Objective: In our community the majority of patients presenting to the ED with acute chest pain come by car and do not recall their MD suggesting EMS. How do private MD's (our customers) view EMS?

Methods: Single mailing survey to all 238 physicians with admitting privileges in Medicine at an urban, tertiary care hospital (722 beds). EMS services provided by 2 private ALS systems and 35 volunteer ALS services operating under one physician medical director and identical protocols. Survey consisted of a scenario with a cardiac patient in the home of the MD, followed by opinions regarding EMS.

Results: 50% return. Respondents were 79% male, mean age 44 ±14yr, 68% internal medicine, 11% cardiologists. Given a patient with acute chest pain at the MD's home, 90% would call EMS, 10% would drive patient. 16% chose to drive for safety concerns, 83% because it was faster. Of those who chose EMS, 10% made negative comments regarding paramedics “playing doctor”. The following perceptions were noted: 3% of respondents indicated paramedics take “too long” to respond to calls, 26% indicated paramedics delay patient arrival to the hospital, and 6% indicated patients get too nervous if told to take an ambulance. On the other hand, 59% indicated EMS prevents cardiac arrests, 83% indicated paramedics can appropriately treat cardiac arrest, and 13% agreed paramedics can provide similar treatment for chest pain patients as hospitals.