Emergency Radiology in the Era of EMTALA

The Emergency Medical Treatment and Labor Act (EMTALA) was enacted in 1986 to combat "patient dumping", where principally uninsured patients or those requiring complex care were discharged prematurely or diverted to safety-net hospitals. The law mandates medical screening and stabilization prior to transfer for all patients regardless of ability to pay. Radiology is central to EMTALA compliance, and the statute has significantly influenced radiology practice, facilitating the rise of emergency radiology as a subspecialty. Though EMTALA led to the standardization of emergency imaging protocols and improved access to timely diagnostic evaluation, it also contributed to increased imaging driven by defensive medicine, patient expectations and ER overcrowding. This article presents and analyzes trends in radiology services utilization, shifts in the culture of the field and the relationships between radiologists, other physicians and healthcare facilities.