...and not.
Greg Burton Greg Burton Sunday, January 26, 2014 3:35:02 PM Know the feeling all too well. I am currently looking for a job because of similar situations. I hate the fact that dollars are more important than people. That goes from both patients and hospital staff treating us like crap. Yet we are not supposed to say anything negative towards or about them.
Ed Hillenbrand Ed Hillenbrand Sunday, January 26, 2014 5:35:53 PM We have had a protocol for this situation for over thirty years: "Here Doc, sign this form and the patient is all yours. Oh, and you have to ride in on the ambulance." I have only had to use it once. They left mumbling something about "Being needed elsewhere." : )
Rescuing Providence Rescuing Providence Monday, January 27, 2014 8:09:49 AM Thanks all for taking the time to read this and comment, I wish every day, every call I handled things perfectly, I don't. It would be much easier for me to write stories about how wonderful I am and how I deliver EMS perfectly, if nothing else perhaps somebody read this and will know better how to handle a difficult situation.

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