IFT non-emergency industry issues

[Jgervin]

I was wondering if in your city or county if there is an oversupply of ambulances or if there is a shortage?

Also, what are the other issues facing non-emergency transport providers?

If someone were to create a service to help out non-emergency transport companies, what wold it be? Maybe more drivers? More transports? Less paperwork? Prepaid accounts for patients ?

 

[WuLabsWuTecH]

There is an over supply of IFT's here. And it would be something that cracks down on them for fraudulent billing. We have had so many companies being hit for fraud lately that I think we'll eventually not have the over supply anymore as they fold and crumble.

 

[Amberlamps916]

Los Angeles County. That is all.

 

[Aprz]

San Francisco Bay Area. When I first started going to school to be an emergency medical technician, American Medical Response was almost the only ambulance company here, and they did both interfacility tranports and 911. There were other small companies like Royal Ambulance, Westmed Ambulance, ans NorCal Ambulance, but you never really saw them. Then Paramedic Plus got the 911 contract for Alameda County, Rural/Metro Ambulance got the 911 contract for Santa Clara County, and they got the Kaiser (hospital) contract for Contra Costa, Alameda, and Santa Clara county. Also ProTransport-1 got the Stanford package (El Camino Mt. View and Los Gatos, Lucile Packard Children's Hospital, and Stanford), and recently they got the contract for Good Sam Hospital. Royal Ambulance recently got Regional Medical Center. Westmed Ambulance got Valley Medical Center. There were a lot of take overs pretty much, and now these mom and pop ambulance shops are much larger and focus on interfacility, and there are some new mom and pop ambulance shops that I don't care for.

I think there isn't too many of 'em. I don't hear anything about fraud in this area. They are pretty much picking apart what American Medical Response used to be here, and American Medical Response actually shut down all operations in this area. I only see them doing 911 in Contra Costa, backup 911 and IFT in San Francisco, and then every other American Medical Response rig I see is long distance, haha. They are pretty rare for me to see in Santa Clara and Alameda County were I mostly am.

 

[Jgervin]

Thanks or the responses. Are there ever issues with patients not paying for IFT transport? Or would patients ever complain about the quality of vehicle or crew?

 

[firecoins]

Thanks or the responses. Are there ever issues with patients not paying for IFT transport? Or would patients ever complain about the quality of vehicle or crew?

Quality crews? Are you joking? IFT comapnies hire right out of emt class, doesn't bother training them sufficiently and throws them out to do jobs. Damn right there are quality issues.

 

[DrankTheKoolaid]

AMR is also the sole 911 provider for San Mateo county. Rural metro is losing Santa Clara county, actually think it has already happened.

 

[VCEMT]

There is sufficient coverage here. In my opinion, IFTs are money makers and every IFT is job security.

 

[djarmpit]

There is sufficient coverage here. In my opinion, IFTs are money makers and every IFT is job security.

I agree. I do IFT's with a Pacific Ambulance and now that they are owned by Rural Metro, I feel a bit more confident in the fact that the company won't go under.

 

[Aprz]

AMR is also the sole 911 provider for San Mateo county. Rural metro is losing Santa Clara county, actually think it has already happened.

Nope, Rural/Metro hasn't lost the contract. Although I am unsure of how satisfied the county is with Rural/Metro right now, in August 2012, they sent out a memo saying that it was only rumors, and that the county is happy with Rural/Metro.

http://www.sccgov.org/sites/ems/Doc...ta Clara EOA Emergency Ambulance Provider.pdf

I think IFT companies getting paid depends on both the contract and/or documentation. Like somebody else said, those EMTs are usually fresh outta EMT school with minimal training so I don't expect that it's that big of a problem, but when the patient's insurance is something like medicare or medical, I've always been taught that you have to do a really good job to get as much as you can outta those, but at the same time, they will at most pay a fraction of what the ambulance company normally bills for, or how much it really cost. *shrugs*

In my experience, a lot of patients just don't know better. The public thinks IFT ambulance = 911 ambulances. It's all the same to them. They don't know what's good quality or not. With IFT, there isn't much to know either. You can get away with putting the patient on the gurney, driving with a GPS, putting the patient in bed, get signatures, and get out. It's really not that hard. Most patients don't need any intervention. The people who complain, in my opinion, would complain regardless of how well you did (both customer service, intervention, assessment, etc).

 

[WuLabsWuTecH]

Thanks or the responses. Are there ever issues with patients not paying for IFT transport? Or would patients ever complain about the quality of vehicle or crew?

