Buffing Calls @ Private NYC Ambulances

[adamNYC]

Ok, now that we established that basically what I stated is "possibly right" in theory and you are merely following orders....have you taken it upon yourself to inquire as to why these orders exist? Have you asked what happens if you do not follow them? Have you been shown these orders in writing and agreed to them?

Basically, is this a written company policy?

Do you see where I am going with this?

Aside from the legal ramifications of you not being protected, is there not an ethical duty to act to those already in need of your assistance?

I know not everyone is as stubborn as I am, but when I am given directions/orders I have to understand them and I have to see them written down. Do you have this in place?

This discussion is not just about liability, this is about growth, both personal and professional within ourselves. We ask ourselves...am I doing the right thing for my patient? Is this best practice to follow if it is not an absolute corporate policy? Don't I have a duty to act for those who call me first?

I do not think this is a black and white reply as the world to me is about 99% gray. Regardless, what say you?

Good point. I'm going to hit up chain of command about it.

 

[ERDoc]

I think the reason it is tolerated there is because most in FDNY have some form of volley background. You have an entire city covered by a municipal service but there are areas that also are covered by a volley organization. It is even more bizarre when you get out on Long Island. Adam, I'm pretty sure you answered your original question when you said, "We were told at our orientation not to go buff calls outside of our chartered area because other vollies have jurisdiction over that area. Even if someone called us directly we cannot go outside of our area. Doing so will put that charter license at risk."

 

[adamNYC]

I was asking about buffing while working privates.

Volly we do buff. Just not house jobs or outside chartered area.

 

[ERDoc]

I would say that question is best answered by your company as each one is different. I wouldn't actively buff calls, if you happen to come across something then help out but the let agency that has jurisdiction run the show and transport.

 

[adamNYC]

On the non-buffed private flag downs that I've had we have always transported. And I would sure as hell rather be doing that then going for a non emergency txp job.

 

[ERDoc]

We have different work ethics I guess. The private is paying my paycheck, then I am doing their jobs. Just because you come across a scene doesn't mean it is an emergency. I used to stop, call it in if no one had and get out as quick as I could once 911 showed up. I only transported from a scene I drove up on once and that was because it was right outside the hospital and it would have taken the vollies longer to get there than it would have taken to walk the stretcher inside.

 

[Jim37F]

I think being flagged down is different than "buffing" a call...yes your original nursing home call could be a legit stroke while this may only be a fender bender....but until proven otherwise there is an equal chance it's the other way around, the SNF call could be any number of BS BLS complaints that we all encounter while there's a trauma center criteria patient up under the dash...

I don't know about you guys, but here, we'll get a change in response if another call comes in that we're closer to the new one, someone else (the next closest unit) will get dispatched to the original call in our place while we run the new one.

....but that's for being flagged down for an incident in your path that you can't just drive by (like a TC of some kind) otherwise my previous post still stands, I would not ever "buff" someone else's call without explicit permission from my employer, preferably coupled with them saying "why aren't you taking those calls?"

 

[drl]

Interesting how that works in NYC. If I did that as an IFT EMT in my county, I'd be out of a job faster than I could open my mouth. Unless we're officially pulled into the 911 system, we're only allowed to control the scene and begin treatment for still alarms/MVAs that we happen on; for transport, we have to wait for the contracted 911 provider.

If we're responding to another emergent call or transporting any patient, we're not allowed to stop.

 

[Smitty213]

Ok, now that we established that basically what I stated is "possibly right" in theory and you are merely following orders....have you taken it upon yourself to inquire as to why these orders exist? Have you asked what happens if you do not follow them? Have you been shown these orders in writing and agreed to them?

Basically, is this a written company policy?

Do you see where I am going with this?

Aside from the legal ramifications of you not being protected, is there not an ethical duty to act to those already in need of your assistance?

I know not everyone is as stubborn as I am, but when I am given directions/orders I have to understand them and I have to see them written down. Do you have this in place?

This discussion is not just about liability, this is about growth, both personal and professional within ourselves. We ask ourselves...am I doing the right thing for my patient? Is this best practice to follow if it is not an absolute corporate policy? Don't I have a duty to act for those who call me first?

