EMS Ambulance 19 May 2022
Why would a hospital block our repatriation?
One of the first laws of medical repatriations is that every journey is completely unique. If you ever read some of our longer reviews on Google Reviews, you’ll see what we mean!
The main reason is that there are so many variables involved:
- your patient’s specific medical needs
- the urgency of their condition
- the mode of transport you want to use
- the challenges of the route back home
In a perfect world, securing your patient’s release from hospital would be the one part of the process that’s totally straightforward. Unfortunately, that isn’t always the case.
Every year we speak to families who desperately want to bring a patient home for treatment, only to discover that the local hospital won’t allow them to be repatriated.
Understandably, that’s extremely stressful. So why does it happen? And what can you do about it?
Why doctors sometimes refuse
In our experience, there are two main reasons why doctors tend to block repatriations.
1: They think it’s unsafe to move the patient
“Do no harm” is the lynchpin of the Hippocratic Oath. Any good doctor, anywhere in the world, puts their patient’s safety before all else – and sometimes that means refusing to let a patient leave hospital if they believe it would endanger their health. The patient may have suffered an accident very recently, they may have just undergone major surgery, they may be in ICU. In circumstances like these, there may be sound medical reasons for keeping a patient where they are. Sometimes doctors believe it’s simply too risky for them to be transported elsewhere.
2: They’d rather keep the patient where they are
The second reason foreign doctors sometimes refuse to release patients is because it’s not completely in their interest to let them go. Sometimes that’s because they’re simply too overstretched to listen. Families often tell us it feels impossible to contact the doctors treating their relative, or to get answers about their condition. Unfortunately, there may be a financial motive too; to put it bluntly, the hospital is likely to receive more money for keeping a foreign patient in intensive care for treatment. While this may not happen in healthcare systems in countries like Germany, the Netherlands or the UK, it does sometimes happen in other parts of the world.
Why they sometimes get it wrong
The truth is that – in nearly every case – it’s perfectly feasible and proper to repatriate a patient so they can receive medical care in their home country. Of course there are legitimate exceptions. But in most cases, the risks are no greater than leaving them in the local hospital. Here’s why.
Doctors don’t always realise the level of care that’s available on a high-quality repatriation
This is very often the root of the refusal: for genuine reasons, the local medical team just aren’t aware that in-transit treatment with a proper repatriation company is equivalent to hospital standards.
Take the ambulances we use for long-distance road repatriations, for instance. Though they may look like regular hospital vehicles from the outside, they’re actually far more advanced inside. The inventory includes things like pressure-reducing mattresses by Decupré, advanced resuscitation and life-support equipment, and oxygen support. (You can find out more about our vehicles in this article: Behind-the-scenes on a road ambulance: what’s on board?). So sometimes it’s just a case of contacting the local doctors and reassuring them about the – even sending them a picture of our vehicle interiors:
Then there are the medical personnel who can travel with the patient. A high-quality repatriation company can supply doctors or paramedics with specialist knowledge of the patient’s medical issues and treatment needs. EMS has a cardiac specialist within the core team, for instance, and our chief flight nurse is an expert in international repatriations for sick children. We also provide 24-7 backup in the form of a Doctor-on-Call – someone who can speak to the foreign hospital staff, and also provide advanced treatment advice to our ambulance team during the journey if it’s ever needed.
Finally, repatriations can – and often do – take place during an unfolding medical emergency. With an intensive-care air ambulance, for example, it’s possible to repatriate very ill patients from war zones and recreate an intensive-care unit on board the specially-equipped jet.
It’s often better for a patient to travel home than stay abroad
Ultimately, the best way to safeguard a patient’s health is to get them into the care of the very best doctors and treatment programmes possible. With all the will in the world, that isn’t always viable in their current clinic or hospital. In some circumstances, it’s not even possible in the country or region where they’re staying. Our view is that, in most situations, patients are best served when they’re near to loved ones, in a high-quality hospital, with doctors who can care for their long-term needs. If that’s how you feel too, please get in touch for advice – we’d be delighted to see if we can help.