The Nature of Transfer Centers as a Concierge Business
As a physician in a regional medical center, I am often called upon to evaluate and treat patients who are in an unstable state. The diagnoses vary, and include STEMI, strokes, septic shock, trauma, hemorrhage, and much more. The patients may come from direct admissions, ED evaluations, or consults. In my previous work at a major tertiary care and level one trauma center, managing such cases was an orchestrated symphony of experienced sub-specialists, domain experts, and ultra-modern equipment. At the regional and community level you sometimes hit the limits of available expertise and resources, especially on weekends and holidays, leaving you and your patient at risk for tragic outcomes.
Transferring a patient to “the next level” is often a snap decision made under the direst circumstances. While keeping your patient from decompensating, you must find an accepting institution and provider, tell your story, decide on transport options, and document all the pertinent information. Time is of the essence, and confusion is the last thing you want or need.
The comparison of transferring a patient to a hospital with and without a transfer center almost goes without saying- it’s the difference between feeling deliverance and being stranded in the desert. However, even transfer centers vary noticeably in their service level, organization, and competency. As a referring physician, I have personally had experiences with transfer centers ranging from “concierge level” service to those that have left me wondering if the purpose was to confuse me more.
Professionalism, courtesy, and solid clinical knowledge from the transfer center agent always make me feel like I have come to the “right place.” Perhaps even more important is when I sense that there is a great working relationship between the transfer center and the accepting physician. I can sense “push back” or a feeling that the accepting physician is annoyed with the call. When the accepting physician understands my predicament, and offers to bring on all the resources he or she has available, it validates the work I have done, and makes me feel like we are all part of the patient’s team.
Without a doubt, that is the transfer center I will be calling again and again.