It always requires the transfer, or you ski it from the top and climb out. It was first skied by Kris Erickson and Hans Saari in memory of Alex Lowe, who cut his teeth in that range and completed many first descents. There are other more direct and straightforward lines in that range, but I'm guessing it's a classic because of its history and it's a pretty representative line for most of the technical skiing in the beartooths.
I always thought the book should have Whitetail Couloir instead of the Patriarch as it's widely recognized as one of the most classic lines in SW montana.
Attachment 397578