Corporate Compliance

What are EMTALA's follow-up care requirements?

Compliance Monitor, September 30, 2005

Q: Under EMTALA, what are the requirements for on-call physicians to provide follow-up care?

A: There is no new guidance to address an on-call physician's follow-up responsibility. EMTALA does not include follow-up care responsibilities. In one court case, an orthopedist agreed to see an emergency patient for a follow up, but the care was subsequently denied at the orthopedist's office. The court determined that EMTALA does not require follow-up treatment. So there may be a civil malpractice responsibility, but there is no EMTALA responsibility.

This leaves physicians and hospitals in a bind with respect to follow-up care. In essence, if a patient has-for instance-a displaced fracture, we think it would be okay to splint the patient, as long as he or she sees an orthopedist in the next day or two. However, if the patient is not going to be able to get the follow-up care, or the on-call physician refuses to provide the follow up, the emergency physician may insist that the on-call physician come in to take care of the patient. This can become a heated situation. However, the fact remains that the on-call physician is not required under EMTALA to provide the follow-up care. The physician may have an ethical responsibility or the medical staff bylaws may address this issue. It's a good idea for your hospital to address this responsibility in its bylaws or rules for its staff.

Editor's note: This Q&A is an excerpt from the HCPro publication A Practical Guide to EMTALA Compliance. To order this book click here.

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