Leaderboard

My bad on screwing up the spelling of HIPAA, i realized it right after i posted it and I cant seem to edit my OP otherwise it would have been fixed. Me and Dwayne had a talk about this the other day Anyways it was the "R.I.P Old Man" that got to me, this same guy was called to assist my grandpa when he had his final heart attack and was unaware who he was until later that day when I said he had died. Had he posted something like that about my grand dad I would have been very pissed. He is losing sight of the fact that that "old man" was someones son, someones dad, someones grandpa ect ect and there needs to be some respect given to not only those who die but their family and friends. If it wasn't a HIPAA violation then I was wrong but you best belive I will hold myself to a higher standard once Im in the field because shit like that is unacceptable from anyone in EMS and I hope you all do too.

I think we're arguing for the same thing... I don't refuse transport now even when I know for a fact I'm dealing with a minor complaint. I'm not able to, I HAVE to offer transport no matter what. My argument is, currently Medicare pays roughly $400 for an ALS 1 TRANSPORT. Doesn't matter if it's an IV "just because" or a sick CHF patient getting ready to die, as long as it fits in the ALS 1 category. What if we switched and payed $200 for an ALS RESPONSE and assessment, plus appropriate billing for procedures (x amount for an EKG, x for an IV, ect) and then bill only for your transport mileage. This way you get reimbursed not for your truck, but rather the important part of the response, your knowledge. Plus, the more you do, the more your reimbursement is. Your assessment shows it can stay home? Congratgulations, you've just saved the system a $1k plus ED bill, which helps prove your worth. So how to keep services from doing inappropriate procedures and running up charges? On chart review if a procedure is not indicated it's not reimbursed. In addition, if service "A" has better outcomes than service "B", service "A" can negotiate for higher reimbursement. The part that most don't like about this plan? Paramedics now have to be VERY accountable for their decisions. The "I'm not a doctor" BS no longer flies under this model. Yes, it's a drastic change. Current providers at all levels are lined up against it, as it requires more education, shifts responsibility back on to them, may actually increase "EMS abuse", ect. However, I feel this is the direction we need to go for the good of healthcare and EMS. It's time to join the healthcare community and drop the "public safety" charade.

The future is now, it's happening all the time, by the time you read this, it'll be the future. The one thing left standing still as time passes us by at such an alarming rate that many of us are looking in the mirror and wondering where in the hell all the time went is EMS. I was twenty-one what seemed like a few months ago, now I'm twenty-four, pretty soon I'll be fifty and I won't even have realized where all the time went. EMS is the same way, we've lost track of just how quickly time and medicine moves. Maybe it's because we've grown up outside of the mainstream medical system, we're not used to the way things really work in medicine. Maybe it's just because we've become so content with the way we do things, that by the time we're at that point in our careers where we could change things, we've either finally reached that golden position of administrator, but are too scared to rock the boat and risk returning to the streets, or maybe we just see retirement on the horizon and just want to put in our last few days in peace and move on to greener pastures. Either way, we seem to have our feet stuck in the mud and can't get them out. None of what I've proposed, either here or in any one of the many threads where I've shared my views about what I think paramedicine should become is ever going to happen until we increase our educational standards. At the same time, if there's one thing I've learned it's that nothing in this world--NOTHING--ever changes without some sort of motivating force. And whether that's the next generation of paramedics demanding more from EMS than what your generation saw, or the inevitable changes in the healthcare environment that are calling for more and more accountability and justification for payment, EMS is going to change. The way I see it, EMS has two paths in front it it. We have the option to continue the way we've been going, but you know what? I've said it before and yes, I'm going to say it again. We're not that good at what we do, and what we do is coming under a lot of scrutiny. Are we worth the money that's invested in us? Maybe not. Seriously, think about that. What if a cost-benefit study was done tomorrow on EMS systems. How sure are YOU that we're worth the buck? Because I'm not sure we could survive that kind of scrutiny. I'm really not. And if we continue down the path we're headed, you and I and every paramedic out there could be out of a job some day. Then there's the other path. The path where we stop holding ourselves back, we stop insisting that we can't and we won't, and we man up, grow some, get our educational standards where they ought to be, and start implementing these practices which have been shown in other EMS systems across the world to not only improve the cost-benefit ratio of EMS, but also elevate our profession and provide the best possible and the most competent care for our patients. And you all may think I get ahead of myself at times, and maybe I do, but you know what? If come tomorrow, it became national mandate for paramedics to have a Bachelor's degree, what would most paramedics say? "Fuck that, they're not paying me enough and it's not going to change what I do, anyway." So why in the hell is anyone going to further their education, when it's not going to do anything for them? You HAVE to have some sort of goals in mind, some sort of changes in care that having a higher education is going to grant people. Right now, people do it to get into admin. That's the incentive to get the degree. Until we start advocating a system that permits paramedics who have achieved higher degrees to expand their clinical skills, there is absolutely NO incentive for people to get that degree. A paramedic with a B.S., M.S., and PhD. is still just as restricted and paid just the same as the certificate mill paramedic. You have to have some bait to dangle in front of them to get them to jump. I'm not saying we should be doing these kinds of practices without degrees, I'm saying, "Hey, everyone, here are some things where we in EMS could do better, some things we could do that will really help our patients. But here's the catch... you gotta get your big boy degree first." I'm sorry, but the average paramedic in this country is not so enlightened that they're simply going to go out and get their four year degree out of the goodness in their heart and out of their deep, overwhelming desire to have more clinical knowledge. That's the reality of it. We have to not only advocate higher educational standards, but have some rewards waiting at the finish line for those who jump on board the boat. It's the same with changing medicare, you want to be paid like a healthcare professional, you've got to become a healthcare professional first. And thanks, Dwayne. I accept your edition to my statement and back it one hundred percent!

