iPMI Magazine Speaks with Dr. Joachim Friese, Medical Director, MedCare Professionals

MedCare Professional offers national and international patient transport. We operate reliably and economically with leading insurance companies, hospitals and groups together, our team has won several awards for its outstanding quality. MedCareProfessional is as the name of the program: Only highly qualified medical staff takes care of the patient, our equipment is many-to-date national and international certifications out for us self-evident proof of our own standard of quality - as a guarantee for our customers and their own motivation. The operations center is the heart and the hub of the company:

This is where all the information here makes the team together between uses. In the center offers will be created to advise people in emergencies, international missions planned, conducted exploratory conversations, solutions found and coordinated operations. From the first contact ask our staff all the necessary information to determine together with the respective client that's right for the patient Transportmodalität. 24 hours a day medical staff are on hand to take on missions to counsel patients and to make medical inquiries as members. Our ambulances, mobile intensive care and ambulance and commercial aircraft, we help injured and sick people with professional help all over the world. We work on all transport routes and in Auslandsrückholdienst, anytime, anywhere.

Please introduce yourself and back ground with in the air and ground ambulance industry?

My name is Dr. Joachim Friese. I am a medical doctor and was born in Germany in 1964. I am the Medical Director for MedCare Professionals. After finishing Medical School in Frankfurt I worked as a trauma surgeon and intensivist in University and teaching hospitals at Hattingen, Bochum and Koblenz. Whilst attending Medical School I discovered my passion for Emergency Medicine and Intensive Care. After years of doing ER in the streets, I was finally airborne in 1995 and gained extensive experience in Medical Missions on fixed wing and rotor wing aircrafts, in repatriations and evacuations.

Who is MedCare Professional and what do you do?

MedCareProfessional is an internationally operated air and ground ambulance provider situated in Hattingen, Germany. Situated close to all major central European airports, MedCareProfessional provides air and ambulance ground services and transportation. This includes Worldwide Repatriation by Air Ambulance; EU Wide Ground Based Ambulance Services; Medevac; Patient Transport Compartment/Medical Escort on Commercial Airlines; ECMO / IABP Transports; Pediatric Transport and Medical travel health advice MedCareProfessional proudly operates a team of highly trained medical staff and experienced flight crews, thus being able to guarantee superior quality and patient care: both domestically and internationally. We run our own 24-hour flight coordination center 365 days a year, with our specialist flight coordinators assisting national and international clients, to ensure a smooth, safe and efficient patient transfer. MedCareProfessional has received full accreditation by EURAMI (European Aeromedical Institute e.V.)

What is most important in the ground and air ambulance industry in 2012?

2012 will be the year in which financial forces and economical cut-backs will influence the international market for Air Ambulance Owners and Operators, plus all types of Medical Service Providers. New channels need to be opened to ensure competitive capacity. The growing exchange of information amongst providers, eg. concerning standards and regulations especially in the air ambulance market, gives hope that good quality and a high standard of service will finally come out on top, despite the current situation.

MedCare Professional is accredited by EURAMI. How do air ambulance accreditation programs like EURAMI and CAMTS benefit the worldwide air ambulance industry?

The quality standards of air ambulance providers differ amongst different countries.To establish an international standard is a very specific challenge. The above named associations aim to guarantee a high level of medical care and aeronautic safety by scrutinizing closely each applicant's quality management system and process.In my opinion, the accreditation of an air ambulance provider is a guarantee of quality for clients in the insurance market.Within the next years EURAMI and CAMTS will be established all over the world and will separate "the wheat from the chaff“.

What are the benefits of your air ambulance fleet and aircraft flight range?

We can currently fall back on a fleet of several Lear 35 and 55 jets, all dedicated air ambulances as well as several Turbo Props. Their popularity lies in their cost-effectiveness and their reliability. To cover longer distances without the need for refuelling we are looking forward to the oncoming arrival of a Challenger 601 air ambulance in a three-stretcher configuration. Most of the popular holiday regions in Europe and North Africa can be reached in one go, but even repatriations from the other side of the world pose no significant problems.

