Rural Patients Unable To Transfer To Major Arizona Hospitals
As Arizona's biggest hospitals fill up with COVID-19 cases, physicians in some of the state's smaller or more rural communities fear it's their patients who need specialty care who will pay the ultimate price.
From Bisbee up to Flagstaff, smaller hospitals are trying to maintain the delicate balance of caring for patients without having to transfer them to major hospitals in Tucson or Phoenix. The state's largest health care providers have been deluged with virus-infected patients — most of whom are unvaccinated — as well as patients who put off care during the early months of the pandemic. The inability to find a bed has left smaller facilities such as Santa Cruz Valley Regional Hospital in Green Valley frustrated.
A Tucson gastroenterologist drove to Green Valley last week to operate on a patient who couldn't be transferred anywhere in the state to get the surgery. The hospital has filed a complaint with the Arizona Department of Health Services about the inability to transfer, the Arizona Daily Star reported.
“We started calling the hospitals in Tucson and Phoenix, and every single one turned us down,” said Stephen Harris, CEO of Santa Cruz Valley Regional Hospital, told the newspaper. The patient lived “only because this doctor was nice enough, was human enough to save his life.
Harris said there's no quick way to find out if hospitals are full. Staff have to spend a lot of time just making phone call after phone call.
In Cochise County, Dr. Cristian Laguillo, a senior physician with Copper Queen Community Hospital in Bisbee, said he has never felt this helpless trying to assist patients — even while serving a tour in Afghanistan as a combat medic.
A patient who needed cardiothoracic and pulmonary expertise and surgery last weekend died before Laguillo could find an ICU bed in an appropriate hospital.
“I did everything I could to save him," Laguillo said.
Dr. Julia Brown, director of emergency services at the Bisbee hospital, couldn't find transfer beds available in Tucson over the last week.
Dr. Heidi L. Lodge, chief of staff and director of the Douglas Clinic, had three patients recently die because they couldn't get to a facility with more specialized care in time. She expects to see more instances of this.
“We understand the need to ration care in the times of a pandemic, but currently care is being rationed in favor of COVID patients by using the (surge) line. The line has proven invaluable to us, but we need to be able to use this asset for all patients requiring a higher level of care," Lodge said.
The surge line in Arizona was created in April 2020 by the state Department of Health Services to facilitate transfers of COVID-19 patients across the state. But it's meant to be used to track down beds for COVID-19 patients.
Laguillo thinks the state surge line has to change to be for all patients in critical need, not just virus patients.
“We need the same type of service now more than ever for every patient, not just the COVID patients,” he said.
Northern Arizona Healthcare, the provider that serves 700,000 people in Arizona's high country, is limiting the volume of booked surgeries so nobody will have to be transferred, according to Josh Tinkle, chief operating officer. During a briefing Wednesday, Tinkle said Northern Arizona Healthcare is fortunate to be able to provide several surgery specialties.
“The big challenge across the state, everywhere is just full. You can’t really transfer anybody unless you’re on a waiting list and you really need to,” Tinkle said.
Officials at nearly all of Tucson's hospitals say they can receive patients. But none provided information on whether they have had to decline patient transfers recently, the Daily Star reported.
“We accept transfers from in and out of the Tucson area when we have the space and staff to accommodate them,” said Becky Armendariz, a spokeswoman for Banner Health. “This has been our practice throughout the pandemic, and it has continued.”
The inability to accept patient transfers is a crisis nationally. Washington state is facing its own COVID-19 crisis and has little capacity to help neighboring Idaho deal with an overwhelming surge of cases driven by unvaccinated people, according to state hospital executives and doctors there.