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New EMTALA Regulation Could Increase Shortage of On-Call Specialists in Emergency Departments
Posted on: 09/03/
WASHINGTON, D.C. -- The American College of Emergency Physicians (ACEP) today said the new EMTALA (Emergency Medical Treatment and Labor Act) regulation from the Centers for Medicare & Medicaid Services (CMS) creates uncertainty that could potentially increase the shortage of on-call medical specialists available to provide backup support to emergency departments and multiply the number of patients transferred to hospitals able to provide this coverage.
George Molzen, MD, president of ACEP, made the following statement about the rule:
"In the new rule, CMS maintains basic patient protections in emergency situations and brings clarity about which areas in a hospital are obligated under EMTALA to provide emergency care. It also clarifies that under EMTALA hospital-owned ambulances can transport patients to other hospitals, which will increase needed flexibility in EMS systems. However, the provisions regarding the obligations of on-call physicians to provide emergency care create a potential crack in the system that could affect patient care.
"Under the new rule, hospitals may not have to provide on-call medical specialists, such as neurosurgeons, orthopedists, and plastic surgeons around the clock for emergency patients. Hospitals also can allow specialists to opt out of being on-call to the emergency department. This means that patients in need of specialty care may need
to be transferred to other hospitals. But the question is where? We already have a shortage of on-call specialists because of the medical liability crisis. This rule could exacerbate an already difficult situation.
"Without a hospital or on-call physician obligation to provide emergency specialist backup, some hospitals may choose not to provide emergency coverage at all. Therefore, the new rule could potentially leave only a few hospitals left with medical specialists, which means those hospitals may be flooded with emergency patients. It could result in conflicts between hospitals over who will provide specialty care and result in delayed care or more transfers of patients, exacerbating the ambulance diversion problem in the United States.
ACEP is the national medical specialty society representing emergency
medicine. With nearly 23,000 members, ACEP is committed to improving the
quality of emergency care through continuing education, research, and public
education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing
each state, as well as Puerto Rico and the District of Columbia.
Source: ACEP
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