Disturbing Obstacle Hindering Philadelphia Medics

[paramedicmike]

This can't be done under the current system in Philly for several reasons. There is no one place to call. So, you call the closest or most appropriate hospital and you'll get someone who's never seen you before answering the phone. Most of the hospitals are teaching hospitals. You'll get a different fresh faced resident answering the phone each and every time. This resident won't have a clue about frequent flyers or street EMS. Their advice, partly because they're scared to make a mistake and partly because they don't know any better, will be to bring in the patient. Add to that, if you called for every patient for whom you thought this was a possibility there would not be enough phone lines, docs or time to call for every patient.

Second, if you try something like this, the department will be slapped with a civil rights lawsuit for each and every person to whom this is attempted. Into that lawsuit will be some inclusion/claim of racism. Medics will be named personally. Docs will be named. Docs in SE PA have some of the highest malpractice insurance rates in the country because they are already sued more than in most, if not all, other areas of the country. Don't expect Philly Fire to back you. You'll get canned so fast it'll make your head swim.

As a side note, people from all over the Commonwealth fight to file their medical malpractice claims in the Philadelphia district because they are almost guaranteed a win. Malpractice insurance rates are through the roof. Quarter to half million dollar annual premiums are the norm here, not the exception...and that's for a doc with NO claims against him/her. (For comparison, I know of a couple cases where docs moved across the river to NJ and had their annual premiums drop from close to $300K to $10K simply by changing their State of practice.)

Lastly, taken everything that's been said so far into consideration, the structure of Philly Fire's response as it currently stands simply cannot support anything other than a "you call, we haul" structure. They struggle to keep up with their current call volume. On many days they *can't* keep up with their call volume. It is simply easier, and takes less time, to pick up, haul to the ER and go to the next one.

I understand that many of the problems facing Philly's EMS system are not unique. I've been around enough to see some crazy stuff in other systems. However, Philadelphia has taken everything to an extreme. I've been all over the country and I've not seen anything as bad as things are in Philly. Does that mean these problems don't exist in a worse state elsewhere? No, it doesn't. I just haven't seen it.

The solution isn't in piecemeal fixes. The entire system needs to be scrapped and started all over again. Radical change is needed. Unfortunately, it's not coming in the foreseeable future.

-be safe