Not sure I understand this comment. Unfortunately each of these cases often occupies an ICU bed for weeks. As a result we transfer dozens of other patients hun

Not sure I understand this comment. Unfortunately each of these cases often occupies an ICU bed for weeks. As a result we transfer dozens of other patients hundreds of miles away, and often after >24 hours boarding in the emergency department, because every other ICU bed is full as well (in addition to mandatory down time for the flight crews, which are also working overtime). With help from my ~5 person ED staff, I've called as many as 50 hospitals in a night (spanning 6 of the largest states) trying to find an open ICU bed. Some relevant conversation on a thread I started in r/medicine: <https://www.reddit.com/r/medicine/comments/r6bl1u/not_accepting_transfers_from_out_of_state/ https://www.reddit.com/r/medicine/comments/r6bl1u/not_accept...>