The EMS system of our nation’s capital is once again making news, this time for not being able to respond to a life-threatening call for service that resulted in a pediatric patient being transported to the hospital by fire engine. It’s another tragic event with tragic consequences.
What was the reason given this time for the delay? Was it a staffing shortage? Did the ambulance or communication system breakdown?
Not exactly; this time it appears that the public is to blame. Abusing the system apparently is causing these problems.
The community is at fault? Really? Please, someone help me to understand this logic.
Granted, EMS systems across the country have been providing service to “non-emergency” patients for a long time, pretty much since the inception of the 911 system. It’s not difficult to imagine why; with reimbursements skewed toward ambulance transportation, it made sense for patients with little pocket money to take an ambulance to the hospital for free, rather than pay for a taxicab. By the same logic, EMS systems do better financially with more patient transports and reduce their liability from risky patient refusals at the same time.
Progressive systems have been shifting resources and providing alternative, innovative solutions to reducing non-emergent service calls. As the traditional fee-for-service model goes away and is replaced by performance-based reimbursement system, there will be more incentives for EMS to provide more meaningful, more effective ways of providing out-of-hospital care.
Still, the number of ambulances in a system is finite. At some point systems drop to level zero. During those times, it’s easy to lay blame on system abusers as the source of the issue. If the system was staffed, monitored and performing effectively, it would make sense to pin the blame on the public.
But DC Fire and EMS has a long track record of deep internal issues that keep it from responding appropriately to its community’s needs. Staffing, broken ambulances, insufficient ambulances, low morale – each has been reported upon in the recent past. Without fearless leadership throughout government, and support from the ground up, it’s going to be very difficult to break from the dysfunctional cycle which is a shame for the citizens of our nation’s capital. Don’t compound the dysfunction by blaming them.
