I was talking with a local college EMS faculty member about determining the right hospital choice for the right patients. She rightly pointed out that emergency physicians routinely deal with patients who are brought to the hospital by themselves, family, or friends.
Here’s my premise about what we do as EMS professionals, especially as it relates to taking the right patient to the right hospitals for the right conditions: We need to be doing a better job for our patients than transport via private vehicle.
Whether it’s assessment, destination determination, treatment, patient advocacy, or patient comfort, our goal needs to be that we’ve done a better job, each and every time, than the patient would have from getting a ride from family or a friend.
It’s arguably a low standard, but I’d argue that we aren’t hitting that standard all of the time. And until we do, it’s hard to justify the existence of EMS. Whether it’s the bean counters who balk at the price, the “policy experts” who balk at the outcomes, or the customer satisfaction gurus who do the patient surveys, EMS is doomed until we can prove, consistently, that patients do better with EMS than without.
Another one of those “we should do this…”
I know of more than one system that mandates transport to the local hospital, no matter what, regardless of the capabilities, or lack of, at the local facility.
I know of providers who routinely try and talk someone out of going to a probably-farther-away facility, rather than where the patient needs to be, or wants to go (due to physician and/or insurance preference) so that they can “get in service quicker”.
Politics tens to play a really big role in some of that…