February 2, 2024
From the time you get within 600 feet of the emergency room, the hospital is responsible for your care, said Dr. Richard Friend, dean of the College of Community Health Sciences, during a January Mini Medical School Presentation to The University of Alabama OLLI program.
Friend is also a family medicine physician and has extensive administration and clinical expertise, including emergency medicine experience.
The U.S. Centers for Disease Control and Prevention defines an emergency room or department as a hospital facility that is staffed 24 hours a day, seven days a week, and provides unscheduled outpatient services to patients whose condition requires immediate care.
“The emergency room at Druid City Hospital Regional Medical Center is known as a Level II trauma center, where they have every resource available, including their own surgery team, and is fully staffed to take care of all trauma patients,” Friend said.
The trauma center levels (Level I-V) refer to the resources available to care for a trauma patient. A Level I facility can provide the highest level of care to critically ill or injured patients.
The ER physicians at DCH Regional Medical Center are employed through a group called Relias Healthcare, which specializes in emergency room care. The ER physicians assess and treat patients in the emergency room, proving the best care possible.
“The hospital tracks the entire health care visit of the patient under the Emergency Medical Treatment and Labor Act (EMTALA),” said Friend.
Friend said that EMTALA prohibits hospitals from refusing to treat or examine patients who come to the emergency department and requires the facility to provide a medical screening examination, a physical exam and a disposition for the patients. A disposition is the discharge of the patient after their visit to the emergency room, which may consist of discharging the patient back to their home or transferring them to another hospital or nursing facility.
“Even if a small local hospital does not have the proper facilities or a labor and delivery department, they are still required to take care of the patient to the best of their ability,” Friend said. “Once the screening exam is finished, the ER physicians determine if the patient’s health concern is emergent, or not emergent, and what resources are needed to deliver the remainder of their care. If a small hospital does not have the resources to take care of the patient, they would transfer them to another physician. The physician that ordered the transfer is responsible for that patient until they reach the other site.”
Friend said that every year across the United States, emergency departments record more than 1.3 billion patient visits, which can become an issue for certain hospitals. “To practice good medicine, we have to do a better job educating and providing resources so our patients can get to the place they need to be and also have an understanding about what is considered emergency care.”
Friend also said if patients come to the emergency room with an emergent problem, such as chest pain, the facility is required to see that patient right away, but if the health concern is less serious, patients might have to wait longer to be seen by an ER physician. A lack of hospital staff and resources could also cause longer wait times.
Mini Medical School is a series of lectured provided each semester by University Medical Center health-care providers to UA’s Osher Lifelong Learning Institute (OLLI) members. CCHS operates UMC.