A revolution in EMS care

We all love the 911 responders as we should. They do save lives. But their roll may be evolving as pointed out (from Alice M) in the September 26th WSJ (click here to read the article). It states, “There’s a revolution taking place in emergency medical services, and for many, it could be life changing.

“From the increasingly sophisticated equipment they carry and the new lifesaving techniques they use, to the changing roles they play in some communities—providing preventive care and monitoring patients at home—ambulance crews today are hardly recognizable from their origins as ‘horizontal taxicabs.'”

Do we overuse the 911 call? I had a conversation with a dispatcher a few weeks ago and she could easily recount “wildly inappropriate calls.” I myself wonder if every slip and fall in a CCRC really requires sirens, flashing lights, firetrucks, and EMTs. In one CCRC I visited I asked the director what their policy for falls was and she stated, “well, we use common sense in deciding what to do, just like we would at home.” Other CCRCs have a policy of “just call 911.”

With modern medical treatment of cholesterol and hypertension the incidence of heart attacks and sudden cardiac arrest is declining. The reduction of tobacco abuse has also helped. So the nature of 911 calls has shifted but there are still clear emergencies such as drug overdose, trauma, seizures, etc.

If you look at the WSJ article there are some interesting suggestions for alternative routes “giving emergency responders the flexibility to manage less-urgent 911 calls….”  Currently Medicare spends $1 billion annually on EMS and emergency department costs. It’s proposed that $560 million could be saved annually if 911 cases were managed in a less expensive manner. So we may see 911 expanding toward primary care and prevention – interesting thought. What ever happened to the personal physician who actually knows us?

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