Healthcare in the United States is complicated, to put it lightly, but despite the layers of bureaucracy, insurance premiums, and out-of-network physicians, there is still a standard of care that every American can expect when going to the emergency room. Under the Emergency Medical Treatment and Labor Act (EMTALA), anyone who goes to an emergency department in need of evaluation and/or treatment for a medical condition is guaranteed a medical screening.
All Medicare-participating hospitals — the majority of hospitals in the country — are required to provide a medical examination to determine whether or not the person seeking medical treatment has an emergency medical condition. If they do, then that hospital must either provide the necessary stabilizing treatment or provide an appropriate transfer to a hospital with the capabilities that can provide said treatment. No hospital with both the capability and capacity to provide this care can refuse treatment, regardless of insurance status, ability to pay, or any other factor.
This means that when emergency care is required, doctors cannot refuse to treat a patient. Under Title VI of the Civil Rights Act of 1964, it is also illegal for a hospital that receives any federal funding to refuse to provide care on the basis of race, skin color, or national origin. If care is still denied in these situations, then there are a number of penalties and fines that can be levied against the hospital, as well as the potential to seek legal action with a medical malpractice lawsuit. However, outside of these circumstances, a doctor may be able to refuse to provide treatment.
When Can a Doctor Refuse To Provide Care?
If emergency care isn’t needed, then there are a number of reasons why a doctor might refuse to provide treatment for a potential patient. Some of the most common reasons include:
- Lack of insurance/inability to pay: Lacking the correct insurance is one of the most common reasons why medical treatment may be denied. An estimated 8% of the US population is uninsured, according to the US Census Bureau, and more than half of all Americans receive healthcare coverage through their employment. Whether someone lost their job and no longer has health insurance, turned 26 and is no longer covered by their parent’s plan, or any other reason, hospitals can decline to provide treatment for non-emergency medical needs if the patient doesn’t have insurance or the ability to pay for treatment.
- Drug-seeking behavior: If a doctor or other medical professional suspects that the patient is only attempting to receive care to secure drugs, then they can refuse to treat the patient. In many cases, they will also include some sort of warning or note on their file to indicate this behavior so it can be more easily tracked in the future.
- The hospital is at capacity, or the doctor is not accepting new patients: If the medical facility lacks the beds needed to provide the necessary care, or even if the doctor is simply not accepting any new patients, they could refuse to provide treatment to the patient. If this is the case, then the patient will likely be referred to a hospital with the capacity or to a doctor who has the space to see new patients.
- The medical care required is outside of the doctor’s area of expertise: Medicine is a highly specialized field, and a doctor trained in one area will likely not be able to provide adequate care relating to a separate field. However, in these cases, it is most likely that they will refer the patient to a physician who practices the relevant field of medicine required.
- The patient is an active threat: This can range from verbal abuse to physically threatening the hospital staff. Outside of providing the required emergency medical care, hospitals can refuse to treat someone causing harm or putting the safety of other people at risk.
The list of potential reasons why a doctor could refuse to treat a patient is extensive, but when that care is either denied for illegitimate reasons or that denial leads to serious medical complications, it may be possible to take legal action.
When Can I File a Medical Malpractice Lawsuit?
Medical malpractice cases can be complicated, but an experienced firm can help you navigate the process and put you in the best position possible to secure the compensation you deserve. If you believe that a hospital’s refusal to provide treatment to you or your loved one directly led to further injury, illness, or death, then you may be able to file a claim. Your medical malpractice attorney will work with you to help prove:
- The doctor or hospital had a duty to provide care.
- The doctor or hospital breached that duty of care.
- The breach of care was directly responsible for the harm suffered.
- Damages caused by this breach of care were incurred by the patient and/or their family.
If you or someone you love was seriously injured because of a medical error or negligence, you deserve the chance to fight for your rights. At Prochaska, Howell & Prochaska LLC, our Wichita medical malpractice lawyers have spent decades representing clients throughout Kansas in order to secure the compensation they deserve. Contact us today to request a free consultation with a member of our firm.
