RE: Flying patients to other hospitals

["Paul M. Wright, Jr." <pmwright@home.com>]

> >As far as the "legality" of your facility's possible directive to fly
> >patients only to your facility, try flying someone to your
> >facility who has
> >been referred elsewhere, or who has chosen to go elsewhere, and see what
> >happens.

John -

I appreciate your perspective and only wanted to offer the thought that air
transport can be thought of as an extension to the cath lab as part of a
"package deal".

The important point is to create appropriate expectations at the point of
referral because things do get sticky once the formal referral has been made
and the patient gets "diverted (poached... whatever the term is)" from their
original destination.  The referring physician simply needs to know that
he/she can refer the patient to XYZ Cath Lab by air or WXY Cath Lab by
ground and those are what the choices are; at that point, it's a
marketing/provider/HMO education issue.  As I noted in an earlier post, the
role of the communication center is critical in not accepting flights that
would be outside the program's policies.

For a possibly analogous example, in the large metropolitan area in which I
live, to the best of my knowledge there is only one cardiac cath lab that is
staffed 7x24.  A referring physician knows that for immediate care at 0300,
the patient must be referred to that facility but that another facility can
get their team in place within some known amount of time.  A decision can
then be made whether the delay in TTDC (time to definitive care) is
acceptable.  The hospital that invests in 7x24 staffing has created a
competitive advantage for itself and is not required to provide that
competitive advantage to other hospitals.  Should air transport be treated
differently?


regards!

paul

Paul M. Wright, Jr.
Mesa, AZ



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