HEMS is healthcare and no exception.
I have preached for Years that HEMS Operator's Mission Statement should clearly state......"We are in business to provide safe, efficient, medical transportation.".
Nothing to do with "saving lives".....unless it is just a by-product of the use of advanced protocols and equipment as part of the service provided to the Patient.
If more HEMS Crews bought into that concept far fewer of them would avoid the pitfall of seeing themselves as denying there Grim Reaper his harvest and thus Heroes.
In this case....I pretty much agree with RadGirl about the value of helicopter patient transfer if appropriate protocols are used to determine the need for transfer by aircraft.
That being said....I have seen the ill or injured that were approaching death be loaded up and transferred to another medical facility purely to prevent harm to the Mortality Rate for the facility requesting the transfer.
I have also transported a lot of folks that had no medical necessity for transport involving the sophisticated equipment and special training enjoyed by our Medical Crews.
At one location we were the transport method of choice for Federal Prison Inmates for security reasons and not medical reasons.