Trauma Docs with lights and sirens?? What do you think?

[Dustdevil]

You say people die in our communities because we have volunteer EMS instead of paid. Documentation, please. Complete with citations. Prove what you claim.

Dude, don't play stupid. If this argument were about anything but your pet issue, you wouldn't even make such an absurd statement. Tick tock. Seconds count. Every minute your patient waits while volunteers at home decide whether or not they want to respond to a sick call while they're watching ER is a minute against their survival clock. Same thing with waiting for you to respond to the station to pick up the ambulance. And especially those daytime runs where nobody is available. Does this happen often in YOUR little squad? I don't know. Doesn't matter. As Rid has pointed out, this isn't about YOU. This is about a broader issue of volunteers in general. Focus.

Second...I have yet to hear anyone, here or elsewhere, offer up any sort of realistic, viable means of funding paid EMS in areas that are currently served by volunteer corps, other than what I suggested (complete nationalization of the health care system).

Well then, like your friend RiderRob, you have yet to read the ten pages of the volunteer topic, or any of the other multiple topics here that have thoroughly addressed the subject. Do your homework and get back to us when you're educated.

[1aCe3]

mmm how did this revolve back to the volly issue on this topic...

[Ridryder 911]

Between Dust and I, we could probably advise you of several professional EMS advisers that can set up EMS in almost any city or townships. Yes EMS can actually make a revenue, enough to pay and make a profit to place back into the system.

There are several small communities < 5000 population, that have 24/7 ALS that was cheaper than their volunteer services.. Yeah, it's called billing. Any township that can provide 3-5 calls a day can provide enough revenue to fund themselves. It is all in how you set up pay structure, having educated billing and coders, and yes educated Administrators & Paramedics that can document properly.

Again, yes there are areas that will have to have volunteers.. and again, Thank God for them!... but, if it is for tradition or the "me" syndrome, yes you are hurting EMS.

Want proof ? The last major Basic EMT curriculum change.. they actually "dumbed it down" ; so it would not offend volunteers . This also would not cause a decrease in volunteerism.. so instead of increasing the required knowledge, we went backwards. Ever see any major medical terminology or how about the types of fractures there are in the latest curriculum ? Was in the old curriculum.. that is why there are so many newbies that ask so many questions.

Want more ... ever heard of the National EMS Scope of Practice.? Hmm let's see in the beginning .. Paramedic practitioners, allowing increase level of education and requiring more education on all levels... but, wait.!

What about the volunteers ?

What would this do to volunteerism ?

OMG : we can't get enough already! .. yadda, yadda yadda...

So what did we do?.. we again.. dumbed it down.. don't want to hurt the volunteers .. Hey what about the patient ?! Don't they deserve better & more care ? !!! or should we care about the feelings of a special interest group...?

Sorry for the rant.. but true professional EMS providers know EMS. It is not a hobby or self satisfying adventure. We on this forum can tell the ones (yes, even volunteers) that take this profession serious and those that want or wish to be...

R/R 911

[n5iln]

Dude, don't play stupid. If this argument were about anything but your pet issue, you wouldn't even make such an absurd statement. Tick tock. Seconds count. Every minute your patient waits while volunteers at home decide whether or not they want to respond to a sick call while they're watching ER is a minute against their survival clock. Same thing with waiting for you to respond to the station to pick up the ambulance. And especially those daytime runs where nobody is available. Does this happen often in YOUR little squad? I don't know. Doesn't matter. As Rid has pointed out, this isn't about YOU. This is about a broader issue of volunteers in general. Focus.

Well then, like your friend RiderRob, you have yet to read the ten pages of the volunteer topic, or any of the other multiple topics here that have thoroughly addressed the subject. Do your homework and get back to us when you're educated.

just for the record: I'm a paid, career EMT. And I both appreciate and value the dedication and commitment of the volunteer staff that serves the village where I live. That service is staffed by a combination of paid and volunteer personnel, and maintains a full duty roster 24/7/365+. For two ambulances. I know. I also volunteer for that service, 24 hours a month. Stubborn, irreducible facts tell me there is absolutely no loss of life due to delayed response in my community; in fact, the service I work for probably loses more to response delays than the service I volunteer for.

Good sir, I'd be happy to continue discussing this topic either here or in the "Volunteer v. Professional" thread. However, your ad hominem stance here leads me to believe you are either unable or unwilling to provide hard, factual information to support your position. I therefore withdraw from both threads; I see no dishonor in walking away from a no-win situation.

[zippyRN]

Damn!

Here we go again!

Hey - Lets bash each other over the head just a few more times to make our points, which, naturally, makes us all feel better.

This thread was originally about whether or not doctors should be allowed to run hot to the ER with lights and sirens. Like so many other threads before it, it has degenerated into the "Volunteer vs Pro" debate, and I find that disturbing. I make part of my living in EMS, and I also volunteer as a firefighter, so I can see both sides of the story.

Okay, here is my two bits worth.

1. Yes, there are doctors who volunteer their time - they work in inner city clinics, in third world nations, and other places where the people simply cannot afford to pay for the services you and I take for granted. Does this mean that the service they offer is substandard? Perhaps it is, because the supplies and facilities are not there, but it beats the hell out of nothing at all! Are they taking away jobs from other doctors, or even themselves? Probably, but more to the point they are saving lives that would not have been saved if they had not been there.

and in some places there are Doctors who volunterer within EMS systems - are there no Event EMS providers i nthe USA who use volunteer staff and in that volunteer staff include Paramedics, Doctors and RNs ?

