Our case manager arranges follow-up care for uninsured patients who have ongoing orthopedic problems. The case manager has to battle with the specialist’s office staff to get a specialist to provide follow-up care. If these physicians were on call at the time of the ED contact, aren’t they obligated to set that fracture, repair that tendon, etc.? Is that obligation only in place if the ED physician speaks with the specialist on call?

There is no EMTALA requirement for on-call
physicians to provide follow-up care; however, on-call
physicians are required to come in based on the
emergency physician’s request.
That’s why emergency physicians sometimes have
no choice but to call in the on-call specialist if they
need a stabilizing service and the physician is
unwilling to provide this service in the office.
Address this “gap” in EMTALA with well-drafted
institutional policies concerning a physician’s on-call
responsibility, including the responsibility to provide
limited follow-up care until the emergency medical
condition is resolved.