The Private Ambulance Service Thread

[GulDukat]

Private ambulance services are the "transfer" jockies of EMS. They cannot be considered part of the EMS system because the employer cares little about Emergency Medical Services. The goal with private services [at least where the boss is concerned] is taking transfers exclusively. Obviously the road crews feel different, but they don't make the rules.

I have seen "emergencies" take a back seat to transfers too many times to kid myself about private ambulance services and what they represent. That's why the turnover rate is so high in private services. No EMT or Paramedic feels good about making transfers their primary focus, thus many hate what they do and where they are at. Those of us who have over 20 years remember the days when medics and EMTs were all proud medical providers, now a chimp can do what private EMS does primarily. Sure "that's where the money is" [transfers] but it isn't and never will be where my heart is in feeling like part of the EMS system. I feel like a cab driver with skills.

Obviously this was written from someone with experience in this particular field.

A few questions for you if you don't mind.

1. You say you have been around over 20 years. Have you always worked at the service you are at now? Have you always worked in the Private sector? If the answer is no, why are you there now? (btw that is not meant to be a smart @ss question although it comes out that way, I'm just honestly curious)

2. Can you describe some of the emergency taking the backseat to a transfer. Obviously you can't be to specific but do what you can.

3. Who provides the 911 service where you operate? How long have they done this?

4. Are you looking for other work? Outside of EMS even?

5. What made you want to be become an EMT all of those years ago?

I'm glad you made your post. True honest feelings and even frustration is what I'm looking for.

[Gerry314]

Obviously this was written from someone with experience in this particular field.

A few questions for you if you don't mind.

1. You say you have been around over 20 years. Have you always worked at the service you are at now? Have you always worked in the Private sector? If the answer is no, why are you there now? (btw that is not meant to be a smart @ss question although it comes out that way, I'm just honestly curious)

2. Can you describe some of the emergency taking the backseat to a transfer. Obviously you can't be to specific but do what you can.

3. Who provides the 911 service where you operate? How long have they done this?

4. Are you looking for other work? Outside of EMS even?

5. What made you want to be become an EMT all of those years ago?

I'm glad you made your post. True honest feelings and even frustration is what I'm looking for.

Very good questions. I will do the best I can to answer them.

1) I started EMS in 1985 as an EMT. I worked then as a Nurses Aide in a nursing home. I volunteered for a municipal ambulance service while I continued to work in the Nursing Home. Within two years I was pursuing my Paramedic. I was offered work by the chief of my volunteer service in 1987 as one of two paid personnel to cover days. I took that with a pay cut because I felt that EMS was so important and vital. In 1988 I was advised I would have to go commercial [private] to complete my Paramedic because of Medical Control matters so I went commercial. I graduated as a medic in late 1988, and my commercial ambulance association began. At that time medics were scarce and they were kept available for the serious calls and they were respected as providers of advanced care by all.

2) To be honest, there are so many it is tough. Not only where I am concerned but with other medics I am proud to call colleagues. I recall a child choking call that came in, in which my colleague Jim was right around the corner from as he was heading toward a transfer he had been given and he was denied diversion requests repeatedly followed by the all too familiar "are you refusing to do the call you were given" BS by the dispatcher, their attempt to catch him in an event of insubordination. He did the transfer. I specifically, was denied diversion to a seizure I was three minutes from in which it was reported that the patient was not breathing. Denied outright to transport a dialysis patient who was already ten minutes late to her appointment.

3) In many areas there are intercept Paramedics that are employees of my commercial service. These are closed shifts and given to the cronies of the managers. They are not subject to the shift bid process. We just lost a service area to a newly established municpal service whose genesis was on the grounds of what I am asserting, that we are not available for their emergencies or cannot meet the demand because of our primary focus on transfers. We are never available because of our companies disregard for the importance of being available for emergencies and their focus on the dollar generators. We serviced this area for 14 years. It didn't happen over night. The history was evident that we were not focused enough on the emergencies predominately for years and the municipality established its own service with that recognition and unchanging reality.

4) Yes, I have thought many, many times of changing my career, Nursing, P.A., Fire Fighter, but I was ignorant and lazy. I wasted time on hopeful vision. I am a long time smoker, started when I was 12. I kept convincing myself I couldn't make the fire department because of that. My longevity is related to a small amount of selfishness. The transition of commercial EMS, if it was a transition, was slow for medics. Medics were revered when I started. EMS may have had the same focus I see today that is disturbing to me, but I was exempt because I was a "medic". As time progressed, the lack of reverance became more and more pronounced as the ranks of medics grew. A slow growth, a slow progression of unimportance crept into my professional life. Soon I was nothing along with many of my colleagues with as many years. We were relegated to transfers as we lost our service areas to other services [commercials that publicly professed better service but we knew better in the rank and file] and to newly established fire based and municpal based services who were tired of hearing "no medic available".