2. Yes again, there are volunteers who are "wankers", who do the job just for the glory or hero syndrome, and they do make the profession look bad. I am also aware of some professional EMS people who are in the game for precisely the same reason, and who have the same result on the public image of EMT's and Paramedics.

biggest problem is the 'you can't sack a volunteer until they kill someone' attitude - this is a world wide issue

3. Yes,there are municipalities that are too cheap, too uninformed, or too clever to pay for a professional service when there are volunteers who will do the job for peanuts. These areas would be able to pay professionals to do the job if vols wouldn't. A slight tax increase would cover the additional expenses. Paying people who were willing to do the job would give the volunteers some incentive to take the training required to make it a career.

4. No, you could not eliminate ALL volunteer squads and have the same or better level of service in all areas. Some are too remote or too underpopulated - the costs could not be handled by the minor tax increase or cuts somewhere else - would you be willing to have your taxes go up to subsidize? A classic example, would be the fire service I volunteer for. If the vols quit, the nearest town that would be able to afford full time fire service is 35 minutes away.

too remote or underpopulated- you are looking at services which are too small - why does the UK, Australia and NZ and otherplaces have regional services ? to cross subsidise those places they need 'disporoportionate' resourcing due to remoteness

[flight-lp]

"Documentation, please. Complete with citations. Prove what you claim."

Well, here is two right off the top of my head.............

Cause No. 98-614000; Estate of Evangelina Zamora Avila, et al. vs. Cy-Fair Voluntary Fire Department, et al; 189th Judicial District Court of Harris County, Texas.

The plaintiff's family member coded en route to the ER and the volunteer medic was unable to operate the defibrillator. Soon after, the department had an in service covering the equipment that all should be able to; less than 50% showed for this continuing education offering. They since have established an Emergency Services District, obtained full-time paid staff, and are now a very competent, well equipped, and progressive service with excellent response times.........

Cause No. 9763; Judy Squier v. Shepherd EMS; In the 411th Judicial District Court of San Jacinto County, Texas

The ambulance never responded! Volunteers who were available did not respond, the pt. went to the ER POV after waiting over 30 minutes and died en route. since this incident this very poor county also established an ESD and now contracts with a private provider who staffs 4 24/7 911 trucks and a transfer truck during peak times. Due to the companies aggressive billing actions and very minimal subsidization's by the county after reducing some unnecessary funding and realigning the fire departments into the ESD (thus eliminating the need for the county itself to have to maintain the funding for fire), both fire and EMS services have greatly improved.

It can be done, in any county, in any state (or commonwealth). Yes, you will probably have to tax the residents. Fact of life, the community will need to get over paying a minimum amount of pocket change for quality services. They also need to get over having to pay for EMS services. Hell, the doc isn't free, the hospital isn't free, EMS shouldn't be either. That's why god created health insurance! Can't afford insurance? Most can and just do not want to or believe they that need to, especially when some agencies offer it for free which is stupid as hell. If a citizen is truly in the need for insurance and can't afford it, they need to look at medicaid. Or perhaps the EMS agency could offer a reduced billing program for those in need. BUT LIFE ISN'T FREE, NEITHER SHOULD EMS SERVICES!!! Another thought for consideration is to start a membership program. IT CAN BE DONE, I JUST THINK THERE ARE TOO MANY HARD HEADED PEOPLE WHO JUST DO NOT WANT IT DONE!!!!!! Reality shall set in eventually.................................

[EMT City Administrator]

This thread is not about Vollies... keep it on subject or post to the other thread.

Admin

[SSG G-man]

This thread is not about Vollies... keep it on subject or post to the other thread.

Admin

Thank you! One volunteer bashing thread at a time!!

Sarge

[Ridryder 911]

Hey.. we have to keep it up for EMT Life to have something to discuss on their forums, since they monitor this site... LOL

R/R 911

[cdemt5710]

:tweety: Medicnorth: I don't think those docs who ride on ambulances in Europe get paid what docs here get. So its not so expensive to pay them over there. Here, on the other hand.....

but to the question of docs using L&S to get to the ER..... it might be a good idea, if they did all the training that's required to minimize the risk. Sometimes that light can save a LOT of time, like the day I was stuck behind a very slow moving car. I had a five mile drive to the station and was able to pass the car because the driver pulled over when she saw my lights on my aging Forester. Saved me almost 5 minutes responding to GET the ambulance (rural area). This might be the case for the surgeon and in areas where the only hospital for 50 miles can't staff a surgeon to sit around all night, it might be a good idea. Important to remember that a doc is not on call all the time, so keeping his EVO skills honed could be a problem. And there's the probationary period to consider. Who's going to supervise said doc as he learns the EVO skills. Its not about driving fast, its about the way we drive fast, and sometimes its not about driving fast at all... When I joined my dep't I couldn't have a light on my car until I had taken the EVOC class, been driving with supervision for 6 mo. and had proven that I understood the skills involved. I don't think there is a system in place to provide the same skills training for the docs. Besides, most of us might be in this business because we're adrenaline junkies and get a thrill out of the response. In the small hospitals I've been to the surgeons have to take a call rotation whether they want to or not. They like their scheduled surgeries and take the rotation so they can keep their privileges. So maybe its a moot point and just a great way to discuss why we can drive in emerg. mode and they can't.

What about a Spyder with lights and sirens..... or a Lamborghini....just like in the movies....