Discussion thread for the "Polls only" thread (Part 1)

[ParallelLines]

I voted to take the patient to the closest ER, but my reasoning is a bit more complex. First, quoting the poll -

@Velocity

You are an ambulance driver. You are transporting a woman who’s suffered serious injury. The risk to her life is low if you can get her to an ER quickly. However, she is imploring the paramedics/EMTs to make sure she is taken to a hospital that is in her insurance network, which would cost her little or nothing. If she is taken to an out-of-network hospital, she could be on the hook for a massive medical bill.

Ok, first, note that while perhaps not intentionally so, you, the driver, are not explicitly an EMT or Paramedic. Most drivers are, some are not according to a quick google search. So, right off the bat, you may be utterly unqualified to make the evaluation stated in the first line. And if they’re in the back being treated by the other EMTs, who have more firsthand knowledge, why are YOU making the decision? And even if you -are- all paramedics/EMT, you just don’t know enough to be SURE. If things are bad enough for an ambulance to have been called and assuming the original analysis is correct that it requires urgent care, then get more info for the patients safety ASAP, which means the closest option, with none of the unknowns about traffic or other issues, which brings us to this:

@Velocity

The out-of-network emergency rooms are all nearby. The in-network emergency rooms are all further away. You do not know how much things like traffic or other variables may slow your arrival. Assume that you yourself will face no legal liability and the only considerations are patient $ vs. patient odds of survival.

Again, huge number of unknowns in terms of taking them to their preferred location. The whole question is stated to be based on a real case, but we’re supposed to (in that final line) assume there are no consequences, legal or otherwise. But at that point, it makes the poll largely pointless, because the final clause says there ARE consequences, just not legal ones. The patient survival vs costs. At which point, survival > saving money.

Plus, speaking from some experience, if the PPO is going to nitpick about an emergency room visit despite most boilerplate agreements, they’re going to ding you for everything else, including the damn ambulance ride. My wife was once billed $5 grand for an ambulance ride because it was out of area / network, after she was thrown in one by an EMT against her will for what was serious but not critical dehydration issues.

Our system is fucked up, the whole network thing is only going to add one minor, probably negligible layer of suckitude and not worth the risk. Because even if I’m somehow not liable for any legal issues, if my patient dies because they were trying to save money, and I agreed, I’m going to be far more damaged by the event than by my worries about her budget.