FARGO — Essentia Health complains that it has “identified a trend” involving some ambulance medics who ignore patients' requests and take them to Sanford Medical Center against their wishes.
Sanford, a rival of Essentia, denies the allegation, which has not been made as a formal complaint. A Sanford administrator said the health system, which owns F-M Ambulance, welcomes an investigation.
“We’ve noticed a trend that concerns us,” Dr. Christopher Anderson, an emergency department physician at Essentia hospital, said Thursday, May 9. “We want to make sure that patients have a choice when they’re taken somewhere,” and that choice should be honored.
Anderson said he hasn’t personally heard from patients who have said they were not taken to Essentia despite making their wishes known to ambulance medics, but said he has heard such reports indirectly.
“I think it’s definitely become more apparent recently in the last several months,” Anderson said.
Essentia would not specify the source of its concerns, but spokeswoman Tara Ekren said, “Patient feedback would absolutely be one of the avenues.”
In rare instances, when time is critical, it would be proper to take someone to the nearest emergency department, Anderson said. Otherwise, a patient’s choice should be respected, he added.
“We want to make sure that choice is honored,” Anderson said. “If they do choose Essentia, we’re more than capable of taking care of them.”
Susan Jarvis, Sanford’s vice president of operations in Fargo, said Sanford works closely with Essentia in providing services through F-M Ambulance, the only ambulance service in the metro area.
F-M Ambulance once was jointly owned by local hospitals, but Sanford’s predecessor, MeritCare Health System, was left with sole ownership when the other hospitals folded or backed out, including Innovis Health, Essentia’s predecessor, Jarvis said.
“We were kind of the last man standing,” she added.
Ambulance service is regulated by the North Dakota Department of Health and monitored by the city of Fargo’s Ambulance Service Oversight Committee.
Jarvis said Sanford and F-M Ambulance comply with all laws and regulations involving ambulance patient transports.
“If somebody has a doctor at Essentia and wants to go to Essentia, we’ll take them to Essentia,” she said. “I know that we haven’t done anything wrong and welcome any formal investigation into this. If Essentia has an issue with that, I’d love to have them call me. So far, they haven’t.”
She added: “Our mission is to take care of the community we serve.” Operating F-M Ambulance is part of that mission, Jarvis said.
Cities commonly have a single ambulance service, because of the cost of providing the service, or designate service areas in metro areas with multiple ambulance services, she said.
Members of Fargo’s Ambulance Service Oversight Committee, which receives monthly reports of ambulance transports, said they have not heard any complaints of ambulances not taking patients to Essentia despite their wishes.
“I have not had any concerns brought to me at all,” said Desi Fleming, a member of the committee and director of Fargo Cass Public Health. “I have not heard of any issues.”
Steve Dirksen, chief of the Fargo Fire Department and chairman of the oversight committee, also said no allegations of favoritism by ambulance crews involving Sanford over Essentia have been brought to the committee’s attention.
Monthly reports showing where ambulance patients are taken have shown consistent trends, he said.
“I know for a long time a majority of patients go to Sanford,” Dirksen said. “We haven’t been long enough with the new Sanford to tell if there’s a difference,” he added, referring to Sanford Medical Center near Veterans Boulevard, which opened in 2017.
Christopher Price, director of emergency medical systems for the North Dakota Department of Health, said complaints of ambulances bypassing one hospital in preference for another are rare.
State officials have not received any complaints alleging favoritism by F-M Ambulance, he said.
Transport plans dictate where patients requiring trauma, stroke, cardiac or general care are taken. In Bismarck and Fargo, the two North Dakota cities with more than one trauma center, the distances between hospitals are so minor that the transport plans don’t specify which should be prioritized, Price said.
Similarly, the transport plan doesn’t distinguish between a Level I trauma center, the highest level, or a Level II. Sanford Medical Center in Fargo is the state’s only Level I trauma center.
“They don’t recognize a difference in either case, assuming they’re close by,” Price said.
In the 1½ years since Price has overseen emergency medical systems in North Dakota, “This hasn’t been a complaint for anybody, an official complaint.”