Dipping the Drivers License into EMTALA’s Can of Worms

Sean Scorvo, MD

Sean ScorvoPlease allow me the driest lead-in sentence imaginable for an article: EMTALA (the Emergency Medical Treatment and Active Labor Act) is part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986.  I apologize for that…I suppose I should explain the reasoning for my milquetoast moment.

The law’s goal was to prevent the day’s common “wallet biopsy” practice wherein one of the first questions asked upon a person’s Emergency Department arrival, or an ambulance’s report  was “do you” or “does the patient” have insurance?.  If the person didn’t have insurance, or if they just couldn’t prove it, the person was frequently advised to go to another hospital.  While this saved the hospital money, the delay in treatment sometimes cost people their lives or exacerbated the condition they were seeking care for.  Thus, the short story is, EMTALA saves lives.  However, things are never quite so simple as they seem and, as you might have guessed, where there is a short story, a long story and a proverbial Can of Worms isn’t far behind.

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