Interesting read, Squinter. I know that you have been very involved in trying to make some changes there, and have met with acute frustration. My point remains the same, though: until we actually get enough people from the trenches to get involved, nothing can possibly change. You are allowed to bitch about ACP - you have been there. I dont care how much it appears that it is a tool of the Conservative government.... if 100 people with a vision for change show up, it will be a different story. Yes, we do get what we deserve, my friend. Send two busloads of paramedics to the AGM, and watch the sparks fly! (BTW, some of my best friends are EMRs, lol)

OH, I see you dont want to talk about this universe, you want to talk about an alternate universe that is somewhere in the future. Your argument is similar to we drive cars, but in the future we will all have personal hover-crafts, so we should stop using cars now. Having an attitude of "patients should suffer because I do not agree with the way the world operates" is very scary.

Definitive care does not equal the ER in every scenario. The CURRENT EMS standard of care in the U.S. How about you show me where you got those numbers? And since when did every patient need (or actually get) labs and X-rays at the ER?

The cases described aren't laziness, they're stupidity (political correctness be damned). Some of the laziest providers I've had the displeasure of knowing throw everyone in the truck, do as little treatment as they can get away with, and write a half assed report. The problem with leaving people at home in the US is the average medic is too uneducated to tell who can stay and who can't. Cases above happen because a lot of providers are too stupid to realize this. The "just one life/I don't want to get sued/transport is our job" crowd is keeping EMS in the dark ages. Right now EMS provides questionable benefit for expensive service that only transports to the most expensive hospital real estate per hour outside the OR. EMS in current form won't survive a real cost benefit analysis. There will be people asking uncomfortable, hard to answer questions at some point. As to price tags on human life? Like it or not, it's done daily.

This post deserves an award. Since when was clinical excellence and competency deemed laziness? Oh, that's right. Ever since parawannabes decided that instead of increasing their education and becoming true clinicians, they'd rather remediate the whole profession to defaultist taxi drivers that have no common sense and no strength of conviction to elevate themselves and become the folks who can make these kinds of decisions on their own.

Ok I know I am getting slammed on this one. I read the artical first and then I was just able to watch the video as youtube is banned at work. Now in watching it first of all a terrorist dosn't give a crap about a 6 year old. And whether we like it or no there are sleeper cells in our countries. In watching the video the TSA worker was polite and explained everything she was going to do to the mother and while patting down the child. The child complied and didnt look like she was under any stress, she wasnt crying or fussing in the video at least. When I saw the statement Groping I assumed that it was a male TSA worker and not a female and yes that would have been different I guess. Now the drug test, In my community there is a drug dealer that would put cocaine in his sons diaper to transport it. His son was mentally disabled so it was unlikely that anyone would check him and they never did. The worker seems to think that maybe the child could be carrying drugs and that is why they are doing the test. The parents could have said something that was very innocent and were red flagged. I hate flying but do have to do it for my day job. When I travel I do so a day before I have to so that I can take my lovely Adivan. When going through the gate after the adivan the lady said where are you going. I said oh Im off to Kamloops. She looked at me and said are you sure. Yep I'm sure when in fact I was going to Kelowna. RED flag and I was searched, my carry one was torn apart and even my computer was taken away for a bit to be tested for drugs and bomb stuff. I think I look like the person next door but I said something in a stoned up state that cause the flag. Do I like the fact that our world has come to having to search 6 yr olds nope but that is the way it is. If she wasnt checked and was wired for a bomb or was carrying drugs and then it was found out, that TSA worker would be hanged for not searching her. We live in world of uncertainty and a whole lot of bad people so I guess this is the new way of air travel. OK slam away

