A few years ago, Marcela Flachsland’s family learned her then 77-year-old uncle had advanced pancreatic cancer. Her early impression of the New Jersey acute care hospital where he was a patient was one of confusion and conflicting information from the medical staff. The family felt their uncle’s interests would be better served in a cancer-focused facility.

They sought a second opinion from the nearest branch of a renowned cancer center. A physician told Flachsland’s aunt they could treat her uncle with chemotherapy. However, doctors at the acute care hospital insisted a transfer would be too difficult for the weakened patient and that moving him was not a medical necessity.

“As a relative, you want to do everything possible,” Flachsland says. “You’re just trying to find other options. My aunt was devastated and frustrated, and she didn’t know what to do.”

You Can Choose Your Care Location

“The benefit of American health care is that patients are empowered to choose where to receive care – even in an acute event,” says Russell Graney, founder and CEO of Aidin, an online platform that helps connect providers, patients and payers to improve health care outcomes.

“Patients are often unaware that they can change hospitals – or are told by the staff that it isn’t possible,” adds Julia Hallisy, founder and president of the Empowered Patient Coalition.

Arthur Caplan, a professor of bioethics and founding head of the division of medical ethics at NYU School of Medicine in New York City, agrees. Patients absolutely have the right to transfer to another hospital, he says. However, the impetus for action – getting a second hospital to agree to take the patient – falls to determined families.

It’s a “medical urban myth” that leaving a hospital against medical advice will get a patient into trouble with insurers and billing, says Dr. David Alfandre, a physician and health care ethicist and associate professor in the department of medicine at NYU Grossman School of Medicine who has done extensive research on AMA (against medical advice) discharges. Physicians shouldn’t exaggerate AMA consequences to discourage patients from leaving, he adds.

“While practicalities like distance, insurance coverage and the hospital’s ability to provide the necessary care govern most decisions, if a patient or family feels their loved one isn’t receiving the care they need, it’s essential to speak up, advocate for yourself and if necessary, transition your care to another team,” Graney explains.

What to Consider When Thinking About a Transfer

When a patient has to remain in the hospital under protest, the family, friends or medical agent should ask for a social worker or patient relations professional to step in as an intermediary between all parties, Hallisy advises. “Usually,” she says, “by the time a family wants to change hospitals, there has been some type of issue involving a breakdown in communication.”

Transferring from one facility to another isn’t always easy. There’s no magic “transfer now” button you can push to set events in motion, and there’s no overarching authority or central agency you can turn to for support in making a transfer happen.

But that doesn’t mean there’s nothing you can do.

When considering a transfer, “the first and most important thing to nail down is where you’d like to transfer,” Graney says. “Your care team first will need to find an accepting physician at your new hospital to ensure you’re landing in a safe environment that’s ready to take on your needs.”

In determining this best location, think about quality and whether the hospital you’re considering transferring to can offer any better care than what you’re already receiving. “Quality of care should be every patient’s first priority, and only a patient and family can jointly assess if the current team’s approach is going to work,” Graney says.

Indicators of a hospital’s quality include: