Under EMTALA, hospitals cannot refuse emergency care even if a patient has filed a malpractice lawsuit.
Physicians may refuse non emergency treatment in certain cases but must avoid patient abandonment.
EMTALA requires medical screening and stabilization regardless of legal disputes.
Returning to the same hospital or doctor does not automatically weaken a malpractice claim.
Lawsuits can significantly impact the doctor patient relationship and clinical decision making.
A seemingly simple question in a large Facebook group of American Physicians sparked a layered debate on law, ethics, boundaries, and the realities of modern medical practice:
The responses revealed not just legal considerations, but deep emotional undercurrents about trust, professional identity, and the strain of litigation in American medicine.
Many physicians quickly pointed to a foundational federal law: Emergency Medical Treatment and Labor Act, commonly known as EMTALA.¹
EMTALA was enacted to prevent hospitals from refusing emergency care based on insurance status or financial considerations.¹ ²
Enacted in 1986, EMTALA requires that any patient presenting to an emergency department must receive:
An appropriate medical screening examination
Stabilizing treatment if an emergency medical condition is found
Transfer if the hospital cannot provide appropriate care
Importantly, EMTALA applies regardless of insurance status, ability to pay, or legal conflict with the hospital or physician.¹
Hospitals that violate EMTALA risk federal penalties, fines, and potential exclusion from Medicare participation.²
One emergency physician summarized the practical reality:
“You can’t prevent someone from going to a hospital. To the ED at least. Even if they are dangerous for some reason, accommodations have to be made to allow them to have a medical screening exam and then discharge.”
Another added:
“Yes. If they show up in ED they must be treated like any other individual.”
The legal consensus was clear. Hospitals cannot refuse emergency care simply because a patient has filed a lawsuit.¹ ²
Here, the discussion became more divided.
Several physicians drew a line between hospital obligations and individual professional boundaries.
A Maryland gastroenterologist wrote:
“Yes patient can still go to the hospital. However, I 100% would refuse to treat if I were named in the lawsuit. The therapeutic relationship is irrecoverably broken.”
Others agreed:
“If you sue me clearly you are unhappy about my care. This relationship is over.”
The argument rests on the idea that once litigation begins, trust is fundamentally disrupted. In non emergent settings, physicians may terminate the doctor patient relationship provided they follow appropriate ethical and legal procedures, including notice and continuity planning.³
These steps typically include:
Give proper written notice
Allow reasonable time for transfer of care
Avoid patient abandonment
Ensure no emergency condition is present
One physician emphasized documentation:
“You need to find another provider to give the care you won't, and you'll need to document why.”
This aligns with risk management principles. Improper termination without notice can itself become grounds for a separate claim of abandonment.
The discussion took an interesting turn when several MD JDs (a dual-degree program combining a Doctor of Medicine and a Juris Doctor law degree) entered the thread.
One participant, identifying himself as both a practicing physician and plaintiffs malpractice attorney, offered a nuanced view:
“If the claim is that on a specific day negligence occurred, that has no bearing on going back. It would not be a good look to make an appointment with the alleged negligent doc. But to go back to the hospital building? No issues.”
He added:
“There are plenty of reasons they may go back. Including that’s where their other doctors are, that’s the closest or only hospital etc. And it depends on what the lawsuit surrounds… negligent hiring, sexual assault, criminal matter etc. There are a lot of unknowns so my favorite answer… it depends.”
Another MD JD in the group echoed the same assessment.
The legal takeaway is critical. Returning to a hospital does not automatically undermine a malpractice claim. Medical malpractice litigation typically centers on specific alleged acts, rather than ongoing relationships alone.⁴ ⁵
Continuing care in the same health system may be driven by geography, insurance constraints, or limited alternatives.
Some physicians believed that if a patient returns to the same doctor, it could weaken their lawsuit.
A pain medicine physician from South Carolina commented:
“If the doctor is so bad you are suing them, why did you go back?”
But malpractice attorneys in the thread disagreed. Litigation is typically focused on a defined episode of care. Subsequent visits do not necessarily negate a claim.
A board certified emergency medicine physician from New York shared a real case:
“The patient wanted to continue seeing the doctor and asked her lawyer if they could please drop Dr from the lawsuit because she likes him but just wants to get some money. Her lawyer said absolutely not.”