5) Well you might have guessed that already. I was not satisfied working indoors after a while. When I began providing volunteer EMS service as an EMT I loved the "field" concept. The ability to float around and get outdoors. The pride that we felt in riding in our ambulance around the roads I grew up on appealed to me. The true, heartfelt senasation that we mattered. That we made a difference. The pursuit of EMS stemmed from a friend who worked with me in the Nursing Home and she urged me to join the EMT class with her and I agreed. She said I was great with patients and had something to offer so I joined. That was the very beginning. Well I have said way, way too much. I hope this answers your questions.

[Richard B the EMT]

Would somebody spell out what IFT translates to? Thank you.

There are areas of the US, where "Privates", under contract to a geopolitical area, provide both Emergency as well as non-emergent ambulance service.

The often discussed, and by some, maligned, "Mother, Jugs, and Speed" movie, was about 2 such ambulance service providers, "F&B", and "Unity", in competition with each other for a Los Angeles district's contract for both such services, once you got away from the jokes within the movie. Neither could handle the case load, and the district authorities were about to go to another service provider, when the owners of the 2 companies, on the spot, decided to merge, which was acceptable to the district authorities.

[JPINFV]

IFT= Interfacility Transfer

[whit72]

I don't know where you work, but the 911 trucks in most private companies I have experience don't do transfers, so them having a dialysis call over a choking kid is never going to happen. They are dedicated and all they do is 911.

[Richard B the EMT]

I don't know where you work, but the 911 trucks in most private companies I have experience don't do transfers, so them having a dialysis call over a choking kid is never going to happen. They are dedicated and all they do is 911.

There are areas where that is the policy, but there are areas where whatever ambulance is the nearest, from that service, will handle whatever call comes in first, dependant as to the call's priority.

[whit72]

Richard wrote:

There are areas where that is the policy, but there are areas where whatever ambulance is the nearest, from that service, will handle whatever call comes in first, dependant as to the call's priority.

Oh really. I guess that could be a problem then. I think you have to distinguish between the two 911 and transfer. When you start blurring the lines thats when the problems will arise.

[medic3326]

Hello to all:

First I would like to say. This thread is the reason I signed up for this forum. Although I am new to this forum I am not new to EMS. Being a medic for over 20 yrs I have experienced many types of ambulance services. The thread was started about private ambulance services. So here I go, I am a owner of a private ambulance service in a medium size town. My service ran 3600 calls last year, which is very busy for our area. Considering the average ambulance service in my state runs 700-1000 calls per year I feel we are very busy. Do I consider my service part of the system YES. We respond to all types of calls some emergency, some non emergency. When I opened my service in 1993 I decided that I was not going to be like so many other PRIVATE services, that I would always put my employees first (because they are running calls) but you have to remember that you are being paid a wage you agreed to work for. If you are not happy with that wage then move on. Back to my employees I feel I have the best staff in our area the average medic that works for me has 10 plus years experience and I haven't had a job opening for over 2 years. The reason being I take care of my employees. The medics that work for me make anywhere from 3-8 dollars more per hour than anywhere around. No goverenmet services come close to paying what I pay. My lowest paid medic made over $45,000.00 last year working 48 hours per week. My highest paid medic made $75,000.00 last year working 60 hours per week. These folks could work anywhere in this area, they choose to work for me. I give bonus money from time to time and they get a weeks pay for a christmas bonus. So in the respect that I may be different than alot of owners I know I am. I never ask them to do something they have never seen me do. Now to equipment, no we don't have the newest of equipment, but we do not cut corners on patient care. We sit down in a group (I have 20 employees) and we round table equipment that needs to be upgraded. We look at all the options and then make a decision together. If they choose a more expensive piece of equipment then they know that it will cut in bounces, but they make that choice. If 2 pieces of equipment will do the same thing for alot different money then why spend more. I work with each person on scheduling monthly, I give 12 hours PTO per month and employees get paid time an a half for working major holidays. So to sum it all up yes private service are part of the system, they have to have money to operate, and yes you do have to look at the bottom line very very close. But I am very proud of what my service does. We do alot for the community, not not just local we have sent teams for disaster relief on more than one occiason. If your heart is in the right place as a private service then you can far surpass many government services. In the end we should all put the patient first and quit being so worried about what other services are doing. We do not worry about any other service in our area, we feel if we treat the patient like we would want our family treated then we can't go wrong. Is everything always perfect by no means, we have problems like every service, but we handle them by talking and working them out in a manner so each person has a say. I will end for now but this is my thoughts for this thread thanks for your time.......

[whit72]

Medic3326 wrote:

The reason being I take care of my employees.

That about sums it up. If you can stay true to your employees they will work hard for you, as I am sure you know. This could be and sounds like it is a win win situation for everyone involved.

Congratulations on running a successful company that hasn't lost sight of the litlle people that make it go. =D>

[JPINFV]

Hello to all:

[Really long post without paragraph breaks]

1. Welcome to the city.

2. The enter key is not the enemy.