For us, the reasons we don't transport patients to the hospital in normal circumstances, is threefold:
1. Our primary mission is as an LE helicopter, not a medical transport. So with our secondary mission of rescue/medical, we'll do a rescue with hoist or short haul to recover a patient and do initial care, but we don't normally transport. That is because with a patient onboard, we are dedicated to the patient care and out of service for any LE calls until we drop off the patient.
2. We're not a medevac helo, so we're not equipped for full ALS work onboard. If we have a patient code while enroute to the hospital, we don't have drug intervention onboard. Hence why we only transport critical patients in exigent circumstances.
3. Being that its not our job to transport patients, we don't in fact compete with civil air ambulances. The only government helo in the normal medical helo dispatch rotation for transport in AZ is the DPS Ranger helo, namely because they were first in the state in the early 70s. If, for example, we come across a vehicle accident in a remote area, we'll land and assist and if units on scene request us to transport and no one else is available, then we will.