Emergency doctor group slams U of Chicago's ED diversion plan

Dear Anne - First of all, thanks for the work that Fierce Healthcare does. It's a great resource. However, I must take exception to the first line of the article above.. "Usually, when emergency physicians discuss EMTALA, they're fretting over the cost imposed by uninsured patients who may not have needed their help in the first place.." I practiced Emergency Medicine for 27 years (retired a year ago, though my disappearing 401k may send me back) and EMTALA has, in my experience, never been perceived as a burden by ER doctors. While it may at times be over interpreted, its central mission, to prevent dumping of uninsured patients, is totally consistent with the mission of ER medicine and practice, and has been a great boon to patient care. I remember all too well the days in the early 80s of being forced to defend, to the hospital administrator, any admission from the ER which was uninsured under the threat of losing my contract. These stressors and ethical dilemmas (should I be transfer this indigent patient to avoid a browbeating?) were essentially eliminated by EMTALA and no ER doc would want to go back to those days - we were the ones stuck in the middle. It is the hospital administration (as evidenced by the U of Chicago incident), squeezed by budgetary constraints and not having direct patient care responsibility, which is the primary driving force behind means testing prior to care. ER docs, who serve as de facto universal care providers for those who are otherwise without healthcare access (as GW Bush famously declared), serve as patient advocates both to administration and to attendings who are loath to care for ER patients - we're the only ones there 24/7/365 and we are a pretty sensitive barometer re the health of our system.

Thanks again