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EMS News in Focus
by Arthur Hsieh

How targeting frequent fliers can solve 911 abuse

The key of a successful program is to not only refer frequent 911 callers to social services, but to also check in on their progress

By Arthur Hsieh

Over the years we EMS providers have complained about our “frequent fliers,” those who “abuse” the EMS system by calling for an ambulance repeatedly, for seemingly inconsequential complaints or downright faking symptoms so as to get a ride to the hospital, a free meal and a warm place to sleep.

While that might describe a couple of patients, the vast majority call 911 because their access to meaningful interventions is little to none.

The EMS-to-ED-to-street-to-EMS merry-go-round is just one symptom of a health and welfare system that needs overhauling. Funding for real mental health services is lacking, care for our country’s veterans is downright scary, and the social service system designed to help the most needy should go back to the design board.

What’s great about the program targeting frequent fliers in Fresno, Calif. is that high-frequency callers are not only being referred to the right social service, there is follow-up from EMS in making sure the patient follows through.

That’s terribly important to the success of the program. It makes sense that the reason a patient may not follow through is the same reason why he or she might default to the easiest path: calling 911 for an ambulance. 

I suspect the program will end up costing far less than the process of trundling these folks back and forth to the hospital on a daily basis.

That’s a key point in our rapidly evolving health care reimbursement system, and I hope other systems will pick up on the idea and expand upon it.

EMS is no longer a “you call, we haul, that’s all” service. It has to deliver the right service to the right patient, at the right time. 

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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