Cathy Lizak
Contributing writer
last updated 12/08/2019

Doctor’s Discharge Orders affect Your Patient Transport Options

Dealing with the hospitable during a medical transport

Air Ambulance

Your mother fell ill away from home and you want to bring her closer to family. What transport options do you have? Cost is definitely a factor, and you were thinking one of those low cost ground options might be best. Does she qualify? It depends on her medical condition. It also depends on the type of discharge her physician gave her.

When a patient is in a medical facility, they are under the medical care of an attending physician. The attending physician will not release the patient unless the patient is either well enough to go home, or the patient is going to another medical facility.

The attending physician determines the type of discharge your patient will receive. If the doctor feels the patient can go home without further medical care, the doctor will give a General Discharge. If the doctor believes, however, that the patient is too ill to go home and must go to another medical facility, the doctor will give a Medical Discharge.

Legally, a medical discharge means that the doctor is turning over responsibility of medical care to another doctor. Once the patient leaves the facility, the current attending doctor no longer has legal responsibility for the patient. When the patient arrives at the new medical facility, the new attending physician has legal responsibility to care for the patient. But who has legal responsibility for care during the transport between the sending and receiving facilities? That responsibility falls on the transport company’s Medical Director.

So, can your mother go by one of those low cost ground options? If the doctor gave her a general discharge and she is not in danger of a medical upset, the answer may be yes. Check with her doctor and the occupational therapist to understand if she can endure the trip. Get a letter from her doctor stating such to provide to the transport company.

With a go ahead from her attending physician for a non-ambulance transport, the next step is to choose which option is best suited to your patient. There are several to choose from. The least costly is a town car with a nurse, but other options include, a wheelchair van, a long distance, non-medical stretcher van, airline medical escort or a medically assisted train transport. Please call Global Air Ambulance at 1-800-948-1220 to find out more about these low cost options.

However, if the doctor gives your mother a medical discharge, the only options are ground and air ambulance. Ground ambulance transports come in different levels of care, starting with basic life support, then advance life support and finally critical care life support. There are also specialty ambulances for neonates, patients on vents or other specialty equipment, and extremely overweight persons. Air ambulance transports, on the other hand, can manage all levels of care by matching medical personnel to patient needs.

What if you do not want to use one of the ambulance options, even though the attending physician will only give a medical discharge? Some families decide to take their patients out of a hospital AMA or Against Medical Advice. You are free to leave a hospital without a general discharge, but doing so relieves the attending physician of any legal responsibility.

If you check your patient out against medical advice, a transport company cannot provide a non-medical transport option. In addition, the transport company cannot provide any transport, under that scenario, unless you find a receiving physician that will accept the patient at a new facility. The transport company cannot legally take an AMA patient home, unless a home healthcare company or hospice care company takes over care.

Some cases arise where a family is uncomfortable with the care being given at the current facility and want desperately to transfer their loved one to a new facility. Sometimes, the attending physician will not even give a medical discharge. One reason for this is that the patient is too unstable to be transported. Other times the reasoning might be suspect. Global Air Ambulance has trained medical professionals who can gather medical information on your behalf to give you peace of mind as to the condition of your patient and the possibility of transport. We then can work with the sending facility to put a plan in place which will allow for the transport of the patient as soon as possible and as safely as possible.

Because having a receiving facility is a critical step in the process, we are available if needed to help you find a new facility and receiving physician that will accept your patient. Under most circumstances, a call to the admissions department with patient and insurance information is all that is required. Often times an additional call between the sending physician and the accepting physician is arranged. We are available to help facilitate the doctor to doctor communications as well as any other transfer of information that is required to expedite your patient’s transfer.

If your questions have not been answered in this post, or if you want more clarity on your specific situation, please talk to one of our case managers at 1-800-948-1220. We would be happy to help you understand all your transport options.

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