I do not think this is a black and white reply as the world to me is about 99% gray. Regardless, what say you?

I wholeheartedly agree with you on the "not abandoning your duty to the first dispatched patient", and NY has no official "duty to act", soooo there's that. However, having spent some time in the past at a large private in a NY metropolitan area I can say that it is not out of the question that a "flag down" would take precedence over a dispatched call for the simple reason that you are driving a billboard and so cruising by an incident could "knowingly tarnish the companies reputation", which in many cases is against policy (however self centered it may be).

To the OP, was not even intentionally researching the topic, but I stumbled across a now repealed law that made it a serious violation to do what you're talking about doing, in the exact area you are talking about doing it. So is it illegal? Not anymore technically according to the state, but it was obviously a major issue at one point so I would avoid doing it so you don't tick off the wrong people and have the law reinstated.

 

[adamNYC]

Smitty: Link to that article/page/website etc. ?

 

[NomadicMedic]

Reminds me of the old "wrecker wars" when all the tow truck companies would listen to scanners to hear when the PD called for a hook. They'd all beat feet to the scene to be the first and get the tow.

 

[Smitty213]

I found it while trawling amongst the NY PHL 3000, I believe it was a law titled "Suffolk County emergency medical services". It laid out very specific guidelines to prevent the kind of "buffing" you're describing, even as far as laying out rules for driving your ambulance back from a hospital through an area that was not yours to cover.

 

[Smitty213]

Like I said, it's no longer technically in effect, but it was only repealed in '11 so the problems are probably still in recent memory for most, henceforth my advice to tread carefully...

 

[ERDoc]

Smitty, I believe I found the section you were referring to.
https://www.health.ny.gov/professionals/ems/art30.htm#BM3017

This only applied to Suffolk County, which would not have affected Adam. It was written because several of the privates were doing exactly what Adam is talking about and buffing the vollies calls. I think I remember it coming about because someone with political connections got picked up by a private that buffed a volley call and he/she nearly **** a brick when they got the bill.

 

[Smitty213]

That is the one! And yes, I know it only applied to Suffolk County, so while it didn't pertain to the five boroughs, it's dealing with the same general area/culture/group of providers (last I knew, many of my Island friends were involved in the City and vice versa), so I figured it held some relevance. And that's a very interesting backstory!

 

[ERDoc]

Don't quote me on the back story, but something like that stands out in my memory. You don't mess with the vollies on LI.

 

[Smitty213]

You don't mess with the vollies on LI.

Four years of college with numerous Islanders taught me just that...

 

[Tigger]

As in listening to PD/EMS radio and lights and sirens to that call before 911 EMS gets there

Lights and sirens to a call you were not dispatched to? That is just plain stupid.

 

[46Young]

I worked in the NYC 911 system from 2003 - 2007, for Hunter Ambulance-Ambulette from 2002-2003, and MVVAC for a short tint in 2002. My understanding is that the vollies or privates could buff a street job, but not go into a residence or any other non-street scenario, like a subway, restaurant, anything that you couldn't "happen to pass by accidentally." With the privates, I would be careful with "getting flagged down," because the company can reference the time you went 10-63, your expected 10-88 time and expected route, and can see if you deviated from a reasonable route to happen upon the street job. The excuse of avoiding traffic won't always work.

The FDNY and voluntary BLS crews will probably be happy to take the cancellation, but the ALS may want their usual BLS people to get their back instead of some unknown quantity in a private or volly bus. When I worked 46E and 46Y, we had problems from some local vollies buffing house jobs, and would be in the apartment before we got there. They got in trouble with the Conditions Boss a few times. Don't make that mistake. Stick to street jobs like MVA's.

Edit: When working for a private, your paycheck comes from revenue from scheduled calls, and you also screw the other units because one of them will have to take your original call, probably turning into a late job. If you want to work NYC 911 jobs, get a NYC 911 job.

 

[Bullets]

This concept is so freaking weird to me. If a private ambulance company was listening to our channel and responding to calls, L&S especially, without being specifically requested, our PD would ticket the EMTs for reckless or careless driving and probably charge them with interfering with an emergency incident. It would be a huge deal