For a trip to the ER, some are opting for Uber over an ambulance

Millions 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.

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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.”