Emergency Medical Treatment and Labor Act, Medical Screening Exams, and Challenging Patients: Legal and Ethical Considerations for Your Emergency Department (AAAEM and Quality and Patient Safety Interest Group Sponsored)
All of us who practice emergency medicine in the US are held accountable to Emergency Medical Treatment and Labor Act (EMTALA), and we take pride in caring for any patient for any reason at any time, no questions asked. The Emergency Department is both the front door and the safety net of the healthcare system, as established by EMTALA. But when it comes to the nuances of the law and what a “medical screening exam” entails, combined with the need to emphasize staff physical and psychological safety, there are more questions than answers: Who needs to complete the medical screening exam? What needs to be included? What consent is required in order to perform a medical screening exam, and can any requirements be included with this consent? What are the risks – legal, regulatory, and otherwise – of an inadvertent EMTALA violation? And, perhaps more importantly, what ethical considerations must we take into account? This didactic will outline the background of EMTALA, the law itself, and legal and regulatory implications of violations. Then we will discuss practical considerations for today’s overcrowded, understaffed EDs. Finally, we will use structured prompts to guide attendees through a brief discussion of the ethical considerations of how we approach challenging patients at triage, in the waiting room, and in other settings prior to their undergoing a full evaluation.
Presenters:
- Jonathan D. Sonis, MD, MHCM
- Kian Preston-Suni, MD, MPH
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Jonathan D. Sonis, MD, MHCM
Chair of Quality and Safety, MGH Emergency Medicine/ Assistant Professor of Emergency Medicine, Harvard Medical School
Massachusetts General Hospital/Harvard Medical School
Jonathan D. Sonis, MD, MHCM is Associate Chief Medical Officer and Vice President of Medical Affairs at Newton Wellesley Hospital/Mass General Brigham and an Assistant Professor of Emergency Medicine at Harvard Medical School. He is a member of the emergency medicine faculty at Massachusetts General Hospital. Dr. Sonis also serves as Associate Medical Director for Emergency Medicine at CRICO, Harvard's patient safety and medical malpractice company.
Dr. Sonis has extensive leadership experience related to quality improvement, patient safety, provider and staff communication, and patient experience, and lectures and publishes frequently on these topics. He received his MD with Alpha Omega Alpha honors from the Tufts University School of Medicine and trained at the Harvard-Affiliated Emergency Medicine Residency where he served as a Chief Resident. He has completed educational programs in leadership, quality service, and value-based health care, and earned his Master in Health Care Management at the Harvard School of Public Health. -
Kian Preston-Suni, MD, MPH
University of California, Los Angeles
Dr. Kian Preston-Suni MD, MPH is the Acting Chief of Emergency Medicine at the Greater Los Angeles VA Healthcare System and Assistant Professor of Clinical Emergency Medicine at David Geffen School of Medicine at UCLA. He leads a department commited to emergency care for veterans, with a committed EM trained faculty and programs including Geriatric Emergency Medicine and SUD treatment. He also oversees an effort to improve emergency care for patients experiencing homelessness.