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For those interested in the origins of modern hospital-based medical 
helicopters, I offer the following - and forget about the Viet Nam military 
experience, which is often cited by today's historical revisionists or 
deconstructionists. Hospital managers of the early 1980's couldn't have cared less.

The epicenter of modern hospital-based air medical services lies in an 
article published in the Harvard Business Review in 1980 entitled, "The Health Care 
Market: Can Hospitals Survive?" The article was written by Jeff C. Goldsmith, 
who at the time was the Director of Health Planning at the University of 
Chicago Medical Center. The piece addresses the economic survival of American 
hospitals, vis-a-vis impending regulatory and health policy changes. 

It was the first to coin the term "captive systems of distribution," which 
describes various methods that hospitals could use to escape their markets' 
geographical constraints, and pluck patients from other markets including their 
competitors'. Among many, Goldsmith named freestanding clinics, taxi cabs, 
ambulance services, outlying hospitals and aircraft to accomplish this patient 
feeder mission.

Thereafter, hospital managers embraced this article as the "bible" for the 
future. That is where the whole medical helicopter issue really took off (so to 
speak), not because of Viet Nam successes, but rather as a vehicle for 
economic survival going forward. Seemingly, everyone was getting into the helicopter 
business. And, in the early '80's, the American Society for Hospital-Based 
Emergency Air Medical Services (ASHBEAMS) was founded in order to promote 
standardization and address safety concerns. It all metastasized from there - not out 
of some selfless or noble generosity on the part of hospital managers to 
better serve the public, but rather as a strategy to optimize in-house census and 
net revenues. Follow the money.

The Health Care Market: Can Hospitals Survive?
Jeff C, Goldsmith, Harvard Business Review
(Sept-Oct); (p..100-112), 1980

Bob Kellow






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