Critical Work: Saving Lives in the Sky

Anthony Maggio doesn't remember the helicopter ride that he credits for saving his life.

"I was unconscious the whole time," said Maggio, a Weymouth resident who was put on the flight two years ago after an automobile accident. "I was bleeding from the back of my head, and from my knee. I was losing blood fast."

Maggio, 37, has nothing but praise for the Weymouth Fire Department and the Boston MedFlight helicopter crew, which rushed him to Boston Medical Center.

"Without them, I probably would not have survived," he said.

Maggio is one of the thousands of people who have been assisted by Boston MedFlight, the emergency medical air transportation system, which makes about 2,300 flights a year to assist critical care patients.

Like Maggio, most people only know of the system if they've been served by it or watched one of its twin-engine helicopters descend upon a bloody accident scene.

"I would say that most people have no clue that MedFlight's even here," said Dr. Suzanne Wedel, its chief executive officer.

MedFlight, a nonprofit public charity, is supported financially by six Boston area hospitals: Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women's Hospital, Children's Hospital, Massachusetts General Hospital and Tufts New England Medical Center.

In its 20 years of operation, the organization has transported about 28,000 patients, Wedel said.

The average charge for a MedFlight ride is $6,000, and most of that is paid by insurance, she said.

"If a patient has no insurance, we often work out a situation where you can pay, say, on a monthly basis," Wedel said. Ninety percent of MedFlight's $15 million operating budget comes from third-party reimbursement and patient revenues, Wedel said. The six hospitals cover the rest. The agency provides about $2 million worth of free and unreimbursed care annually since patients are not required to have health insurance to get MedFlight services.

"We lose money every year," Wedel said, adding that she expects an operating deficit of about $1.5 million this year.

"We are looking at alternative ways of bringing in revenue. We have hired a development person, and are in the process of trying to let people know we are a nonprofit organization, and that we take care of people regardless of their ability to pay."

Billing and other monetary matters, however, take a back seat when a flight crew is called into action.

Every crew that goes out consists of a pilot, a nurse and a paramedic.

"Their duties are very specific, so there is not a crossover distraction," said Rick Ruff, lead pilot.

Three MedFlight aircraft are based at Hanscom Air Force Base, including two twin-engine helicopters, each capable of carrying two patients, and a fixed-wing jet, which can carry one.

A second helicopter, similar to one of the ones at Hanscom, is based at Plymouth Municipal Airport.

MedFlight also uses two critical-care ground vehicles, one stationed in Boston and one in Plymouth.

The medical situation most people are aware of - a helicopter swooping into an accident scene - accounts for only about 20 percent of MedFlight's trips. The other 80 percent involve transporting critical-care patients from one medical facility to another.

Pilots make the call on whether a flight can proceed if weather is bad, but there are strict weather-related guidelines pilots must adhere to, Ruff said.

"You're going to have days where you can't fly for weather," Ruff said. "You adjust.

"We don't want a situation where they're told that, 'Hey, it's a little kid on the highway, you need to go out there,' and they go out in really nasty weather and kill themselves and their crew. That doesn't help anyone."

For survivors like Maggio, the help is a blessing.

Maggio was driving a car on Pleasant Street when a van, coming the other way, crossed over into his lane and slammed into him head-on.