Navigating Healthcare – Patient Safety and Personal Healthcare Management

Abuse of Resources – Its Everyone’s Responsibility

Posted in Healthcare Information, Healthcare Policy by drnic on September 8, 2009

I spent the last weekend up to my neck in organizing a local soccer tournament with 280 teams, hundreds of games and thousands of participants. Weather challenged our scheduling with severe thunderstorms and rain but we managed to pull off most of the tournament and get everyone to play their games.

We had some injuries including at least one fracture to an arm, some cuts bruises and even some concussions. Local services provide excellent coverage and I have experienced the great response and work when I refereed a game when one of the players fractured their leg in a hard tackle. The local ambulance crew arrived quickly, drove onto the field to collect the player and took them to a nearby facility and where they received excellent care.

Since I am part of the tournament staff and easily identified I get included in much of what is going on. In once such instance one of the facility organizers stopped me to tell me that the medical crew were pulling in to the back to deal with the bee sting. I was immediately concerned thinking about anaphylactic shock and followed her outside to meet the ambulance crew and the police escort to get them across grass fields. The local facility staff meets the crew and says:

She’s inside

Wait a second I just walked out from there and I did not see anyone lying comatose on the floor? Did I miss something? We proceeded inside and I look at the patient. An middle aged lady sitting on a chair with one foot partially obscured with a bag of ice……..!

My initial thought is there’s some mistake the patient must be in a room nearby. But no – this is the bee sting patient. The detail was correct – it was a patient with a bee sting. A bee sting on her foot.

This is an abuse of the system. Its inexcusable. I challenge anyone to provide me with any reason that could possibly justify calling an ambulance for a bee sting to the foot. There is no anaphylactic shock problem. There is no transport issue here – for anyone to have arrived at the facility they had to drive or be driven.

This is inexcusable and there seems no other way to curb this wasteful selfish behavior that by imposing financial penalties. That individual should be required to pay for the cost of the ambulance, the crew, the park escort and any subsequent treatment she received in the Emergency room – at the full rate. No insurance coverage or subsidies.

Unfortunately that position is a slippery slope and will quickly lead to the requirement to justify every call for an ambulance and visit to the ER. Fine in such cases of flagrant abuse but what happens when its not so clear cut or the patient believes with the best intentions it was the right call. We want to err on the side of best choice and care without inhibiting those people that genuinely need these services but are afraid to call for fear of punitive charges.

The only solution I can see is have an independent body determine justifiable use. A body that is not linked to the payors, service providers or patients. Clear guidelines and a quick independent process for review and arbitration of cases that are not clear cut.

Maybe this is already in place. No doubt it can and will be abused – but if we cannot take our own persona responsibility then we can hardly expect the insurance companies to accept this level of abuse of coverage and to pay up for in appropriate use of expensive emergency services.