Column: San Antonio EMS Abuse Even Worse than Reported

A paramedic recently challenged my reporting on 911 callers who abuse EMS.

I wrote last month that one of every four ambulance transports for basic life support is noncritical, that more than half of all calls do not require emergency care.

The paramedic dismissed my sources and told me the vast majority of calls and transports from his station "are total BS."

To prove it, the paramedic offered to compile a log of ambulance runs and forward me the results. Some colleagues would do the same.

Well, the weekday logs are in. They are hardly scientific -- four paramedics compiled them over a few days -- but their content is still disturbing.

The logs show -- and other paramedics confirm -- that I grossly underreported EMS abuse.

The first weekday shift log showed 16 calls for an ambulance. Only one hospital transport was necessary.

One call came in as "sick party, burning urination." The paramedic wrote that the patient "did not want to drive in case he had to pee again. Did NOT need EMS."

A second call was marked "Hemorrhage." The patient had a "small scrape to hand with dried blood. Looked days old. Wanted hands cleaned and inquired about 'something for pain.' Did NOT need EMS."

Then there was the guy with back pain. The paramedic notes the back pain had been chronic for a year, and the caller had seen the doctor the day before but did not get his pain medication.

"Wants ER," paramedic writes, because insurance "will pay 100 percent for an ambulance ride. Did NOT need EMS."

A second log shift noted only five necessary hospital transports out of 13 calls.

Among those who needed an ambulance: "Patient in labor. She had no plans on how to get to hospital when labor began. Just figured she would call 911."

One who didn't need an ambulance apparently needed a bed. The 911 caller couldn't move into his apartment until the following day. "Wanted to go to the ER to get checked out until then," the paramedic writes. "EMS thinks he wants a place to sleep."

The logs do show real emergencies. Among them: two suicide attempts, two patients who needed mental health assistance, one case of profuse bleeding, and a man suffering from intoxication -- "18 pints of beer over 12 hours."

But medical emergencies were the exception. The logs show a majority of calls ran along the lines of:

--Bite: "Patient was wondering if there was anything to put on bug bite. Did not need EMS."

--Person down: "Man sleeping along fence."

--Assault: "Patient with 1/2-inch cut to finger."

--Cardiac arrest: "Patient was actually sleeping in car outside work."

--Toxic ingestion: "Patient took Xanax three days ago. Mom wants EMS so he won't get kicked off bus."

The shift logs show 68 calls to EMS and 35 transports. Some transports were precautionary; others (bumped knee, sprained leg muscles, etc.) were unnecessary. Only 15 required emergency assistance.

Were the logs embellished? Perhaps. But calls and e-mails from emergency room nurses suggest the logs were accurate.

"Hey Ken, tonight a patient called EMS because her hives weren't any better," one nurse wrote. "She was seen in ER the night before and didn't get her scripts filled.

"I have had patients call 911 from our waiting room wanting to go to another hospital. I've even had a patient call the police to file a report that he was not getting seen fast enough."

Want to see a doctor, but don't have a ride? Call an ambulance (and get ready to pay, on average, about $480 per transport).

In San Antonio and across the nation, that's the trend.

EMS, it seems, is losing its original meaning. Some say it now stands for Easy Medical Shuttle.

Call Ken Rodriguez at (210) 250-3369.

News stories provided by third parties are not edited by "Site Publication" staff. For suggestions and comments, please click the Contact link at the bottom of this page.