Finally, civil enforcement under EMTALA via lawsuits has expanded the liability of hospitals, since the hospital is directly liable for any patient harm caused by violations of the law by the hospital’s staff or by the responsible physicians—the emergency physician and/or on-call physician. Furthermore, plaintiff’s attorneys have learned how to use EMTALA to circumvent state tort reform protections and even the damages caps in some states.

The Future

Now, we look to the future of EMTALA and the influence it has on our practice.
Yes, EMTALA contributed to crowding, boarding, lack of specialty coverage, increased transfers, and governmental insertion into the practice of medicine, and it poses a giant unfunded mandate on emergency providers.

However, it unquestionably saves lives. It affirms the unique and venerable role of the specialty of emergency medicine as the safety net of the U.S. health care system. ACEP should be proud of its 50 years advocating for patient access to emergency care, and EMTALA has profoundly facilitated that mission.

Dr. Bitterman is president of Bitterman Health Law Consulting Group, Inc. in Harbor Springs, Michigan. He defends hospitals and physicians accused of EMTALA violations in court.