EMTALA: ON-CALL PHYSICIANS

Course overview

The emergency medical system depends upon Emergency Department access, availability of specialists and subspecialists through the on-call roster, hospital bed and staff availability, and a referral system for tertiary or highly specialized care. These critical elements of the system are addressed in the Emergency Medical Treatment and Active Labor Act (EMTALA). It is essential that physicians who provide on-call services for hospitals understand their obligations related to EMTALA in order to keep patients safe and maintain compliance with EMTALA, thus avoiding EMTALA fines and litigation. Compliance with EMTALA takes a coordinated effort by the hospital governing body, hospital administration, the medical staff, nursing, and others; it is a web of interrelated responsibility. In this activity, we provide an overview of the requirements of EMTALA and the related CMS regulations, Interpretive Guidelines, and other relevant documents pertinent to the on-call physician. Most EMTALA issues and alleged violations are related to screening and stabilization and patient transfers to and from other facilities; therefore, we discuss each of these issues in this activity and examine relevant cases to clarify the on-call physician¿s obligations. After completing this activity, practitioners should be able to: apply knowledge of the on-call physician¿s obligations regarding medical screening examinations and stabilizing treatment under EMTALA to clinical practice in order to keep patients safe and maintain compliance with EMTALA; apply knowledge of the on-call physician¿s obligations regarding transferring patients to and accepting patient transfers from other hospitals under EMTALA to clinical practice in order to keep patients safe and maintain compliance with EMTALA; and identify legitimate reasons under EMTALA for refusing to accept patients in order to keep patients safe and maintain compliance with EMTALA.