An advisory opinion by the Department of Health and Human Services Office of Inspector General says yes.
In the May 21 opinion, OIG acknowledged that hospitals increasingly are compensating physicians for emergency coverage. "We are mindful that legitimate reasons exist for such arrangements in many circumstances," including a scarcity of available doctors in particular areas and compliance with the federal Emergency Medical Treatment and Active Labor Act.
Many hospitals already pay hospitalists subsidies for their inpatient duties, one of which is to take care of unassigned uninsured patients. Perhaps the AMA believes hospitalists have an ethical obligation to provide charity care to these patients.
I have a different suggestion. If it's OK for hospitals to pay physicians to be on call in order to maintain compliance with EMTALA rules, shouldn't it be the US government and not the hospitals who are fitting the bill for the uninsured being treated under EMTALA rules? Any lawyers out there want to take on the federal government? It could perhaps save your life one day when you need a doctor to care for you, but everyone is at home sleeping.
11 Outbursts:
Do YOU work for free?????
Didn't think so...
Frank
And also, the bigger the hospital the more likely that sub-specialists will be called in for things that ER docs do at smaller hospitals (or that there will be residents in that sub-specialty immediately available).
For example my wife (a plastic surgeon) often gets called in for ridiculously simple, small lacerations whereas if you showed up to a smaller hospital with such you would expect the cut to be sewn up by the ER Doc. She doesn't complain too much though, she's had a few of these tiny laceration patients come back for breast augmentations and the like later :-)
My name is frank drakman and i've never done anything questionable in my life. I am the best and most elite but my blog is pure shit. Happy, how do you tolerate these troll scumbags on here
I've never seen an ENT called in for an emergent airway or anything similar. Nope. Never.
Um. Me neither?
If anesthesia can't get an airway and you can't get an airway because the patient's face is blown off or something, you cric em. If your ER doc can't do that, well, either they suckass and need to take ATLS again or the patient is going to Jesus (or both, I guess).
Happy needs to just delete this post and save himself more embarrassment due to not knowing the basics of this law. Whether hospitals should pay docs to be on call is an interesting question but a FAIL on the blog post since EMTALA/Federal govt has nothing to do with that question.
And you'd also guaranteed that Ambu-bags were in each room of Happy's hospital when they weren't.
I HAVE seen ENT called in emergently because a cric isn't always appropriate. But of course you know everything because you TRIAGE patients.
I wish he'd simply delete your replies rather than his posts since you're nothing but a blog troll.
Well ENT can be called in for whatever (even though ER docs should be able to handle an airway; that's their job), but EMTALA doesn't require that ENTs be on call only that the emergency doc and facility stabilize to the extent that their facility is able. If this were so, no rural hospitals could have ERs.
It would be illegal if the patient needed an ENT for an emergency condition (whatever that might be), there was one on call, and you dumped the patient on the county facility anyway.
I can't help that Happy says things that are just plain wrong a lot of the time. We're (nurses) required by the FEDERAL GOVERNMENT and JCAHO to demonstrate competence in applying this law. We need continuing education, tests, and our EMTALA forms are audited all the damn time. So, yes, a triage nurse (I'm not just a triage nurse btw, just maybe once a week since we rotate jobs) is usually far more knowledgeable w/regards to EMTALA than a hospitalist who works in a receiving "level I" (may want to check on your hospital's trauma designation BTW, Happy) hospital.
Frank could be a pizza man, as he says.
or her could be in an inpatient rehab center with tons of time on his hands to obsess over HH.
Or he can live in his parent's basement.
But wait,gas man never have problems with substance abuse-it's only the poor souls who got stuck doing IM, FP, or Psych.
There doesn't need to be any specialialist-type physician on-call for any EMTALA rules. EMTALA says you can transfer your patient to a facility that has the necessary services if your facility does not. Happens all the time in rural areas.
This is more a decision on the part of hospitals to keep from losing money by being forced to transfer the patient, not anything having to do with EMTALA other than the necessity to not let your patient die while waiting hours and hours or days and days for a specialist to get around to coming in when an emergency exists.
You guys talking about EMTALA not causing hospitals to pay for call seem to be all from the transferring hospital side. From the tertiary referral center side what has been happening is 1) EMTALA gets passed. 2) the smaller hospitals figure out through the much vaunted training as noted above that all they have to say to the bigger hospital is "we don't feel comfortable with this patient and the larger hospital then MUST take the patient 3) the subscpecialists at the bigger hospital find that they are now essentially on call for every no-pay patient from every 24-200 bed hospital within 250 miles 4) the sub-specialists then bitch loudly to the hospital and threaten to drop privileges and take their lucrative procedures to another, smaller hospital where this won't be a problem and finally 5) the hospital applies some green ointment to the buboes which shuts them up (for a while).
Now obviously EMTALA doesn't "mandate" this call pay but if it makes the hospital economically non-viable without it then the distinction is moot.
Please don't feed the troll.
Because specialists are never needed for patient stabilization.
I've never seen an ENT called in for an emergent airway or anything similar. Nope. Never.
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