HJBR May/Jun 2022

DIALOGUE 14 MAY / JUN 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE   It’s not just the ones who need a ride, there are other people who have legitimate medical conditions who take the most expensive means of medical transporta- tion to get to the most expensive method of medical evaluation and treatment for condi- tions but don’t need to be in the emergency department. That’s what’s kind of killing us in the world of emergency medicine from prehos- pital well into the emergency room. I won’t say that, rather it’s one of the many things that’s kind of killing the system because a lot of those patients are being paid for with government money to take, again, the most expensive means of medical transportation to the most expensive means of medical therapy and evaluation for conditions that don’t require they be there. But, they don’t have any other option. Editor So, who ultimately pays for overuti- lization or unnecessary utilization? Godbee You and I do. Meaning, it’s pretty much tax dollars — state, local, Medicare, Medicaid, federal government — paying for all that to the overwhelming majority. Here’s where we stand, and again this is what I would like people in our local community to know, not just the health- care people, but everybody that lives in Baton Rouge. I wish we could explain this to them. We did a study of our people look- ing for frequent users of the EMS system. These are just general, broad numbers to put it in perspective. We have, let’s say, maybe, half a million people that either live, work, or are traveling through East Baton Rouge Parish at any given time of the working day. Of that number of people, we have, no kid- ding, 2,000 people (of 500,000) that are 20% of the 911 calls and workload within EMS. Less than 0.5% of the people that live in the parish are 20% of the workload of EMS by call volume, number of calls. One step further, there are 600 people within the parish, so down to about 0.01%, even lower, that are 10% of the workload of EMS. So, that speaks to your overutilization and somewhat to the level of inappropriate uti- lization of the 911 system. We’re getting hit hard by a very small number of people, and that’s what we needed to address. And then we try to address, well, why are they using it so frequently? I’m harking back again to jaded cynicism. I know a lot of my colleagues in the emer- gency department, they roll their eyes and they’d go, “Yeah, a bunch of drug seekers.” Absolutely not. It is not drug seekers. They are not. The people who are utilizing the system at that level of frequency and that heavy of utilization, again, where 2,000 are 20% of our workload and 600 are 10% of our workload, are people that have abso- lutely legitimate medical problems, but they don’t know how to work through the medi- cal system. That’s the problemwith overuti- lization of EMS. Sure, there are people who use it as a taxi ride to the hospital. We get it, we have it, we understand it. But if you look at the largest bulk of numbers, it’s not necessarily them. It’s the people who don’t know how to navi- gate the system. They can’t get what they need out of the system normally, and then their bailout is us as the safety net. We’re here to save you when you need us — 911, and they go to the emergency room. Again, taking the most expensive means of medi- cal transportation to the most expensive means of medical evaluation, of treatment for something that is a legitimate medical issue, but it’s not an emergency. Editor What’s your opinion on bystander CPR? Godbee Bystander CPR is one of my biggest “Bystander CPR has the biggest impact of survival from cardiac arrest than anything else anybody does. That’s what saves people. I am absolutely, absolutely devoted to doing whatever we can do to get bystander CPR out to everybody on the planet because that’s going to save lives.”