Playing hocus-pocus with ambulances
The closer you look, the less you’ll see. It’s a mantra not just among magicians and used-car salesmen. It also reverberates, at least subconsciously, among politicians, bureaucrats, and others.
Often with good intentions — but sometimes with bad — they tend to influence decision-making by employing verbal sleight of hand to misdirect attention to just one aspect of an issue, excluding all others.
Yes, Marion County at times has too few ambulances. It’s important to note, however, that no safety net, despite its importance, can be absolute. Having an overpass at every intersection undoubtedly would save lives, but not every road, street, or alleyway can justify such expense.
When a system breaks or comes close to breaking, the temptation is to throw money at it. Recruit yet more top-dollar paramedics. Build yet more costly ambulance stations. Failing that, blame the person in charge — in our case, a county ambulance director who has convinced us, after two years of uninterrupted monitoring of every ambulance dispatch, to be expertly and tirelessly on top of the situation day in and day out.
The sleight of hand occurs when framing the question. It’s not so much whether the county has too few ambulances as whether it has too many ambulance calls — and too many people wanting to be absolute rulers of who gets what emergency services when.
Helpful friends and neighbors and better training for dispatchers could eliminate some of the more than half of all ambulance calls that result in no one being taken to a hospital. That could up to double the number of ambulances available at any given time.
As for other times, instead of upgrading our ambulance service, perhaps we could consider upgrading our hospitals and nursing homes so that they can handle more of the relatively simple situations that now require time-consuming transfer of patients to other facilities. That also holds true of the region’s Level 1 trauma centers. Why should their lack of capacity be something the ambulance service is called upon to correct.
Simple things also would help. When transfers do occur, perhaps the hospitals — instead drawing lines in the sand about who determines what has priority — could have their patients ready to go so ambulances don’t have to spend half the transfer time waiting for their patients to be loaded.
We also could try a unique idea, like taking the unused Florence ambulance, refurbishing it, and making it available for hospitals to use — with their own nurses staffing it — for routine, non-emergency transfers to and from other hospitals and nursing homes.
That way, no one would be in a position to challenge the lines in the sand that they draw. They could prioritize their own calls and allow the county medical service to remain, as its name implies, for emergencies only.
It’s a system that works in many counties across the nation, including in Dickinson County, just to our north, where two hospitals run the ambulance service for the entire county.
Metaphorically lynching the county’s emergency medical director won’t save lives the way the sleight of hand would lead you to believe. It will just solidify the image of Marion County as an employer willing to retain only those officials who kowtow to powers-that-be. Address some of the real problems and we can make real progress.
— ERIC MEYER