Years ago I was working with New York City as an EMT out of Queens General Hospital. I remember being in shock after picking up an otherwise non-ill appearing man who gave a complaint that I currently cannot recall. We took him in a city ambulance to the local hospital. The part that shocked me was that he never entered the hospital. He thanked us and proceeded to go across the street to do his shopping. He never was sick and never intended to enter the ED doors. We served as free transportation for him.
Beginning January, 2011, a Medical Director is required for all ambulance services in the Commonwealth of Pennsylvania. Additionally, the ability to contact Medical Command is required of all ambulance services as well. This seems as if we are heading in the right direction regarding oversight. Up until now, AEDs were optional for BLS ambulance services. The mandate that they are onboard has prompted the need for having a Medical Director. Hopefully, this will generate some quality control. Hopefully, this will not be a localized step forward in one individual state.