Seems to me we should be shunting PT to Ubers
Seems to me we should be shunting PT to Ubers
Originally posted by Thales of Miletus
If you think I have been trying to present myself as intellectually superior, then you truly are a dimwit.
Originally posted by Toma
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Said it before will say it again: Apple cider vinegar with extra floaties. But make sure there is none left on your teeth.
Wait for a year for any scars to heal up before using.
DXY 100
When you've been in a life threatening emergency situation, and the staff candidly ignores you and slooooowly goes about the business of saving people's lives, you might get upset too.This quote is hidden because you are ignoring this member. Show Quote
Fuck Alberta healthcare and fuck the majority of the staff who can't be bothered to do their job with one ounce of haste. They get paid to do a job, if they do a shit job, they will get hassled. The only reason they still jave jobs for doing a shit job, as mentioned, they have a monopoly enforced by government.
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Call ambulance for headache or back pain. Oh lawd. The problem isn't wait times and lack of staff, it's the population abusing the healthcare system.
I'm 1/2. My dad took ambulance ride twice in his life. The high BP and potential heart attack, he got admitted immediately. The other time for something else, was in hallway with EMTs for like 6 hours before being admitted.This quote is hidden because you are ignoring this member. Show Quote
But the time he got admitted quick was during the peak of COVID where people are avoiding emergencies rooms.
The conclusion I'm reaching based on your data and comments is that we don't need ambulances for much of what ambulances do. We seem to need at least these additions to the healthcare system:This quote is hidden because you are ignoring this member. Show Quote
1. An abundant ambulance alternative for the non-severe, non-urgent requests.
2. A superior version of intake which can accept and triage an unlimited number of patients immediately upon arrival by the ambulances. Why do hospitals not have this already is a mystery to me?
3. Immediate move towards using something equivalent to NP or Physicians Assistants to treat shit quickly in the hospitals (assuming that doctor capacity is ultimately the rate limiting step).
4. A fee for the use of emergency services.
It sure would be nice if our public healthcare system could figure out an incentive to get smart people in there to manage it.
Uber solves healthcare
Originally posted by Thales of Miletus
If you think I have been trying to present myself as intellectually superior, then you truly are a dimwit.
Originally posted by Toma
fact.This quote is hidden because you are ignoring this member. Show Quote
I don't disagree, but the empath in me also says that everyone has a different tolerance level for what THEY feel is an emergency, and its a slippery slope to make people attempt to decide what is severe enough to call an ambulance. That is a system that results in really sick people avoiding or not calling for fear of ridicule for doing so. People are too simple in general for that kind of thing. Like I said, what I feel is an emergency and would use an ambulance or ER for is much different than what someone else would, that doesn't necessarily make them wrong.This quote is hidden because you are ignoring this member. Show Quote
Plus we have 811, and people like that call 811 and they will get told to head to emergency many times. Or shunted to 911 many times. Giving advice remotely isn't as easy or cut and dried as it seems either, its laden in liability.
At least your posts are easy to reply to.This quote is hidden because you are ignoring this member. Show Quote
1: there is, Aaron Paramedical, AHS Community Care Paramedics/Mobile Integrated Health/City Center Team, Genesis Medi-shuttle, Alberta Paramedical Services, etc
2:Triage isn't necessarily inefficient, it can take anywhere from 10-20 min depending on the volume arriving at the hospital at that time. Sometimes is almost immediately because you're the only one there (in the EMS line, not the wait room line), other times there was 4 units arriving at the same time. Its a dynamic system you're trying to apply a static solution to
3:There are NP's. NP program access is a problem for sure, and there could be more of them, but physicians run the hospitals. There are plenty of physicians in the hospitals, its that the entire system runs a bit slow. Discharges take too long. Waiting for radiology to read reports takes too long. Doing labs takes a long time. Doing CT and Xray takes a long time. Its a system of schedules, that needs to be booked in advance enough to serve the inpatients, as well as have enough slack that they can roll in the constant influx of outpatients in the emergency. Its a hard balance, you can't "Plan" that sort of thing, see my above comment. There's specialists, sometimes they're actually doing their specialist thing and aren't available for the emergency right away, like in surgery or ICU. Again, NP's won't treat shit any faster in a department, that isn't the hangup. People go to Urgent Care for that kind of thing and its still 4-5hrs to get in and out. And in hospital people get discharged from the hallway all the time, they don't even make it into a bed in the department, treatments and diagnostics are started and conducted while in our care. Now that's an argument that it is using EMS as capacity which is a sensitive topic that we all want to see eliminated. It could be, if nurses would take over care of patients in a hallway in that transition phase, and I'm not sure why that never started or got traction.
