For trauma centers, it’s a zero sum game. The number of trauma patients in a given geographic location is fixed. (Actually, it goes up slowly over time as the population increases). So if a new center opens, those patients are redistributed. The new center gets more patients because they are now “designated.” And the existing centers get fewer because there are not as many patients left.
Click here to read more at Dr. McGonigal's blog. (linked with permission)
For helicopter air ambulances, the effect can be dramatic. A local hospital achieving level-two status means many of the patients that would have previously been flown are now driven into town. Flight volumes can be cut in half. A close working relationship with a hospital has always been key to success for any HAA program - in this case it is even more so. The facility that used to refer patients out can now receive many of them. But the referral areas shift and new relationships (or better ones) with EMS agencies must be developed.
Sidebar: Some thoughts on gaming the system...
More so than ever before, flight teams must seek to be an integral component of every agency they serve. The temptation to cross over the line of what is ethical, legal, and moral must be resisted however. Paying a fee for calls which circumvents the practice of using the closest appropriate aircraft is a dirty secret which cannot be concealed forever - and the anti-fraud arms of the government are long and strong. People talk.