By Matt Smith
WebMD Health News
Reviewed by Brunilda Nazario, MD
May 12, 2017 -- The low cost and convenience of ride-booking services like Uber and Lyft have put a dent in the taxi business and other traditional ways to get around a city.
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Are ambulances next?
In cities from coast to coast, drivers for car services say they've picked up someone who wants to go to the emergency room, from people with breathing problems to women in labor.
One of those was Colette Marshall from Orlando, FL, although she didn't realize it at the time.
In January of 2016, Marshall was 6 months pregnant with her third child -- she had 18-month-old twins -- when she started having sharp pains that were getting worse as the night went on.
She thought she was dehydrated and needed an IV, so she decided to go to the hospital.
"So instead of waking anybody up, and waking up our 18-month-olds, having all of us go to the hospital, I just said to my husband, I'll Uber to the hospital," says Marshall. "At that point, I didn't know I was in labor, I just told my driver that I was heading to the hospital to get checked out because I was having strange pains."
By the time she got to the ER, the pains were within 2 to 5 minutes of each other. Her son Korben was born soon after, at 2 pounds, 12 ounces.
"I've always had a good experience with Uber," Marshall says. "I don't think that Uber driver even knows I ended up having a baby that night."
There are no available statistics on how often drivers pick up people headed to the ER. But drivers frequently talk about it on chat boards.
"I've taken two passengers to the ER, one with a dislocated shoulder and another that was passing a kidney stone. Not a big deal, not difficult," one driver in Pittsburgh said on a message board popular with Uber drivers.
Another talked about getting a call to an affluent Washington neighborhood the day after a 2016 snowstorm: "When I got there, to my (then) dismay, I see him literally dragging himself towards my car, hand on his chest, stating he was having chest pains and was getting dizzy," the driver wrote. "I offered to call 911, as the hospital he wanted to go to was over 15 minutes away but he insisted for me to take him. Fortunately, I was able to get him to the hospital and he was admitted, but it made me wonder why someone in that situation would prefer an Uber over an ambulance -- the only rationale I can come up with is money."
Uber, the industry giant whose name has become almost synonymous with the ride-booking business, says it's glad people have called for its drivers in times of need -- but it doesn't encourage people to do that.
"We're grateful our service has helped people get to where they're going when they need it the most," the company says in a written statement. "However, it's important to note that Uber is not a substitute for law enforcement or medical professionals. In the event of any medical emergency, we encourage people to call 911."
Lyft, Uber's biggest rival, also says that its platform "is most appropriately used in non-emergency situations."
"In emergency situations, you should dial 911 for immediate assistance," the company says.
While people like Marshall took Uber for the convenience, experts say costs may play role as well.
Ambulance runs can cost $1,200 to $1,500, says Ryan Stanton, MD, a spokesman for the American College of Emergency Physicians. Stanton, the emergency medical services chief in Lexington, KY, says emergency medical services "are definitely over-utilized." But a private driver isn't likely to get you to a hospital faster or provide immediate medical care on the way.
"If it's a true emergency, you don't have anybody with any medical training who can attend to you," says Stanton. "That's the goal of EMS. It's not necessarily to get you to the ER faster, it's to initiate care in the field, so the care has started before you get to the hospital."
"IF you think that your condition is unstable or critical enough that it could deteriorate in the near term -- the next hour, couple of hours, few hours -- I would definitely use an ambulance," he says. But if your condition isn't worsening quickly, hiring a car "might be a decent way to get to the hospital."
Some drivers say they're reluctant to pick up passengers in a medical crisis.
"I'm not an ambulance. I am not qualified to treat/transport you and I'm not taking on the liability," one Dallas driver posted on a ride-booking message board. Another added, "Anyone bleeding isn't getting a ride ... I just offer to dial 911 for them."
While it may not be smart to call a ride-booking service for a life-threatening situation, some health care providers are incorporating those carriers into nonemergency service. Lyft and the Blue Cross Blue Shield Association are working together to offer members free rides to doctors' appointments.
Uber and Lyft have partnerships with hospitals and assisted living facilities, which can use them alongside traditional services like transit systems or taxis to ferry passengers to doctors' appointments. A 2008 study in Florida found that every dollar spent getting people to regular health care could save $11 in hospital costs later.
That's attracting entrepreneurs like Imran Cronk, whose Philadelphia-based software startup Ride Health is designed to get more people to nonemergency care.
"Hospitals are very enthusiastic to adopt these more efficient, lower-cost, convenient modes of transportation," said Cronk, whose company aims to connect medical centers with transit, taxis, or ride-booking companies. "There's a few providers who have led the charge in demonstrating these partnerships, but they're all very early on in the game, and providers are still figuring out how to work with these new transportation systems."
For those deciding whether to use the service to get to the ER instead, Hany Atallah, MD, the chief of emergency medicine at Atlanta's Grady Health System, says people "need to exercise common sense."
"If it's something they determine is more minor, like a cut on a finger where they're able to control the bleeding but need their hands to drive ... then maybe it'd be appropriate to take a ride-share service rather than an ambulance," he says.
In other cases, though, such as a stroke, a patient may not immediately recognize the problem.
"It's not denial, but because the part of their brain that is affected by the stroke makes them think everything is OK," Atallah says. But a stroke "requires 911, lights, and sirens to get people to the hospital as quickly as possible, because time is of the essence."
WebMD senior news writer Brenda Goodman contributed to this article.
SOURCES: Ryan Stanton, MD, EMS director, Lexington, KY. Hany Atallah, MD, Grady Memorial Hospital, Atlanta. Imran Cronk, CEO, Ride Health. UberPeople message board. Kaiser Family Foundation: "Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers." Kaiser Health News: "Medical Providers Try Uber, Lyft For Patients With Few Transportation Options." U.S. Government Accountability Office: "Nonemergency Medical Transportation: Updated Medicaid Guidance Could Help States." Florida State University College of Business: "Transportation Disadvantaged Programs Return On Investment Study." Blue Cross Blue Shield: "Blue Cross and Blue Shield and Lyft Join Forces to Increase Access to Health Care in Communities with Transportation Deserts." Colette Marshall, Orlando, FL.
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