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  • Last modified 2596 days ago (Aug. 17, 2011)

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A secret topic

Marion County’s knee-jerk decision to switch from plain English to convoluted codes when dispatching ambulances is the latest example of how government responds when citizens attempt to look over its shoulder.

Fearing scrutiny by those who pay the bills, government increasingly resorts to secrecy — a tactic more characteristic of totalitarianism than democracy.

Up until now, government has done so mainly with what should be public meetings, often with disastrous results. Remember last year’s KBI investigation of a you-know-what-ing match between Marion’s mayor and then-city administrator? Want to know whether this year’s deposed road and bridge superintendent did something wrong in office? Too bad. You just pay the bills. You don’t get to know how your money is spent. Things you really need to know about all too often are dealt with in meetings to which the public is specifically not invited.

Last week, the county carried this to an extreme by creating a system reminiscent of Little Orphan Annie decoder rings when dispatching publicly funded ambulances.

It’s not as if this was something experts had told the county to do. Nationwide, security experts are unanimous in their advice that public agencies should eliminate, rather than institute, secret codes and signals. They even want to get rid of the old “10-4.” Listen to public-safety scanners in adjoining areas and you will hear exactly why ambulances are dispatched.

What Marion County appears to be afraid of is not patient privacy, as it claims, but rather the right of those who pay to subsidize emergency medical services to learn how those services are being used.

So far this summer, public monitoring of emergency dispatches via this newspaper’s Docket page has had several positive results:

It called attention to problems with posting of emergency medical technicians at a motocross course near Marion and ultimately prompted the creation of a new system that will result in less waste and greater safety.

It helped bring to light the burdens caused by a rash of grass fires, ultimately resulting in a burn ban during our heat wave.

It exposed how ambulances, often needlessly, were being summoned to fires before anyone knew whether the fire was anything that might require a medical presence, ultimately leading to consideration of a new policy.

Officials seem to like it when scrutiny works to their benefit. What they don’t like is when other questions are raised:

Why was it necessary to send an ambulance from Marion to Burns to get someone to sign a “refused treatment” slip when first responders already knew the patient had mistakenly pushed a panic button and there was no medical situation to investigate?

Why was a county-subsidized Hillsboro ambulance used to transport a patient from Wichita to Newton — a trip that neither began nor ended in Marion County but used Marion County equipment, depriving half the county of timely ambulance service for nearly half a workday, solely because it would be less expensive for the patient?

Why is it that so-called first responders are routinely summoned in addition to ambulance crews when emergency supervisors know no medically trained responders are available and, seemingly half the time, the first responders actually get there after the ambulance?

Are some patients who need ambulance transport so fearful of the price that they drive themselves — or have EMTs come back later in private vehicles to drive them instead?

Are others abusing the system, treating it as if it were a concierge medical practice of free house calls for upset tummies?

Has a hospital, which has cut staffing, been using EMTs not to transport patients but to replace laid-off nurses during in-hospital treatment?

Our Emergency Dispatches column, based on ambulance broadcasts, was not an attempt to generate prurient gossip, as alleged. Rather, it was an attempt to let taxpayers see how the service they pay to underwrite is being used and help them determine whether it might be time to challenge man-made rules under which Marion County ambulances operate.

We have nothing but unbounded admiration for the extremely dedicated and talented EMTs who staff the county’s ambulances. We are concerned, however, that questionable policies may be working them to death. If that happens, the only alternatives will be an extremely costly, full-time ambulance service or a gross degradation in the quality of emergency medical care in the county. At this point, neither is an acceptable option.

From the start — despite a claim that we adjusted our policies after a few weeks — we were extremely careful not to divulge specific addresses or other identifying information broadcast with medical calls. We even asked the county to identify any transgressions we had made. None were pointed out to us. The privacy argument clearly was a ruse. The county simply does not want anyone other than county employees to know what other county employees are doing as part of their jobs.

Even if it were true that privacy was a concern, there’s a very valid reason — one that Commissioner Randy Dallke wisely alluded to — for not hiding the true nature of calls.

Dallke’s professional experience in emergency services taught him what I learned in a very personal way a few years ago, when an off-duty EMT, hearing a call about sudden cardiac arrest, rushed to my father’s home before the ambulance arrived and quite literally saved my father’s life because he knew the urgency of the call.

Would that valiant EMT, who deservedly earned my lifelong admiration, have responded if all he had heard were “run code thirty-eight alpha tango,” or some such gibberish?

Heaven help us when patient privacy and bureaucratic secrecy take priority over saving lives.

— ERIC MEYER

Last modified Aug. 17, 2011

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