This illustrates a difficult truth. Lawsuits are not always personal expressions of distrust. They may be financially motivated, strategically structured, or directed at institutional liability.⁴ ⁵
Perhaps the most emotionally charged exchange revolved around professional identity.
An obstetrician and gynecologist (OB-GYN) wrote:
“When did we lose our backbone of leadership that we believe litigation makes a patient not a person in need of care?”
Another physician from Les Ulis countered:
“Doctors can also have boundaries. I don’t owe anyone anything but good care if I take you on as a patient. If you sue me clearly you are unhappy about my care. This relationship is over.”
The thread reflected a generational and philosophical divide.
Some physicians emphasized the ethical obligation rooted in the Hippocratic tradition and professional duty. Others emphasized psychological safety, moral injury, and the toll of prolonged litigation.
One physician who had endured a lawsuit for years described the anxiety of repeatedly disclosing it on credentialing paperwork, only for the case to be dropped. For those who have lived through it, the emotional impact is not theoretical.
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A specific scenario was raised:
"If the sued physician is the only specialist on call, can they refuse and request transfer?"
Under EMTALA, if a physician is on call and the hospital has the capability to treat the emergency condition, the hospital must provide stabilizing treatment. An on call physician may not simply refuse based solely on litigation status.¹ ²
However, exceptions may arise if there is:
A credible physical threat
A restraining order
A documented safety concern
In such cases, hospitals often involve security or law enforcement while still fulfilling EMTALA screening and stabilization obligations.
As one emergency physician put it:
“Even if they are dangerous for some reason, accommodations have to be made to allow them to have a medical screening exam.”
EMTALA does not disappear because litigation exists.¹ ²
Several physicians pointed out practical limitations:
“Particularly in rural areas with few other options.”
In communities with limited specialists, refusing to treat may not be feasible without risking patient harm or EMTALA violations.¹ ²
The legal right to refuse elective outpatient care does not override EMTALA obligations in emergency or resource limited contexts.¹ ²
Another side conversation addressed whether colleagues should even know about a lawsuit. One member noted:
“Lawsuits are typically a matter of public record.”
Malpractice litigation in the United States is generally filed in civil court and becomes publicly accessible unless sealed, contributing to transparency but also professional stress.⁴
From a legal standpoint:
Yes, a patient can return to the hospital for emergency care. EMTALA requires it.¹ ²
Yes, a hospital must provide an emergency medical screening examination regardless of litigation.¹ ²
Maybe, the named physician may decline ongoing non emergent care if proper termination procedures are followed.³
No, returning to the hospital does not automatically invalidate a malpractice claim.⁴ ⁵
From a human standpoint, the issue is more complex.
For some physicians, treating again reinforces professionalism and confidence in their care. For others, it represents an untenable breach of trust.
As one physician bluntly put it:
“Only in America. Let me sue you and go back for care to the place I mistrust.”
And yet, in America, that is precisely how the system is designed. Emergency care is not conditional. Professional boundaries are permitted. Litigation and treatment can coexist.
The answer reflects the modern physician experience: legally structured, ethically layered, emotionally charged, and increasingly defined by the intersection of care and litigation.
Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd (1986), https://www.law.cornell.edu/uscode/text/42/1395dd.
Centers for Medicare and Medicaid Services, State Operations Manual Appendix V – Interpretive Guidelines: Responsibilities of Medicare Participating Hospitals in Emergency Cases (EMTALA) (Baltimore: Centers for Medicare and Medicaid Services), https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/som107ap_v_emerg.pdf.
American Medical Association, Code of Medical Ethics Opinion 1.1.5: Terminating a Patient-Physician Relationship (Chicago: American Medical Association), https://code-medical-ethics.ama-assn.org/ethics-opinions/terminating-patient-physician-relationship.
David M. Studdert, Michelle M. Mello, and Troyen A. Brennan, “Medical Malpractice,” New England Journal of Medicine 350, no. 3 (2004): 283–292, https://www.nejm.org/doi/full/10.1056/NEJMra032292.
Michelle M. Mello and Troyen A. Brennan, “Deterrence of Medical Errors: Theory and Evidence for Malpractice Reform,” Texas Law Review 80 (2002): 1595–1637, https://texaslawreview.org/wp-content/uploads/2015/08/Mello-Brennan-80-Texas-L-Rev-1595.pdf.