The EMTALA law renders many common practices by physicians and hospitals in violation. Even practices that seem prudent use of time and resources may result in substantial violations and fines. Following are key examples:
1) When asked to come in to see an ED patient, responding with instructions to admit or to run various tests. This does not delay the clock when it comes to prompt response within a “reasonable” time, specified by UHSH policy to be 30 minutes of being contacted or 20 minutes in an emergency.
2) When asked to come in to see an ED patient, debating with the ED physician over the necessity of coming in. Once the request is made, the duty attaches. Decision power goes to the physician with eyes on the patient, and response is not negotiable.
3) When asked to come in to see an ED patient, refusing and suggesting that the patient be seen by another specialty. Same as #2. Response isn’t negotiable.
4) When asked to come to see an ED patient, refusing and ordering the patient transferred due to severity or scope of condition. The requested physician must respond and phone evaluation is not sufficient. Once the on call physician arrives, a transfer may be appropriate which he would then effect the transfer. If the ED physician only wants a phone consult, this should be clearly documented. CMS highlights phone transfers as special attention areas.
5) Refusing to be listed individually on the call list and insisting that only the group name be listed. CMS requires that specific names and direct contact information be available. (Source: Medlaw.com)