You are dispatched to a reported motorcycle down in a trouble area in your district. On arrival you find a single motorcycle has impacted the side of a big rig tractor which was turning in front of him. He is laying supine, helmet removed prior to your arrival and is alert and oriented.
The rider states he was travelling at 20-30 mph and pulled the brakes when he realized he was not going to make it around the truck. The skid marks leading up to the truck match that story and you begin your assessment.
Deformity to the left clavicle, self splinted and pain on palpation to the left flank are noted with no flail segment noticible on palpation or observation. No other trauma is noted and the helmet is pristine.
As you begin to cut the leather jacket, after convincing him it will not be a good idea to pull it off considering the injury, he pulls rank.
"Ease up kid, I'm a Doctor. Just do what I say and I'll be fine."
You pause a moment and consider his statement. After the first try to move his arm ends in screams, he reluctantly agrees to cut just only the area needed.
As C-spine precautions are applied he bats them away and adds another gem, "I'm not going to Regional Trauma, take me to Saint Farthest."
Saint Farthest is a local ER, most often staffed with a general practitioner doing their rotation. They have no surgical capabilities and the last time you took a patient there with a decent laceration there was an argument.
The patient identifies himself as a trauma doc and doesn't want to bother his co-workers.
He'll agree to the collar and board if you agree to take him to St Farthest.
What do you do?
You make the call.
Read through the comments, the click HERE to see what call I made.