At the small hospital in Andrews, Texas, in the heart of America’s oil patch, doctors had a critical patient this month who needed an urgent non-Covid-19 procedure that the smaller facility couldn’t perform. Hospitals nearby had the right equipment and specialists but were overrun.
Physician Alyssa Tochterman of the 34-bed Permian Regional Medical Center made a pleading call to the chief executive of the closest large hospital. “Can you find someone to do this procedure?” she asked.
Dr. Tochterman then made an offer she wouldn’t have considered before the pandemic: “We’ll take him back,” she said. The patient wouldn’t stay after the procedure, as is normally the case, and would return to Permian Regional to recuperate.
“That’s not how things are done,” said Dr. Tochterman. She is one of four doctors at the rural hospital, which has no intensive-care unit. “Never in the history of ever” have small hospitals transferred patients to bigger facilities for procedures and immediately brought them back, she said. She was desperate, Dr. Tochterman said. It worked—the patient got the procedure.
The trade-off is one of many that doctors and nurses at the nation’s smallest hospitals are now making to help patients, as the pandemic’s largest, most widespread U.S. surge pushes rural health care to its limits. Hospitalizations nationally have nearly doubled in November, setting a record Nov. 10, and every day since, to reach about 90,480 people in hospitals with Covid-19 on Thursday, Covid Tracking Project data show.