One of the on-going issues in my profession is the utilization of emergency services for mundane issues and minor health-related concerns. For example, I have had numerous requests for ambulance transport because the patient had visited their regular doctor, but since the patient didn't like what they heard, they wanted to get a second opinion from the ER doctor. Of course, they wrongly assumed that if they took an ambulance to the ER, they would get to move to the front of the line for treatment. Usually, this "treatment" is no more than a slight adjustment of the amount of a hypertension medication or some other similarly minor tweak in their treatment.
A parallel problem is trying to get access to a doctor to deal with these issues. It is obvious that a patient with on-going health problems really should be talking with their regular doctor. This brings us to one of our 'frequent flyer' patients. "Mary" was an elderly diabetic who lived with her 3 cats, bowls of candy, eclectic music collection, and her paranoia. She frequently called to request transport because she was tired, ran out of medication, was having a bad day, etc. One day about about 2 PM we were dispatched to her apartment because of "shaking". Once we arrived, she explained that the doctor had given her a new prescription (to add to the dozen or so she currently took) and it made her feel "funny". Because of that horrible reaction, she stopped taking ALL of her medications. Now after about 6 hours with no medication, she was not feeling quite right.
It was obvious that we were going to recommend she resumed her usual dosages of her medications and likely the symptoms would go away. Just to be on the safe side, I decided to call her doctor who practiced at a large nearby clinic. I picked up her phone, dialed the number, and was surprised to hear, "...
the number you are calling is not accepting calls at this time". Since it was the middle of the day and this was a multi-office clinic, I felt I must have mis-dialed. I repeated with the same results. On a whim, I grabbed my cell phone and dialed the same number. It was answered on the first ring, and within 10 seconds I was on the line with the doctor who did not need any help in recalling this particular patient. He agreed with our plan and recommended that we should not transport.
Once we were on the road back to the station, I suddenly realized -
the doctor had blocked her number!I am not sure what to conclude from this, but some days I wish the 911 system could block a few more numbers.
Actual reasons for 911 dispatch from my own experience:
- my cat is sick and I am afraid I will catch whatever they have
- I burned my finger lighting a match and now the grocery store is closed and I can't buy any ice for my finger
- I heard a noise - I think it was a car
- while driving to the ER, three blocks away - I got sick and vomited, now I need an ambulance to transport me the rest of the way (nausea and vomiting had stopped by the time of our arrival)
- roof fire (sun warming up the frost on the roof)
- "the doctor said I should get my blood pressure checked"
- I can't afford a taxi - can you take me to the next town?
And many more...