4: It costs to use an ambulance. Its something to the tune of $285 if we show up and don't transport, and I think around $550? if we take you in. That dissuades nobody except the people I'm sitting in their house, they're actually sick, they NEED to go in, and they're stressed about the bill and want to refuse. See my reply to jutes.....I have to plead with people sometimes to make the best decision for themselves so I can start treating them. I can't stress enough, it more often than not has the wrong effect.
I appreciate your suggestions Buster, but you can't huff in as if none of this "simple solution" stuff isn't in place, hasn't been tried or has been discussed as impractical. They just read like Trumpism solutions. Why hasn't anyone tried injecting disinfectant, its so simple, its right there. Disinfectant kills viruses. The Healthcare system is extremely nuanced and HAS to be able to serve the general public, protect vulnerable populations, and not drive people away from seeking care. That is a fundamental basis of the system, and that sometimes means over servicing, and sometimes at the expense of other efficiencies. Can it work better? Absolutely, but that would cost MONEY, which everyone is up in arms about already. You won't get better service or more with less.
Last edited by TurboMedic; 07-26-2022 at 02:47 PM.
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I find your posts very interesting, thanks. Are all of the typical outsider's comments on management correct or is the reality different there too?This quote is hidden because you are ignoring this member. Show Quote
Z32 TT
1996 Integra - winter beater with studs - RIP (deer)
2002 WRX - to be sold
2010 sti - winter
Sounds like fixing it is too hard, we should just pay them more and then they will work harder.
Surge pricing.This quote is hidden because you are ignoring this member. Show Quote
Are you suggesting there aren't problems? Or are you suggesting there aren't solutions?This quote is hidden because you are ignoring this member. Show Quote
Because you REALLY wouldn't like my other solution - which is to cut funding and privatize the healthcare system (along with the complications that arise).
As you appreciate my input, I appreciate your answers. However, you are incorrect that I can't "huff in" and suggest some "Trumpism" suggestions. No offense to you, but you have no training in business efficiencies, management, and where/how creating scarcity is a good thing. I'm happy to hear your input on what you observe, but I don't think it's within your expertise to determine how to solve the problems.
Our public health system (and especially the AHS) is not run by adults. The primary problem is the lack of political will to make the changes, and we can blame the public/voters for that. You're incorrect that the solutions aren't simple. They actually ARE simple - but that doesn't mean they are easy to implement.
Great ideaThis quote is hidden because you are ignoring this member. Show Quote
Originally posted by Thales of Miletus
If you think I have been trying to present myself as intellectually superior, then you truly are a dimwit.
Originally posted by Toma
fact.This quote is hidden because you are ignoring this member. Show Quote
What take? You mean the question I asked to get clarity on?This quote is hidden because you are ignoring this member. Show Quote
I've never seen it take longer than maybe 5 minutes to get checked in with the triage nurse. It's the wait AFTER being checked in while you sit in the waiting room that takes longest. So are you saying there is specific cases where paramedics will wait with patients after they are checked in, right up until they are under direct care of a doctor/nurse? That's certainly not the protocol I've ever witnessed. Are the paramedics that just get people checked in and then leave, not following protocol?
The usage fee is the one I've been horny about for years that seem like it would be the biggest decrease of system stressors. If you have a legit emergency, you're not going to sweat 100$ to deal with it. If your kid has the sniffles, you might just think twice and wait for a walk in clinic to be open.This quote is hidden because you are ignoring this member. Show Quote
I spent 6 hours in the Foothills hallway recently.This quote is hidden because you are ignoring this member. Show Quote
Every patient had a paramedic, whether that was the one they came in with, or some other one that is watching two patients because the original paramedic is off shift.
Paramedic did not leave the patient until they were admitted to an ER bed, or the OD guy who was discharged to CPS.
Ambulances already have a usage fee that could be considered hefty.This quote is hidden because you are ignoring this member. Show Quote
Is there a fee structure that we could implement that would provide a dis-incentive for using ambulances frivolously?This quote is hidden because you are ignoring this member. Show Quote
It's already almost $300/ride. Not sure where the marginal price is.This quote is hidden because you are ignoring this member. Show Quote
The problem with medical procedures is that they're almost priceless, because most people value being alive above all else.
We need food to be alive, and yet find that price discovery in foodstuffs is fine.This quote is hidden because you are ignoring this member. Show Quote