r/Paramedics • u/Dowcastle-medic Paramedic • Jun 25 '25

US EMTALA and bypassing a hospital

So I had a pt today totally stable but she has an injury I know the local type 4 community hospital (20min) is not going to be able to fix. It was suggested by the clinic staff where I picked her up to go to the type 3, 1.5 hours away. But one of the ER drs for the community hospital happened to be there and looked at the injury and said no just take her to our hospital.

She said the type 3 couldn’t deal with that either and she would need to go to One 3.5 hours away so go and get her c spine cleared…

So we did and then I get chewed out by the ER drs on call saying I can NEVER bypass them based on EMTALA. I always have to stop and let them stabilize the pt and cat scan and such…

That’s not true is it?

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u/No_Helicopter_9826 Jun 25 '25

EMTALA has absolutely nothing to do with your decision-making process when choosing a destination for your patient. It's not at all relevant. EMTALA also does not in any way make a hospital responsible for patients who DON'T present to that hospital for treatment. If you don't go there, that patient simply doesn't exist to them. Whoever told you this is not just wrong, but wrong in a confusingly bizarre way.

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u/finis08 Jun 25 '25

By “bizarre way” you mean not giving a shit about pt care and only caring about the missed financial opportunity because their hospital was bypassed. Generally speaking, every time I hear a hospital complain about a potential EMTALA violation it is because they just wanted the ability to bill the patient or they think I have zero understanding of EMTALA. They are wrong on both accounts. Regardless, I will be taking my patients to the most appropriate place given the situation at hand.