Dr. B: Well jeez doc, my schedule is full for the next few days, but maybe I can work her in between appointments on Friday. Tell her not to worry, I'll see her in my office. I'm sure we can get her plugged in.
Dr. A: Thanks Bill, she really feels badly about not being able to pay you much and her husband says they can pay some over time... They are really nice folks and will try their best.
Dr. B: Yeah, okay, probably won't see a dime but let's get her in. I'll ask the oncology folks to get involved too. Jim will jump on this. Maybe we can fix her.
Dr. A: Thanks so much. See you at dinner on Saturday, got a few days off coming up.
Dr. B: See you then.
PHYSICIAN TO PHYSICIAN CONSULT POST-EMTALA
Dr. A: Hey Bill, I've got a patient down here that has a lung mass. She has no insurance and no job and is quite angry. Had to wait three hours to be seen and all. She needs a biopsy and maybe surgery and chemo. Can you help?
Dr. B: What, am I on call for the ER?
Dr. A: That's what it says on the schedule.
Dr. B: You guys are killing me. That's four patients over the weekend that will cancel my clinics on Tuesday. You guys just cost me over five grand from paying patients.
Dr. A: Yeah, us too. Thirty people waiting to be seen. Twenty walk-outs today. Eighteen ambulances and four of them reasonable calls. This woman was actually diagnosed with a lung mass last year but never followed up. Still smokes. Came in tonight because she's been coughing up blood. Says she 'can't afford to see a doctor so she came here.
Dr. B: Fucking incredible! What does she think that the ER is free?
Dr. A: It is free to her. She will never pay for any of this, says she's disabled. Drove herself in, has a cell phone that she's been talking on half the time I've been in the room. Seems quite unconcerned except for the wait. Says her lawyer said to come here and that we have to treat her.
Dr. B: Do we?
Dr. A: Yes.
Dr. B: Lawyer?
Dr. A: Yeah, she's suing the poor sap who took her chest film a year ago. Says he didn't explain the consequences of the XRAY findings to her adequately... says she didn't understand this was dangerous. Went to the lawyer before coming here.
Dr. B: Holy shit, now I really don't want to take care of her! Hey can't you transfer her to the General?
Dr. A: No, EMTALA prohibits it.
Dr. B: But she can't sue the city hospital but she can sue the hell out of me! Can't you get Dr. C to take this one?
Dr. A: No, his privileges are suspended for not signing his charts on time.
Dr. B: Suspended for not signing charts?
Dr. A: Yes.
Dr. B: Well, come to think of it, I haven't signed my charts in a while. Maybe I can get suspended too?
Dr. A: Worked for him.
Dr. B: Can we get oncology to consult?
Dr. A: They aren't on call tonight?
Dr. B: Well will they help out after the biopsy?
Dr. A: Don't know, you will have to ask them, we only heave oncology ten days out of the month.
Dr. B: Fuck this! I knew I should have gone to business school. I can't wait till I retire. Just so you know, I'm seriously considering dropping my privileges and doing all outpatient stuff, surgery center, the whole bit.
Dr. A: Join the club. Sorry.