Quality crews? Are you joking? IFT comapnies hire right out of emt class, doesn't bother training them sufficiently and throws them out to do jobs. Damn right there are quality issues.

Not paying would result in not being picked up anymore!

And I bet patients complain about the quality, but the companies don't care. A satisfied patient pays just as much as one that isn't satisfied, and most facilities are contracted. Sure, patients can request a different IFT company, but this requires them to A) fill out paperwork that's normally done for them and B) find one that's actually better!

 

[usalsfyre]

B) find one that's actually better!

I love the bias against IFT....

Some of us are actually trying to improve quality. I would also put the majority of my crews up against the crews from the largest 911 provider in this area, seeing as how we do things like treat pain, recognize sepsis and titrate oxygen, all of which are SEVERELY lacking when it comes to that service.

 

[WuLabsWuTecH]

I love the bias against IFT....

Some of us are actually trying to improve quality. I would also put the majority of my crews up against the crews from the largest 911 provider in this area, seeing as how we do things like treat pain, recognize sepsis and titrate oxygen, all of which are SEVERELY lacking when it comes to that service.

It depends a lot on the area. In my current area, and the area where I grew up in, IFTs do no emergency transports. I also find that those doing 911 take their jobs more seriously than those in IFT and therefore the professionalism reflects it. Right or wrong, when I worked in IFT, my uniform meant nothing to me. Yes, I showed up to work and was professional and courteous, but I didn't really care about the company because I knew they didn't care about me. But when I don the FD uniform, I wear it with pride and I make sure that not only I, but also my partners act in a respectable manner when wearing the uniform.

 

[usalsfyre]

I also find that those doing 911 take their jobs more seriously than those in IFT and therefore the professionalism reflects it. Yes, I showed up to work and was professional and courteous, but I didn't really care about the company because I knew they didn't care about me. But when I don the FD uniform, I wear it with pride and I make sure that not only I, but also my partners act in a respectable manner when wearing the uniform.

Please understand this is not directed at you personally....

I see this a lot, and as a person who has made a "career" out of EMS it burns my nether regions. As another poster said in another thread, don't be a knob. Understand your actions reflect on you (the hospital doesn't forget you were a jackass in an IFT uniform just because you're wearing an FD uniform today) and the rest of us who do give a crap. There's a lot of FDs that use the "brotherhood" bit to cover up the fact they will ask you to do something that is potentially lethally stupid (to you or the patient) because "we've always done it that way". Not all of them...but there's enough out there.

Yes its a jaded attitude, and no I don't hate firemen. I have grown weary of seeing people die over abstract childish concepts though.

 

[Akulahawk]

It depends a lot on the area. In my current area, and the area where I grew up in, IFTs do no emergency transports. I also find that those doing 911 take their jobs more seriously than those in IFT and therefore the professionalism reflects it. Right or wrong, when I worked in IFT, my uniform meant nothing to me. Yes, I showed up to work and was professional and courteous, but I didn't really care about the company because I knew they didn't care about me. But when I don the FD uniform, I wear it with pride and I make sure that not only I, but also my partners act in a respectable manner when wearing the uniform.

I've never worked for a fire department. I did my medic internship with a FD that took EMS very seriously though. Does it matter? Not one bit. When I put on my uniform, I always acted in a very respectable manner, regardless of who I was "working" with at the time. I actually enjoyed my IFT time for two reasons: one, the patients I saw were usually sicker with more comorbidities than the vast majority of 911 patients (therefore 911 was usually easier) and two, I got to see various presentations of many disease processes and got to be able to put them together with typical meds for those. In short, I had to think about what I was doing.

The IFT company I worked for also did a fair amount of 911 as a backup service. Guess what? Given the quality of the other IFT companies at the time, we always were politely greeted by Fire (instead of getting the "oh crap it's them...) and it wasn't unusual for our personnel to be questioned about why they didn't do/get certain ALS procedures going. The ED staff kept forgetting that we weren't Paramedics.

You will get known in the local area for the kind of provider you are... not for who you work for. The fact that you have one patch on your sleeve versus another isn't likely going to be noticed. They will get to know you. When you do your call-ins for either report or request for orders, they'll get to associate your voice/name with the quality of care you provide and learn to trust you or not trust you.

It doesn't matter who you work for. You are the one that they'll see wearing a uniform of some sort bringing a patient. They will take notice of your attitude at times and put two and two together and understand that you've got a less than good attitude when working at a private EMS agency vs a public/fire agency that does EMS.

You have no idea how much I could go on about this. It will follow you.