Why are we doing this more and more?

So, the inimitable CCC over at Captain Chair Confessions got me thinking with his recent post These people got lights and siren responses  

Why is it, roughly 40 years into this grand experiment called EMS, that we seem to be responding more and more frequently to all manner of nonsense in a code 3 response?

This seems to fly in the face of reason, logic, and science.  I am just wondering why it is that we have many studies that seem to at the minimum, imply that increased use of emergency response proves to rarely provide a benefit and yet it goes on.

We are supposed to use science and reason and all manner of things, but we seem to flaunt it just as often.  I find it pretty damning that many times over the years we’ve even seen Jeff Clawson, of MPDS fame/infamy depending on your mindset, decry the overuse of code 3 responses.  If we have all this evidence pointing to less use of code 3 response, why do we feel the need to adhere to such silly things as 8 minute response time “standards”?  Especially when that “standard” isn’t the same from municipality to the next?

Maybe if we’re going to have all this science and evidence we could use it.  Just maybe.

Clawson, Jeff. “Unnecessary Lights and Siren Use: A Public Health Hazard.” International Academies of Emergenct Dispatch. N.p., Oct. 2002. Web. 11 Mar. 2014. <https://www.emergencydispatch.org/articles/uneslightnsiren.pdf&gt;.



So, this is simply an opinion, no facts really to back it  up, just anecdotes from myself and many I know across the country.  Why is it that we are constantly running Code 3 to all this nonsense.  There’s this graduated response system built into MPDS and you know that Joe blow is calling because he’s drunk and wants a sandwich.  You make it an Omega, you still send us, and you send us Code 3?

So, when we go through that red light and the kid jumps from behind the parked car and we can’t stop and kill him, how’s that going to look on the 11 o’clock news?  “Ambulance kills child while responding to local drunk”.  Sure, we can say you could drive slower, etc.  But, in so many systems, if you don’t make the times, your service gets penalized, usually monetarily.  And, if you’re the only responsible one, that means you get to be the sacrificial lamb eventually.

Integrity? Principles?  Those are all great, but let’s face it, most people in Fire/EMS don’t have a lot of responsibility with money and such, and as such we usually can’t afford to be without a job.  So the employer wins.


Therein lies today’s question.  Are we really here to do what is the best for the patient?  Or are we here to be a PR machine/appease the lawyers and accountants, medicine and science be damned?  I know this is EMS heresy, and frankly I don’t care.

And we say we provide customer service….

I saw this article, http://www.nytimes.com/2013/12/05/health/think-the-er-was-expensive-look-at-the-ambulance-bill.html?_r=0 , recently and it made me wonder.

In the realm of private EMS, it seems like all the rage these days in high performance EMS is about customer service.  Now if you’re in any other business and the salesman doesn’t have all the information, he isn’t going to do very well.  Somehow though, in EMS sending out the salesman(medic), performing what amounts to scare tactics followed by lack of information is not only considered acceptable, it’s the preferred method.

I’ve seen very few places, maybe I’m not looking in the right places, that inform their medics of all the various charges that the patient may encounter.  Now, if I go into other businesses, I can easily be shown the charges up front prior to being provided with the service.  Even in other medical realms if you ask nicely, you’ll get the costs up front.  But routinely in EMS I’ve seen where you can’t seem to get any sort of straight answer other than we can only tell you how much it’ll cost after you take the ride.  Sounds kind of like the oft quoted statement from Congresswoman Nancy Pelosi “…we have to pass the bill so that you can find out what is in it…”

Not really the way I’d want to run a business or provide great customer care.  But I’m probably not running those places for some reason beyond my ability to comprehend.  And all along I thought we were here for the patients….my bad.

Rosenthal, Elisabeth. “Think the E.R. Is Expensive? Look at How Much It Costs to Get There.” The New York Times. N.p., 4 Dec. 2013. Web. 4 Dec. 2013. <http://www.nytimes.com/2013/12/05/health/think-the-er-was-expensive-look-at-the-ambulance-bill.html?_r=0&gt;.