"Needless" calls & System abusers: How do you break the cycle?

[mako887]

Hi! I've been a firefighter/paramedic with the City of Miami (FL) Fire Dept. since 1980. I've been riding rescue (ALS) steady since 1983. In that time, I've been on numerous calls which, for lack of a better definition, should be classified as "needless."
Anyone who has been riding ALS for any length of time knows EXACTLY the type of calls I'm talking about: People who call for blood pressure checks at 3AM; the person who's been "sick" for the last week and suddenly decides NOW is the time to visit the E.R.; "ran out of meds" a week ago, need a ride to the hospital to get more. Then you've got your "system abusers." These are the people you know BY NAME. Just hearing their address over the dispatch gets you agitated. Pull up a dispatch record on these people and it wouldn't be out of the ordinary to find that your unit has responded to this person at least once every week.
I'm sure each of us would like to say to these people, "Sorry, this doesn't qualify as an emergency. You'll have to arrange other transportation to the hospital." Then we'd turn around and leave. Yeah, I know, "abandonment" and all that. Tell me another way to convince these abusers that we're not just a "big red taxi" at their service? I'd really be interested in hearing how other departments handle these type of calls.
Thanks a lot for letting me "vent."

[Ledbelly]

Mako- I don't think there IS another way to handle these calls. A somewhat feeble attempt that was initiated here merely involves more paperwork (and another report) for us; the pt. has to sign an acknowledgement that their 'condition' may not be recognized as an 'emergency' by Medicare, meaning they will have to pay. Of course, if they're not using Medicare...; and even if they are, they probably have no intention of paying anyway. Seems like we always have around 20-25% write-offs in every budget and no recourse to collect. If you find an answer I hope you pass it on!
Good Luck, Lee

[stone35]

I don't want to sound sick or anything, but a friend of mine was an Army nurse and they had this one guy who always came down with abdominal spasms right around P.T. time. On his fourth or fifth trip to the doctor to get out of P.T the doctor called his bluff. He sat there, looked at the guy, then he ordered an anal swab and analysis. That meant that the doctor whipped out one of those ten inch q-tips and performed an anal probe. Needless to say that soldier made every P.T. after that. Sometimes you just have to get a little creative.