Free Taxi Ride

[Sandog]

This seems to be a recurring theme with EMS people. Person calls for chest pains, so you have decided this person is just wanting a ride to the hospital for whatever reason. Days later, patient dies and your in front of a review board.

When to offer the refusal sheet? This question may be impossible to answer, but this situation will, and does occur, and if you stay in EMS long enough, it will face you like a ugly date you accidentally gave your address to.

We as providers have a fudiciary obligation to inform would be ride alongs of the cost of a ride to the hospital, at the same time, do we really have the training to make the call? This is a grey area all providers will face at some point. Is there a right answer here? I don't think so, best we can do is to continue to take CE units and empower ourselves with the knowledge to make the right call. Sure, some might say, "Why should I for 10 bucks an hour?" Why? Cause you chose this profession, and it is what you do, money must be secondary, or go back to school and head for Wall street.

Did I have a point? Not really...

 

[rescue1]

When to offer the refusal sheet? This question may be impossible to answer, but this situation will, and does occur, and if you stay in EMS long enough, it will face you like a ugly date you accidentally gave your address to.

Well, in the date situation I usually pretend my grandmother has had a stroke and run out the back door, but I'm not sure how effective this will be on the ambulance.

I guess to answer your question, in current US EMS, you offer the refusal sheet when the patient decides they don't want to go to the hospital. As a whole I don't think most systems in America have the training to be able to implement an effective "No, we're not taking you" plan.
Unfortunate, yes. But until standards are raised, that's how it is.
Now, if the patient is refusing because they think they can't pay, then we need to try and talk them into going, assuming it is for a legitimate medical reason (I hesitate to say "medical emergency", because we know how few of those there are).

 

[Tigger]

Working a BLS truck, the refusal sheet only comes out when the patient tells me they don't want to go the hospital. Even if I am confident that the call is BS, I'm not going to try and make someone that says they have chest pain refuse transport. If they want to go, I'll take them because I'll get hammered by QA if I don't.

 

[RocketMedic]

At the heart of the issue, my employer gets paid for transports. I'm paid to transport people to the hospital, clinic, or other facility as appropriate or requested by the patient. My job as a paramedic, as defined by my employer, is to provide appropriate and necessary medical care to patients, transport them, and document for billing.

Hypothetically, if a person wanted an ambulance as a taxi, and paid us for it via secured means, my employer would facilitate that. It would be expensive, but it would happen.

More realistically, I tell my patients that money honestly doesn't matter- I will take them to the hospital if they want, because my employer is contracted to do so, regardless of ability to pay. If they still refuse care and/or transport via ambulance, that's their choice.

 

[bstone]

Only accept a refusal if the PT doesn't want the transfer. Make sure you document and log everything.

 

[canadadry]

I love when they say "I don't have money for a taxi", then I say "so you can afford a 700.00$ ambulance ride?"