MedCare Professional operates a fleet of ground ambulances across Europe. Can you explain the unique points of the service, key clients and Geographical focus?

Firstly, we operate several ICU ambulance units, each with a physician/ICU nurse crew. Those are in demand from the nearby cities or county councils, to maintain their interhospital transfer of severely ill patients, mostly ventilated, requiring ECMO, etc. But also insurance companies and private clients make use of this service. The ICU units are also delivering and picking up patients from all over the EU.

The MedCare Professional website has a dedicated Air Ambulance empty leg section. Is this an area of the business that has grown as payors seek new ways to contain costs?

As insurance and assistance companies seek to reduce the bottom line, whilst maintaining the quaility of care the patient recieves, we have witnessed a growing demand and utilization of empty leg flights. The Air Ambulance Empty Leg Section on our website offers the possibility to make use of any air ambulance capacity available. Over the years there has been avialble capacity during some horrific natural disasters. MedCare Professional welcomes new worldwide partnerships with reputable air ambulance owners, operators and service providers, to insure capacity is utilized where possible.

MedCare Professional solves many cases and saves many lives’ at home and abroad. What was the most memorable case of 2011?

One of the more disturbing cases this year was transporting two severely burned young women from Volgograd to Aachen University Hospital in Germany. They were victims of a gas explosion in a night club on Valentine's day, both suffering burns of more than 50% of their body surface as well as severe inhalation injury. Volgograd sported minus 25° Celsius that day, snowfall and strong easterly winds. We had a fleet of ambulance cars at the airport, as there were 20 victims in all. We arrived with a Lear 55, double-stretcher ICU. One patient was already intubated and mechanically ventilated, the other was conscious and breathing spontaneously. Both had burned their face, all extremities and the chest. On the plane both patients received triple CVCs, arterial cannulas and general anaesthesia with Propofol/Sulfentanyl.

Prior to this, patient 2 showed respiratory insufficiency and was intubated via fibre endoscopy, as their airways were severely obstructed due to the inhalative injury. During more than 3000 KM‘s of flight, both patients needed high amounts of I.V fluids, but were picked up by ambulance cars in Cologne Airport in a cardially and respiratorily stable state. Later enquiries at the respective burns units told us that both survived and faced multiple surgical interventions for skin grafting.

MedCare Professional provides pediatric transport. The safe transportation of children poses many challenges; what are they?

Evacuating neonates or stabilized children by air presents a lot of challenges because pediatric patients are far more vulnerable to the stress of flight. The team is ideally made up from flight experienced pediatricians trained in NeonateICUs and pediatric nurses. Apart from our incubators, our additional equipment on board of the planes is designed to meet the needs of children, everything exists in a „child-size“ version. Accompanying parents are cared for, especially those who suffer more on the flight than their child. And last but not least, a good air transport should not be ruined by inadequate reception on the ground, therefore we usually cooperate with university hospitals who have their own NICU, perinatal care units, neonatal outreach programs and boast cadres of medical and surgical pediatric subspecialists. We either provide pediatric ICU or ambulance ground transports ourselves or are received by the hospital’s crew.

How do you see the ground and air ambulance services industry developing in the next 5 years, and how will MedCare Professional position itself to maximize those opportunities?

The last few years have seen a surge in the number of small air ambulance providers on the market. A considerable part offers medical flights without any profound expertise but at a low cost, thus being a potential threat to soundly working established air ambulance providers. Those are under pressure not only by the rigid policy of cuts in local governments and the insurance industry, but also by the constantly increasing fuel prices. Providers are forced to act economically sound and to adapt innovative concepts. For example, the „fleet operating tactics“ have to be checked for effectiveness, double-stretcher ambulance flights, „floating base concepts“ and cooperations with other providers will be the rule rather than the exception. Nonregarding these restrictions, I am convinced that reasonable pricing and sustained quality ensure a sound positioning on the market.