AMR does provide ALS care, as well as BLS. They even do Critical Care transports, which involve transporting people on ventilators and multiple IV drips. The reason why private services are private, is economics. Private services do the same work, with the same people at the exact same certification levels as municipal services, but they do it with less bureauracracy than a municipality.
If a private ambulance service needs a new ambulance, they go and purchase it, versus having to meet with city hall, or county board members.
Mind you, private ambulances are supposed to meet the same standards as a municipal-run service. But they may also be a bit more liberal in their treatment practices, depending on their medical director.
And yes, private ambulance services DO practice medicine. EMTs and Paramedics are allowed, under their scope of practice-authorized by a doctor-to act autonomously while on duty. They do not have to call to get orders to splint broken bones, nor to administer life-saving interventions to a heart attack victim. To say that they are not healthcare providers is an insult to those who go to school for years, and have to do hundreds of unpaid clinical hours to attain their certification/licensure.
It matters not whether the EMT or Paramedic works for a fire department, city service, or private ambulance service. They wear the same patch, and recieve the same training as their colleagues. Some work more trauma-oriented jobs, and some work at making sure the sick and critically ill patients get to the proper hospitals, or as the case may be, taking care of the elderly by returning them to their nursing facility.
I know this is a tangent, but since we have an expert here – What is the actual difference, in simple terms, between paramedics and EMTs? Reading the Wikipedia articles don’t really clear up the issue for me – there seems to be a lot of technical issues involved, but I don’t get a basic understanding of the difference. I’m looking (perhaps futilely) for a simple difference, like “psychiatrists are licensed physicians and can prescribe drugs, while psychologists are not” or “in X jurisdiction they call them this and in Y jurisdiction they call them that, but they’re essentially the same thing.”
Random in which regard? Jaxnative1210 is correcting your assertion that AMR doesn’t provide ALS care. They do. The post also offers some reasons why some ambulance service is private. A large number of local governments have elected to outsource ambulance service yet still provide fire service. Private companies can and do offer the same level of service for a much lower cost.
Not related to my first paragraph, I’m surprised Hatzolah has not been mentioned in this thread yet.
Yeah, I read the post poorly. I blame my phone :smack:
That said, I never meant to imply that AMR doesn’t offer ALS care, however, to the best of my knowledge, their contract with the LA County Fire Department is only to provide BLS ambulances.
That leads to things like this, where a man who forgot to pay his $75 fire department bill was treated to firefighters watching his house burn down. It includes this gem: “South Fulton’s mayor said that the fire department can’t let homeowners pay the fee on the spot, because the only people who would pay would be those whose homes are on fire.”
Where I grew up in New Jersey the EMS was originally handled on a volunteer basis, like the fire department. About a decade a go, demand grew to have full time EMS in the town. It now functions on a hybrid basis with full-time EMS provided by the police, and the volunteer companies handling the spill over. There are private ambulances in the area, but they handle patient transporting so not to tie down an EMS crew for emergencies.
Where I live now EMS is handled full time by the fire department.
Interesting. First, because apparently fire fighting services are already on the market (and I now have a price indication).
Second, because of the underlying argument. Should fire fighters also serve those who didnt pay their bill? (mind you, this article is one-sided. Maybe the man didnt pay his bill for years, or said some nasty things about the fire chief’s mother when they friendly reminded him)
When you dont pay your gas bill, the heat goes out. Regardless if it is -20 outside and you are likely to die from hypothermia. I seem to recall something about the utility company not being allowed to cut off your gas when there are litte children in the house but I doubt that is an actual law.
When you don’t pay your insurance, you do not still get money for your burnt down house
Nobody seems to have issues with thsoe examples, why expect different from a fire department?
I can see this be a problem in non-rural arreas though. What if a town house owner chooses to not take fire fighting protection. The fire brigade would still have to show up to protect the houses on either side.
It depends on the circumstances. Any ambulance, public or private, can’t refuse someone service for a medical emergency. At the service I work for, we can refuse to transport someone if we determine it’s not medically necessary. This requires consultation with a medical control doctor and only happens very rarely. It also has nothing to do with ability to pay or insurance status.
Interfacility calls are another story. This would be something like a transfer from a hospital to another hospital or a hospital to another care facility (nursing home, rehab facility, psychiatric facility, etc) an ambulance service can screen for ability to pay. That said, in my experience, most facilities have a contracted ambulance provider and if the patient can’t pay for the transfer the facility pays the ambulance bill.
