M

illions of Americans take an ambulance trip every year; others get rides from willing friends or, tempting fate, drive themselves.

But in recent years a new trend has arisen: Instead of an ambulance, some sick people are hailing an emergency Uber.

Though firm numbers are hard to come by, drivers for Uber and Lyft say it happens with some regularity. In an online chatroom for Uber drivers, dozens of posters share experiences with passengers who hail a ride with bloody cuts, asthma, anaphylaxis, or broken bones.

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The trend, experts say, is driven by a few key factors. Ride-hailing services are cheaper and more predictable than ambulance services. And it allows riders to choose the hospital they’re taken to. But emergency Uber and Lyft rides come with significant risks — to drivers, to patients, and potentially to the companies themselves.

‘There’s definitely a liability’

Francis Piekut, who drives for Uber and Lyft, recalled a passenger who requested a pickup at a Boston-area Starbucks last year.

When Piekut arrived, he discovered it wasn’t a typical fare. “They were burned and wanted to go the emergency room,” he said. He treated the situation like any other ride, he said, dropping his passenger off at the hospital and not asking any questions. “I don’t know how bad it was, but I knew they were in pain really bad.

“I didn’t mind it,” Piekut added, saying that he would do it again. “I was already there, and I know the ambulance costs a lot.”

But that sentiment isn’t universal. Some riders have reported being turned down for an emergency ride.

On the web forum, some drivers shared stories of refusing passengers who looked like they needed emergency medical care. They cited reasons like not wanting to get blood on their car seats, or to be stuck with a dead body in their car.

One Boston-area driver for both Uber and Lyft, who requested not to be named for fear of hurting his business, recounted the story of a group of three people who hailed him last year.

“The women tell me their friend is not feeling well, and they want me to take them to the emergency room,” he said. “I told them no and to just call 911. I have to respect the rules of the road; I can’t speed like an ambulance.

“And there’s definitely a liability thing,” the driver added. “If anything happened to the guy, it’s definitely on me and the insurance I have to carry.”

Officially Uber agrees that riders should call local police or emergency medical services for emergencies.

“It’s important to note that Uber is not a substitute for law enforcement or medical professionals,” said Uber spokesperson Brooke Anderson by email. “In the event of any medical emergency, we encourage people to call 911.”

Still, despite that official stance, the company does occasionally honor drivers on its website for providing emergency transport.

Emergency departments respond

A motivating factor for patients can be cost. The price of an ambulance ride to the hospital can range from $600 to $1000, according to the Department of Health and Human Services, while ride-hailing would rarely hit three figures. Moreover, with ride-hailing, customers know the cost of a trip before they book it. Ambulance services, by contrast, send bills long after they are used, and often the final amount is unknown until the bill is received.

And using Uber or Lyft also lets users choose the hospital, said Chandra Steele, who wrote about taking Uber to the emergency room last summer in PC Magazine. Her medical emergency was severe bleeding, and she knew where she wanted to go.

“My brother was a doctor at the hospital I wanted, but ambulances have to follow certain protocols,” she said. “Ambulances just take you to the closest hospital, which wasn’t the one I wanted to go to.”

And some emergency departments are even beginning to embrace the idea. Last summer, Washington, D.C., city officials began studying the use of ride-hailing to respond to what they describe as “non-emergency, low-acuity” calls, which accounted for nearly half the city’s 911 calls in 2015, according to a report released in February.

“In our research, we found that many of these calls did not require an ambulance,” said District of Columbia Fire and Emergency Medical Services Department spokesperson Doug Buchanan. In fact, he added, it would be better if more people used ride-hailing services instead of an ambulance.

“We would love our residents to take that initiative,” he said.

Operators would route medical emergency calls to triage nurses, who would then determine whether the situation calls for an ambulance, a ride-hailing service, or something else altogether. It’s unclear whether drivers would get any special training for transporting such passengers.

The program is part of the mayor’s budget which will be voted on next month.

Dr. Mark Plaster, an emergency room physician in Baltimore, concurs that trips to the ER can vary greatly in severity — and that the transport options should as well.

“I would hope that no one who needed truly urgent medical attention would take an Uber,” he said. “If you need medical care en route, a private car is a bad idea, because you won’t have the personnel or equipment to treat you.”

He is not completely against the idea, however.

“Rideshares don’t take ambulances out of service, and not everybody coming into the ER is in a dire situation,” he said. “And the ambulance can be expensive.”

“I don’t care how they get there,” he added. “Just get there.”

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  • There are rules on the books in Massachusetts which govern the operation of ambulance services within the Commonwealth. Included in these regulations, all ambulance services must submit a “Service Plan” outlining their response times to emergency calls. Missing in these regulations is a compliancy check to insure these regulations are being met. There is also no requirement for a 911 ambulance service to advise the caller how long the response might take even though most of the ambulances are electronically monitored similar to Uber and run times could be determined by distance and availability of equipment. These regulations in fact, were established to keep private ambulance services from poaching on public agencies who generate huge sums from operating ambulances within a city or town to offset their public safety operating expenses or other pet projects. This revenue is also very difficult to uncover in cities and towns annual published budgets. The City of Boston last year, carried over 85,000 patients. Multiply that by $1100 for a Basic Life Support ambulance or $2200 for a Paramedic Advanced Life Support unit. Charges for mileage and equipment used i.e. IV’s and oxygen as well as gas mileage of $30.00 per mile are also charged to the patients insurance company. Different charges are assessed for Medicaid and Mass Health victims but they represent a small percentage of calls. The annual budget for Boston EMS is 52 million. Where does the overage money go? Why are some outlying neighborhoods of Boston unable to receive an Advanced Life Support unit in the times quoted in the Boston Service Plan on record? It’s cruel and reckless.

    The entire EMS rules must be overhauled! This time, it should be focused on the patient or victims needs and not the bottom line and contain strict compliancy requirements including notification of expected ETA’s! Uber or Lyft might just be the right choice if you live in a neighborhood where public safety is Trumped by financial considerations.

  • I work in the 911 system in NYC and while I don’t have a %, I know from the patients I get assigned to and the patients that other crews bring into the ER for dialing 911, that people dial 911 b/c they have Medicare and just want a free ride to the hospital.

  • well I am sorry…90% of emergency calls to go to the er are NOT EMERGENCIES….and those that call an EMERGENCY ambulance for non emergent reasons take that asset away from some one who might really need it….most just want to get into er faster…and it prides me when they get sent to triage and I to waiting room because their tummy ache or sniffles and headache are not emergent….SMH really JEMS….

    • Ambulance service has become another huge cash cow and, in most cases, a rip off. Market forces are simply at work.

  • With the high level of accidents Uber drivers have, the cheapskates that exploit immigrants who’re on less than minimum wage might end up in an ambulance regardless.

    • You are totally right. Uber in India, has even officially partnered with Apollo Hospitals to offer emergency rides for patients to rush to hospital. WTF ?
      WHAT IS AN EMERGENCY ?
      This means the Uber cab needs to drive fast, violating the law.
      What if a person dies on the way, as the rider would be a sick or injured person.
      What about any blood, vomit, etc !!!
      I am in India and I do Uber (driver) here.
      In India, Uber openly flouts the laws and just like in the US and other places, Uber is exploiting people,
      WAIT : KARMA will materialize … Keep reading news about Uber CEO. Karma will surely decide things.

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