What does it take to get banned here anymore. Since when do we allow this kind of nonsense on a professional forum. I have never been so offended, or turned off of this site. C'mon admin..... get a grip here

Sorry you are wrong, the fact that you will not sleep with someone based simply on skin color is the most basic barometer of how racist you are or are not. I realize it is painfull for the racist to admit, but it is true. There is no other action that more clearly defines how you feel about the other races; if they are not good enough for you to date, then you clearly feel your race is superior. Funny, the crickets are still chirping. There have been 4 or 5 non-racist who have stepped forward, the rest of the room must clearly be racist. Call your mom and tell them you are considering dating a black person, lets see what happens

And in all other periods being black has been considered a physical deformity worthy of being classified as a lesser human and punishable by death. Funny how you scream we should treat African Americans with all sort of respect but have no problems referring to women with derogatory terms such as "chicks". Do as I say, not as I do. As for being racist, if I go out and get drunk, meet some minority woman and sleep with her that night with no intention of ever speaking to her again, does that make me not racist? I married a woman who is half Hispanic and half black (her words), but you'll probably say I only did that because of my white guilt.

Last time I looked homosexuality was not in the DSM, perhaps this has been added in as a new diagnosis? Take care, chbare.

You are entitled to your opinion

First of all this was the topic of the TV show the OFFICE, the night before Wendy posted this, so probably made up. But there is no greater test than who you choose to date, as to whether or not you are a racist (remember racist means that you think your race is superior, not that you burn crosses in peoples yards). You can say you are a vegetarian all day long, but when I see you eat a steak taco, i know it isnt true. And last time I checked, we do have black people up north, but I will issue a "pass" for those who live in Alaska and the Dakotas (although I have seen black people in Canada). Its a simple question, whoever you are dating now, keep it all the same except that you have not met him/her and he/she is black (if you are white, or vice versa), would you date him/her ? You havent yet, so my guess is in your heart you are saying NO, although to be politically correct, you will say YES in here. Whats really a shame is most white chicks will date a mexican or asian, but cant bring themselves to go black.

I am here, all you have to do is say my name three times like beetlejuice. Good point beiber, you are correct, it is sad that this is such a racist country. Now before you all get mad, let me check the dictionary; racist: The notion that ones own ethnic stock is superior. Most everyone in this room is racist, but can't admit it. Here is a little self-test that I have mentioned several times, but cant get anyone to fess up to. To see if you are racist, ask this question to yourself: If I am white, have i ever dated or made love to an african american ? If you are african american, have I ever dated or made love to a white person ? If the answer is no, you are a racist. Even if you are non-racist enough to have done the deed, you would never admit it in this forum for fear of how you will be judged ? Which may make you more racist than the person that never has. Furthermore, every guy in here at some point in his life has done the fattest, ugliest chick (of his own race) because he was hard up and drunk, but never seems drunk enough to cross the jungle-fever line (what does that say) ? Fortunately, the women are a little more decerning, as far as number of partners, but just as racist as thier male counterparts. And please spare me all the comments about how you are best friends with the one AA person at your workplace. You have never had dinner at his/her house, or invited them to yours (at least 98% of you have not).

Here you go, look under "what information is protected": http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

Your logic does not work here, homosexuality is a mental disease, I am not mentally ill, so I would not sleep with a homosexual. I have no problem hanging out with homosexuals in a social or workplace setting, so I do not think I qualify as a homophobe. But back to the original point, I still hear the crickets chirping, where are all those non racist who date everyone ?

Sorry AK, you are wrong regarding this law only applying to those who bill. Anyone who divulges confidential information is subject to the law, but you are correct, this was not a violation of the law, as no specific person was identified. But this does show the need for a law to rein in this whole facebook/internet mess. The poster is right, there was probably only one cardiac arrest in a town that small that day, so it would not be hard to figure out who the poster was talking about. I am tired of constant posts from firefighters, emts, and medics bitching about how their shift is going. If you got time to post about it on the internet, while on shift, I would say your boss needs to find something for you to do.