None of Our Business

Massachusetts Department of Public Health wants EMS crews to gather racial and ethnic information on their patients. From the Boston Herald article:

In the old days, when an ambulance arrived at your door, the first thing the EMT would ask would be something like: “Where does it hurt?” or “What are the symptoms?”

But we live in a Politically Correct world now, and so the Mass. Department of Public Health has issued a new directive, “Guidance on the Collection of Race and Ethnicity by Ambulance Services.”

In this document, the first question to the sick person is not: “Do you want to go to the hospital?” The first question is: “Are you Hispanic/Latino/Spanish?”

Actually, my employer doesn’t like the question, “Do you want to go the the hospital?” In the finest tradition of suggestion selling, The Borg’s preferred phrasing is, “To which hospital would you like us to take you?”

Because you know, if you give them a chance to say no, a significant portion of them will, thus generating no revenue. And I’m okay with that, really. We don’t force people to go to the hospital, and I draw the line at lying to my patient or coercion. We try our best to convince them that it’s in their own best interests, and if unsuccessful, we document accordingly.

But what we don’t do is defer our history and physical exam in order to gather racial and ethnic info. I don’t even gather insurance or demographic info, other than the patient’s age, until after our patient is on the bed in the Emergency Department.

When I’m providing medical care, I could give a rat’s ass about the patient’s racial or ethnic background. If anything, I may alter my demeanor and speech patterns to facilitate better communication, but that’s it.

Race isn’t even part of my patient reports, and if it’s even mentioned at all, it is in the context of the patient’s diagnosis or treatment. Some ethnic groups have medical conditions unique to that group, and we sometimes have to alter our assessments and treatments based upon the patient’s cultural beliefs.

And you know, the same can be said of just about all of my colleagues. Even us po’ old rednecks here in the deep South don’t bother with the patient’s ethnicity when rendering medical care, and we weren’t even blessed by being raised in enlightened places like Massachusetts.

I’m not saying there’s no racism in EMS. We have the same biases as any other group. And honestly, when you see one ethnic and demographic group abusing the system day after day, it’s hard not to become jaded.

But some of us blame the system that makes that group more likely to inappropriately utilize our services, instead of focusing on their skin tone.

But even that second group keeps their racism to themselves until after they drop off the patient at the ED. They may rail about niggers and spics and Chinks and name your offensive term after the call, until I let them know I’m not interested in their hate, but when they’ve got the patient in the back of the rig, the crack dealer gets the same care as the socialite. The most racist EMT I ever knew was as sweet and solicitious to elderly black women as he’d be to his own grandmother.

He’d talk some serious hate about their children and grandchildren after the call, though.

I’m even willing to grant that there are some EMT’s out there that don’t compartmentalize that well. They let their personal biases bleed over into their care. But the thing is, those medical providers are rare, even here in the South.

Apparently, Massachusetts DPH believes otherwise. The Herald article doesn’t say why they’re gathering the information. Maybe they just want to know the ethnic breakdown of the people who utilize EMS.

The question is, why? If there is a point in gathering that information, the only answer is that someone at DPH believes that race and ethnic background matters in the delivery of healthcare.

So who does that make the racists, the EMT’s or the Massachusetts Department of Public Health?

What say you, EMS peeps? Is this any of our business, or should Massachusetts EMT’s tell DPH to get bent?

H/T to Jay G.