I live in a rural community that runs an active EMS crew. We have 4 full-time EMT's and numerous volunteers who work various hours. I've been an EMT for quite some time and cannot ever remember there being tension between our staff and the LTC community. We take every call the same, whether it's a LTC transfer, a cardiac emergency, or a trauma call, it's all run the same. We have a short transfer time to our closest hospital, so an entire background on the person's medical history would probably take longer than the transport itself. We get what we can get when we can get it and we go from there. Whether that is a verbal report or a copy of their chart, we just take it and go so we can work out the details later. I'm sure bigger cities don't work the same as we do. We aren't so busy as to look down on LTC transfers, and it doesn't matter whether there is a DNR or not. So please don't lump us EMT's all in the same group. There are some pretty cocky medics out there who work in the busier areas and see LTC as an inconvenience to them, but we take all calls seriously and never criticize or condemn anyone for calling 911. That's what we are there for, and that's what we do (especially those of us who volunteer). This just gives another side to the argument of whether or not tension exists, and it may just depend where you are and how busy your EMS service is.