Living with Chronic Pain

The Emergency Medical Treatment and Labor Act (EMTALA)


The Emergency Medical Treatment and Active Labor Act (EMTALA), passed by the U.S. Congress in 1986, was created to ensure that individuals have access to emergency medical treatment regardless of their ability to pay. The EMTALA also prevents uninsured individuals from being transferred to other facilities due to a financial loss of the medical institution. Although this law was originally intended to provide emergency medical treatment, interpretations of the law have left the EMTALA applying to all aspects of hospital care.

The Emergency Medical Treatment and Active Labor Act enforces that hospitals participating in Medicare perform a medical screening examination (MSE) on all individuals requesting care in an emergency department (ED). An MSE determines if an emergency condition exists. If an emergency situation does exist, the hospital staff must stabilize the individual or move them to a hospital with better capabilities to treat their condition. Hospitals are required to accept the transfer if they can treat the individual with specialized equipment and personnel. Hospitals are prohibited from delaying an MSE. The EMTALA guarantees that hospitals must provide stabilizing treatment and that physicians must weigh the risks of transferring individuals to another facility.

How does EMTALA apply to individuals with chronic pain?

An emergency medical condition is described as an acute symptom of severity, which includes severe pain. The majority of ED visits are due to pain, which include pain associated with an injury or an existing chronic pain condition. Although some individuals with a chronic pain diagnosis have a primary physician, the ED may provide additional treatment if the current course of action is not working or additional pain is occurring. Other situations the EMLATA covers include emergencies outside of practicing hours of a primary physician or the lack of the ability to obtain a medical appointment when pain is severe.

Many individuals with chronic pain also have other medical comorbidities rendering ED healthcare professionals with incomplete medical histories. A safety concern arises when prescribing pain medications, such as opioids, without a proper medical history of the individual seeking treatment. Oftentimes, due to the complexity of their condition, those with chronic pain usually require more medical attention than an ED can provide. However, individuals in severe pain may feel they have no other way to seek treatment. The EMTALA ensures that these individuals are evaluated; however, referrals to specialists may be in the best interest of all involved.

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