ED On-Call Coverage: Issues and Solutions  

A major challenge facing many hospitals today involves ensuring adequate physician on-call coverage for ED patients. This has occurred for a variety of reasons, including:

• fewer emergency departments and trauma centers;
• increasing use of emergency departments for primary care;
• increasing costs of providing emergency and trauma services;
• varied, inconsistent or nonexistent reimbursement for on-call services; and
• disincentives for physicians to provide on-call coverage.

Unless hospitals adequately address on-call coverage, the hospital may face governmental scrutiny or possible legal liability.

Legal requirements: EMTALA

Hospitals in the U.S. must meet the coverage requirements of the Emergency Medical Treatment and Labor Act, also known as EMTALA. This law, enacted by Congress in 1986, imp...