One of the things I take great pride in, as a pediatric emergency physician, is that the Emergency Department (ED) is a place where the doors are always wide open.
The ED is a place that takes all patients, no matter how minor or major the concern; no matter the time of day; no matter the ability to pay; no matter the language, race, religion, or identity — our unifying goal is that all will be seen and be given compassionate care.
As an ED provider, I see my work as a kind of care that is more rudimentary even than primary care. It is a place of hope and sanctuary to the patients and families that we see, for the worried parents bringing their child in at all hours of the day or night, and for those who have no access to their own pediatricians.
This “open door” policy of the ED was not always the norm at pediatric hospitals. Prior to the passage of the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986, private hospitals commonly “dumped” patients, mostly those who were poor and minority status, into county hospital systems where they would fare much worse. This was often done without the patient’s consent. After review, it was determined that this practice of denying care to certain patients was primarily due to financial reasons and was unethical. Monetary penalties were introduced for hospitals found to be in violation of this law, and soon the landscape of emergency and hospital care changed permanently. Read full post »