A mix of burnt out and overworked workers combined with too much ego can make any employees wanting to leave their job for something better. In medicine, especially transplant, it is no different. A hospital learned it the hard way last summer in Oregon when all of his advanced heart failure cardiologists left within a few months apart. Oregon Health and Science University had to close its heart transplant program which unfortunately left some patients on the waitlist with a big uncertainty about their future. Specialized physicians are in very high demand everywhere in the country so they can easily move to another state with their family to continue their career. The burden of those closures is really placed on the patients and their family. A patient’s mind can go from hopefulness to hopelessness really quick after being told they are losing their medical home for their transplant surgery.
If a transplant program from a large city closes there are probably other options within the same city but this was the only heart transplant program in Oregon. The patients’ care and wait listing status can be transferred to another heart transplant center which means they would have to travel out of state to Seattle, WA in order to receive proper medical attention. It does not mean they will be accepted automatically for transplant at the University of Washington Medical Center. The receiving transplant program will do at a minimum a quick evaluation of each patient before adding them to their list. Fortunately, for the patients in limbo, the Seattle program seems to be busy and aggressive. According to the OPTN, they have performed around 200 heart transplant surgeries in the last 30 months. That makes their chance to be accepted pretty high.
However, if they do get accepted, they will most likely have to incur more out of pockets expenses because of the fact of going out of state. Insurance may be out of network and co-pays are higher. They may have to relocate there, especially if they were living south of Portland, Oregon. Most transplant centers will require from their patients to stay locally after the transplant for a duration of 3 months to a full year. They want the patients to be close by in case some complications arise. Before the transplant though, there is more leeway to stay home and be a few hours away but patients will still have to travel to go see the transplant team for their appointments.
Hospitals executives’ desire to have transplant programs is driven by the fact that it is a very lucrative business as it adds prestige to the hospital. Not all patients referred will get a transplant but a lot of them will get some testing and other procedures done. Programs that are mismanaged and need to close can lead to hospitals losing a gold mine and their reputation. The patients and their family are the ones really suffering from those unintended consequences.