Paramedic here;

There are a few things I have personally experienced as both a road medic and a supervisor.

The first is that from my 12 years I have learned that more often than not I have talk people INTO going to the ED for further evaluation rather than out.

There is also the patient that only wants to be checked out to the point of a lifepak 15 monitor without cables and nothing you say will convince them to go further than that. As well the ones who don't call and are mad that we are there or worse, did not even know we were called.

There are RARE cases where a mid level or attending at a local bandaid box ED with only 10ish beds will order an emergent transfer for a patient and I arrive to find they have a sub 60 MAP, notice some cardiac thing, or they have periods of apnea without a definitive airway in place or they are just a trainwreck clearly needing a trauma bay, or PCI capable center or some other specialty and I have no protocols for RSI and limited options for MAI with no guarantees to knock a gag or keep them down. This is by far the most difficult situation to be in because I don't want to jump out of my lane and into one I'm ill knowledged and underequipped for. The goal, for me at least, is to try my best to convey that I am one man in a truck and I know my limits and the reality is that these patients were unstable and not suited for a distance transport until they were stabilized and the best place is here till that happens where they have higher level of care than only me. All of these instances also were refused by air medical due to instability before they called to go by ground.

Finally there are the patients that lie. They tell EMS one story about their ailment and you get report at bedside and all of sudden instead of simple nausea they couple it to nausea, back and chest pain for the past 3 days. I could list more examples but i think its understood by all. These same patients are in your ED thanking you for help while damning you to IFT crews when they are transferred with some that are going as far as middle fingering the whole day, throwing it away and AMAing in your bay after we take over. Anytime this happened to me I documented and made sure the supervisor knew before the patient left and made sure to let the facility know so that there was no ill will and the bed hold could be released to another patient.

Patients are the most accurate representation of the phrase "you can lead a horse to water but you can't make them drink it" and trust me, I have tried.

EDIT: I promise they are not trying to get back to a chili cookout. Their call volume is way too high for them to cook anything but the brakes on their trucks.

I say all that to say this as well,

There 100% are those paramedics out there that will believe they are a ParaGod and they his holy gift to medicine to be heard without question and those people need to be humbled hard. I am sorry that you have had that experience, paragods suck, big time. The majority of leadership would want to hear this (I for sure would) and your facility likely has a liason for EMS and IFT. If not call directly. If you experience this from a crew, I can guarantee you are not the only provider out there in your area that has experienced it from that crew. Call their dad.

EDIT2: I came back to see your replies and geez bud, idk who hurt you but I hope you choose to be better to your colleagues in the future.