Patient dumping has several nuances. The dumping of an emergency or pregnant patient is prohibited but many patients needing care do not fit into either category.


Types of dumping:

(1) dropping a patient from a practice

(2) shipping a patient from one hospital to another, with the receiving hospital often a public hospital

(3) telling an outpatient to go to another hospital but without making any arrangements


Situations which do not qualify as dumping:

(1) need to transfer the patient for specialized surgery (neurosurgery, etc) or services not available at the hospital

(2) complex problem requiring a higher standard of care


Situations when dumping is an issue:

(1) The patient does not have insurance and is unable to pay for services.

(2) The patient is older and/or sicker and so is more likely to utilize resources.


Reasons a hospital may feel that it needs to dump a patient:

(1) poor balance sheet AND no source of income to cover the costs to care for the patient (unable to afford)

(2) desire for more profit (can afford the care but does not want to provide it)


Hazards for the physician or hospital who may be perceived as dumping:

(1) EMTALA complaint

(2) claim of abandonment

(3) misrepresenting the patient to the receiving hospital


The obvious solution is to provide revenue that can cover the cost of the patient's care, but few seem willing to step up for this.


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