What happens when a patient is at a smallish regional hospital and needs a specialist surgeon?

Intuition says you bring the surgeon to it if it has all the equipment needed as its easier to move the surgeon than the patient in this case.

Unless one is a significant VIP (either as the fragile patient OR the patient’s advocate) the patient must be transported to the surgeon and her facilities. Helicopters and ambulance services do that all the time. The medical insurer for the patient may have some say in this whole process, also.

A decent small hospital will have specialists who hold clinics or do surgeries once a month or more. If it’s an emergency, then they’d transport by air or ambulance.

Here’s one I used to market: http://www.phs.org/phs/hospitals/hospitals/ruidoso/index.htm

Transfer. That is why most regions have tertiary care hospitals (often with a helicopter pad). Even patients on ECMO can be transported, albeit at great risk. Indeed., every major hospital has its own “catchment area”, from which it draws complicated cases such as this. So, for example, Cleveland Clinic might serve most of Ohio, and other neighboring states.

Typically, if the local medical centers do not have a particular specialist on staff, they won’t have invested in the equipment that would be needed (medical supplies are exhorbitant!)... Therefore, the patients are stabilized as well as possible, then transported via Ambulance or Helicopter when necessary.

A surgeon needs privilages and to be credentialed to work at a hospial so I am thinking you would have to transfer the patient. From what I undersatnd some states have laws to go around this in emergencies like natural disasters.

It can go either way, but typically, even if the patient is fragile, the patient would be transferred to where the specialist surgeon and all of the support staff and equipment are located.

If there is no rush for the surgery, then they might wait for the patient to become less fragile and then either transfer the patient or wait for the specialist’s routine visit to the facility. In an emergency, they would stabilize and transfer the patient ASAP.

About a year ago I was having massive abdominal pain and went to the ER at the small local hospital where I lived. They did the MRI and it showed a massive benign tumor in the top portion of my liver and the bottom lobe of my liver had torn away. the pain was from the hemorraging and the tumor had pushed my stomach and esophagus so far that they were threatening to rip away. I needed a liver surgeon and there were only two in this state both in raleigh. A transfer was quickly arranged for me to UNC Chapel Hill because the hospital I was at didn’t have a specialist that would touch me because of how bad I was. They were so afraid that they had to convert a room in the ER into a bed while we waited for a surgical ICU bed in chapel hill. I ended up decompensating and was rushed to Chapel Hill a few hours later. So they usually transfer patients to where the specialists are. sometimes specialists will goto smaller hospitals if they are credentialed there. My rural hospital had connections with wake med in raleigh and some of the specialists see patients there a few days a month. depends on the severity of what you need also.

From experience, they transfer you via medflight/ambulance to a larger hospital with the necessary surgeon/s and the equipment those skilled specialists require.