The LA times reported recently of a woman being sentenced to jail for excessively calling 911 and reporting claiming she was having an emergency.

http://www.emsworld.com/news/11285962/calif-woman-gets-jail-time-for-multiple-911-calls?utm_source=EMS+World+News+Newsletter&utm_medium=email&utm_campaign=CPS131219004

43 year old woman, Linette Young, complained of having panic episodes that gave her the feeling that she was going to die. Yes, this is a common symptom with panic disorders, but after 220 calls in less than year (I wonder how many were transports to the ED), it is obvious that the woman was not getting the care she needed. Her solution was not in the back of the ambulance. After being charged with 12 counts of “harassing 911 call takers” and 13 counts of “reporting false emergencies”, Young was sentenced to three years probation, 180 days in jail, and mandatory psychological counseling.

Does she need jail time? Probably not, but she may have to be a martyr to curb a growing problem.

She obviously does need the mandatory psychological counseling.

In February, there will be a second hearing to determine how much of a cost this fiasco was on the city.

Wow. Don’t mess with LAFD! This is a great example of EMS attempting to get it’s rights back. In Emergency Medicine, we have become fodder of what I like to call “Burger King Medicine.” As placed in their slogan, “Have it your way” is the patient approach and hospitals corporate attitude.

There is a growing population of people who utilize emergency services for their general medical needs and have never had a true emergency. I have a deep interest in how so many American’s hold an entitled attitude with a “me-first” philosophy. Our country is plagued with citizens who call 911 for the most minuscule of problems. Here are a few highlights from my own career. Understand the list can go on.

I need a drink of water. I have a hang nail. I need a ride to the pharmacy. I need new batteries in my TV remote. I just don’t feel like getting out of bed. Just stop asking me questions and take me to the hospital. Some one said something mean to me and now I am sad (not suicidal, just sad). I drank too much beer and now my stomach hurts. I have a cold, my nose is full of snot, and I don’t want to breath out of my mouth.

Abuse of emergency services is a growing trend. Out of my own understanding, it is just because most people do not understand their options and need educating. The world of medicine is a gigantic convoluted cobweb of bureaucracy that most providers cannot even explain. The depth it entails with billing and insurance holds use hostage in treatment. The risk of a law suit holds back the truest of explanations. We can not refuse treatment or transport, so how can we define what is abuse?

You can walk a fine line when it comes to educating a patient. The only people who can truly educate a patient with out legal repercussions is a physician. In EMS, if we offer anything other than transport, we can become negligent.

But, in order to get our rights back as the field providers, we are adapting to this new growing trend of non emergency requests. Why? Surprise! Most of the “customers” who are having non-emergency complaints are also the ones who are not paying their bills! The financial burden that ambulances and emergency departments take on with this cost is astronomical and continues to grow.

The new curriculum for paramedics is attempting to curb this population and their needs. The development of a “community paramedic” is an EMS provider who does not offer transport, but can respond to basic medical needs and non emergency complaints.  They have access to patient records, help with in home treatments that only a skilled provider can do, and help schedule further follow up appointments with physicians. Community Paramedic programs are developing across the nation and have had some amazing results in not only finance but also helping shed the weight that is placed upon local Emergency Rooms.

Here is a link to the NAEMT’s explanation of the program and links to articles and position papers;

http://www.naemt.org/about_ems/CommunityParamedicine.aspx

How could a community paramedic have helped Ms. Young??

Well, if I know any EMS service, in a case like Ms. Young’s I would have hoped that LAFD was proactive. I can easily see a supervisor being called out after she started popping up on the call takers radar. Then attempting to involve family and a social worker. Basically, making all attempts to get her the help she needed with a psychologist. She obviously needed to be on medication. But, did Ms. Young accept these treatments? Did she go to her appointments? Was she taking her medication?

The only true power of the cure is in patient themselves creating a self advocacy and putting the work into creating their own solution. Common sense can tell you what a true emergency is. But how can we compete with a world that allows grown adults to throw tantrums in a fast food restaurant or department store? Since when has it been acceptable to walk on those who serve you? Our medical foundation is becoming more and more corporate. The larger the corporation, the more expendable the employee. Our patients are beginning to realize this. Our medical providers are held on a leash of customer service comparable to any fast food chain.

At the end of my shift, when I turn in my reports and paperwork, I also have to send out customer surveys.

If an emergency room was a fast food restaurant, it would play out like this; the patient would walk, demand their food immediately, and leave refusing to pay for it. What kind of crappy business model are we supporting?

Along with a community paramedic programs, we need to develop common sense police. A group of individuals that you can call when a grown adult begins to act like a  self absorbed two year old having a tantrum. The common sense police will respond and give the grown adult a spanking and five minutes in the corner to reflect on what they did wrong.

But, I digress on the complaints of our health care system. Because the positives out weight the negatives in my book. It is just nice to be truly needed and to actually help some one once in a while. The biggest we can be is to teach people how to help themselves.

 

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