A recent article at JEMS.com on EMS System Abuse told of examples of “frequent flyers” (that is non-emergency patients requesting multiple transports by EMS agencies on a fairly regular basis) many of which would be amusing if they weren’t so sad. The author offered up that while it is a serious practice of abuse by the public, it is also a problem with no solution. Perhaps, however, that is somewhat of an over-simplification as the article did suggest afterall that if we could first cure poverty, homelessness, mental illness, substance abuse, domestic abuse, lack of primary care and education then we could perhaps eliminate the indiscriminate use of emergency services.
From a quick review of the solutions implemented in the past by multiple agencies to avoid abuses involving non-emergency transport including taxi vouchers, bus passes, referrals to physician offices, etc. which have been implemented and then often abandoned it is clear that the problem is not easily solved. The fear of litigation for under estimating the urgency of a call is a strong motivator to permit these abuses, but that also comes at a cost.
While it may be easy for those who are not responsible for managing the budget to say it simply can’t be solved, can agency management continue to utilize resources in an inefficient manner indefinitely by weighing the cost of a potential lawsuit as the cost justification? How does a High-Performance EMS agency balance the unfettered demand for transport with optimization of services to control costs? We’d like to hear about your experiences or insights.