Re: On call physician cash only treatment?
With respect to the physician, your question primarily involves two issues. Unless the physician has contractual relations with your
insurance company (e.g., HMO, PPO) there is no basis to compell
performance through the physician's compensation through insurance. If the child was stablized and
not in need of emergency care then the physician does not have to
provide treatment. The law does protect the non-treatment of patients
who require emergency treatment for life or limb altering events.
Now, beside the physician there is also a duty upon the hospital. Under Emergency Medical Treatment and Active Labor Act, 42 USCS § 1395dd, two duties are imposed on
hospital, a screening requirement and a stabilization requirement.
An "emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain)
such that the absence of immediate medical attention could reasonably be expected to result in placing the health of the individual in serious jeopardy,
serious impairment to bodily functions, or serious dysfunction of any bodily organ or part. The term "to stabilize" means, with respect to an emergency medical condition, to provide such medical treatment of the condition as may be necessary to assure, within reasonable
medical probability, that no material deterioration of the condition is likely to result or occur during from the
transfer of the individual from a facility. The term "transfer" means the movement (including the discharge) of an individual outside a hospital's
facilities at the direction of any person employed by (or affiliated or associated, directly or indirectly, with) the
hospital, but does not include such a movement of an individual who leaves the facility without the permission of any such person.
It is difficult to assess your situation without knowing the severity of the child's injury. Your situation may or may not address the requirements to compell performance of the
physician and/or hospital. Frankly, this particular physician does not sound like the type
of person that I would want to work on a young girl's face.
I wish you the best of luck with
your granddaughter's recovery.
