I read a couple of items about anti-frequent flyer programs and community paramedics the other day. Now, just like any other new idea, of course there is no shortage of resistance.
There was some discussion that centered on concern that the Fresno, California program would lead to some repeat caller who is legitimately sick with serious chronic conditions (like repeat episodes of hypoglycemia or COPD exacerbation) being denied care or transport. I don’t buy that at all. I may sound all grumpy and dismissive on this blog, but I can tell you even the most cynical medic doesn’t think 911 abuse when s/he finds an actual sick person. Even if it’s the same person. Besides, Fresno blacklisted only 8 people in 3 years. Sounds pretty careful and judicious to me.
Now let’s look at the California Nurses Association. They – surprise, surprise – oppose community paramedics, claiming safety concerns because paramedics are too stupid to do it and people are going to be dying left and right as a result. Listen, California Nurses Association, I have met many of your folks, and while most are competent RNs, many are forever complaining about why paramedics are bringing patients to the ED and generally failing to display any sort of sense. The irony is fucking delicious that you oppose the concept of trying to reduce 911 calls and ED visits. Like any profession, you have your share of idiots too, especially in such non-ED settings as
Not My Patient Skilled Nursing Facilities and everyday clinics (and this McDonald’s). That’s not even including all your visiting and hospice and advice and school and jail and dialysis nurses who call us for the absolute dumbest fucking bullshit.
And what have YOU done all these years to reduce repeat 911 callers and repeat ED visits other than give people such shitty discharge instructions as “call 911 if you don’t instantly feel better” and “come back when you need your band-aid changed”?