THE DALLES, Ore. — A rural Oregon hospital is facing a problem that could lead to big repercussions: Adventist Health Columbia Gorge recently learned it will have to find a different way to transfer patients to bigger hospitals.

For more than 40 years, the local fire department, Mid-Columbia Fire & Rescue, transferred patients to hospitals in Portland, Bend and other larger hospitals. 

Trips could take five to eight hours. But on April 25, the hospital learned Mid-Columbia Fire & Rescue planned to stop providing the service.

"Having us transfer patients out of the area creates a strain on local service, local emergency services," Mid-Columbia Fire & Rescue Fire Chief Bob Palmer said.

The small fire department has a couple dozen firefighters. Some days, just a handful of EMTs are working, which makes it challenging when two EMTs are needed to drive a patient.

"When those people are gone, they're gone for five- to eight-hour stints, depending on where they're going, and they're not here and available to serve the community," assistant fire chief David Jensen said.

In a given year, hospital administrators said they transfer 400 patients. In 2023, 195 were transferred by the fire department. Life Flight also helicopters in patients who are in severe condition. However, Life Flight services are contingent on the weather.

Recently, service calls have risen for the fire department.

"Our call volume has increased from 3,000 over the course of the last year to about 4,000," Palmer said.

"Our concentration as emergency service are emergencies that are happening within our fire district," Jensen added.

The decision has led some experts to believe patient transfers could become more challenging for rural hospitals statewide.

"So, I think it's something hospitals and EMS services are going to have to continue to look at and figure out what that solution's going to be," Robert Duehmig, OHSU’s director of the Oregon Office of Rural Health, said.

In The Dalles, staff are still figuring out a solution.

"It's a big issue," Opbroek said.

However, Mid-Columbia Fire & Rescue will continue to provide patient transfers until a new service provider is found. Wasco County officials are working with the hospital to find that new provider, hospital administrators said.

Mid-Columbia Fire & Rescue will also continue to answer emergency service transfer calls when Life Flight is unavailable, Palmer said.