At LifeFlight of Maine's Bangor hangar, pilot Will Bradbury ran through emergency landing tips with flight nurse Denise Saucier and paramedic Brian Merklin before a medical transport flight, NPR reported. "If we need to get out quickly because of smoke or fire, just watch the terrain so that you're not walking uphill into the rotors," he told them. Saucier, who has flown for the service for seven years, still calls it a dream job. The work is getting harder as rural hospitals thin out.
Demand for medical flights in Maine has doubled since 2015. In 2025, LifeFlight crews flew 3,031 flights, more than one every three hours. Demand is up another 10 percent this year, NPR said. Scene calls to accidents are less than 10 percent of LifeFlight's transports; most are interfacility flights from a small hospital to a larger one. Crews also fly to Maine's islands every week or two, and sometimes land in forests and mountains and finish the trip by snowmobile.
Nationwide, air medical services are filling gaps as rural hospitals close, convert to outpatient-only emergency hospitals, or drop services such as labor and delivery. Medicaid cuts estimated by the Congressional Budget Office at $911 billion over ten years are expected to worsen that map, NPR reported. Last year, a woman in a small northern Maine town died after a county dispatch center called 10 ambulance services and none responded. Nicholas George, who runs the ETHOS Database, a national tracking system for air medical programs, said the need is increasing year over year. "When the rural health care system breaks, EMS — on the ground and, increasingly, in the air — is the backstop."
For years, LifeFlight retained only 60 to 70 percent of its workers, CEO Joe Kellner told NPR. Almost a quarter of ground-based EMS workers leave the field every year. This year, for the first time in nine years, LifeFlight is nearly fully staffed. It is one of a handful of independent nonprofit air medical companies. Since Kellner, a paramedic, became CEO in 2023, the service has added a six- to eight-month Critical Care Academy, raised paramedic pay to match flight nurses, and hired a full-time mental-health counselor. Mike Abernethy, a retired University of Wisconsin emergency-medicine professor, called it one of a handful of model programs, in contrast to for-profit operators known for high bills. The 3,031 flights, the doubled demand, and the staffing experiments are Maine's record. They are not a national average, but they show what happens when the nearest hospital gets farther away.