https://paulnystrom.com/tags/transfer/Recent content in Transfer on Paul NystromHugoen-usWed, 25 Mar 2026 00:00:00 +0000https://paulnystrom.com/posts/the-admit-game/Wed, 25 Mar 2026 00:00:00 +0000https://paulnystrom.com/posts/the-admit-game/<p>At times in my career, my job has become less about actually practicing medicine—especially at a small rural hospital. Instead of seeing patients, I often feel like the quarterback of the transfer game. This is not unique to my hospital or health system. Across the country, providers are doing the same thing on literally every shift. Even at medium-sized hospitals that lack certain specialties, a great deal of patient transferring still occurs. This is simply how the game is played.</p>https://paulnystrom.com/posts/the-transfer-game/Wed, 25 Mar 2026 00:00:00 +0000https://paulnystrom.com/posts/the-transfer-game/<p>If my hospitalist isn’t comfortable keeping the patient or we have no beds or no nurses available to care for them, I start calling larger hospitals that are closest to mine. The main campus of the same health system as my hospital is about an hour away and has essentially all the specialties I could need. They can handle nearly any complicated medical or trauma patient. However, they’re across a state line, which sometimes creates additional challenges.</p>https://paulnystrom.com/posts/cah-admissions/Tue, 26 Aug 2025 00:00:00 +0000https://paulnystrom.com/posts/cah-admissions/<p>At times in my career, my job has been less about actually practicing medicine, especially at a small, rural hospital. Instead of seeing patients, I am the quarterback of the transfer game. This is not unique to my hospital or system. Across the country, providers are doing this same thing literally every shift. Even at medium-sized hospitals that still don’t have all the specialties, there is still a lot of transferring going on. This is how the game is played.</p>https://paulnystrom.com/posts/bowel-perforation/Fri, 15 Aug 2025 00:00:00 +0000https://paulnystrom.com/posts/bowel-perforation/<p>She was 85 years old with a bad heart and many chronic medical problems. Tonight, she had severe abdominal pain, and the CT scan showed a perforated bowel. Her future would include antibiotics and surgery. I was at a smaller hospital and spoke with my local surgeon. He was concerned that the patient was too sick to go to the operating room locally and she would need to be transferred to a bigger hospital. She would likely need ICU care afterward. Having abdominal surgery for a perforated bowel is a big deal, and with her baseline cardiopulmonary medical problems, it would likely be a rough road to recovery.</p>