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Home Sweet Emergency Room, an Alternative Approach that Could Lead to Malpractice Claims

Steven E. North, Esq.


Some say the most dangerous place to be when you are sick is the hospital. One reason is that despite the best efforts by hospital management to stem the spread of bacterial infection with careful protocols, there are super bugs that resist eradication and spread easily.

These infectious microorganisms can exacerbate the problem that prompted a hospital stay or a visit to an emergency room, often an uncomfortable place with long waiting times – sometimes in precarious and undesirable settings.

The fact is that many emergency room visits are unnecessary, and most people – especially the elderly – would prefer to be treated at home. An innovative pre-emergency room approach makes this possible while also decreasing the extraordinary cost of transport to, and treatment in, an emergency room.

In home-treatment scenarios, trained paramedics go to a patient’s home, conduct a preliminary evaluation of the patient’s need for care, and when necessary transport the patient to the emergency room. The paramedics serve as a filter with regard to the need for hospitalization.

A recent study mentioned in the New York Times revealed that nine out of 10 patients were satisfactorily treated or managed in their home. It appears, however, that Medicare and Medicaid do not cover at-home treatment by paramedics. They opt instead to pay the much more extraordinary cost of referring people to hospitals for emergency care or hospitalization. That could be because there is a danger associated with paramedics evaluating patients at home.

Paramedics are not medical doctors, and there is a world of difference in their training. When a paramedic, rather than a physician, is responsible for an evaluation, the outcome may be acceptable in a great many instances. On occasion, however, a subtle but dangerous condition may more easily be detected by a physician. Caution and a tendency toward conservative management will protect against potential medical malpractice claims if prompt, necessary hospitalization is deferred because of a paramedic intervention.

Reference: NYT, November 8, 2016 page D3, “Going to the ER without Leaving Home.”