Is It Medical Malpractice When a Doctor Refuses to Treat a Patient?

Posted by Randy Andrus | Nov 15, 2022

Sometimes refusal to treat will fall under medical malpractice. Federal law states that Medicare-approved private hospitals must provide emergency medical care to those who need it, despite one's inability to pay or his/her insurance situation. However, there may be exceptions to this rule. 

If a medical establishment or doctor has refused to treat you and you've suffered further injury as a result of the lack of treatment, you may have a medical malpractice claim. To schedule a confidential consultation with our medical malpractice attorney, call 801-535-4645 or fill out this secure and convenient online form

What Does the Law Say About Refusal to Treat?

Today, it doesn't matter what a patient's insurance status is or if they cannot pay. However, in the past, this was not the case. Private hospitals would frequently transfer patients to public hospitals if they could not pay. The practice became known as “dumping.” In 1986, the federal government implemented the Emergency Medical Treatment and Active Labor Act (EMTALA) in an effort to stop patient “dumping.” The law states that hospitals that receive funds through Medicare are obligated to treat patients who need emergency care regardless of the patient's ability to pay for it. 

But There Are Some Exceptions

Not all medical facilities are subject to the Emergency Medical Treatment and Active Labor Act. Some examples of medical facilities that may not fall under the law include some private doctor's offices, clinics, medical labs, and hospitals without ERs. Many recent court opinions and amendments have enforced that hospital-affiliated urgent care clinics must adhere to the EMTALA. 

Some other situations in which a doctor or medical provider may refuse to treat include:

  1. When patients are abusive or behaving aggressively while seeking treatment, creating a dangerous or potentially dangerous environment
  2. When patients are seemingly seeking treatment in order to abuse drugs
  3. When a specific treatment falls outside of a doctor's practice area
  4. When a patient's treatment comes into conflict with the doctor's obligations

Private doctors may not be subject to the EMTALA. As such, they may refuse treatment to a patient for nearly any legitimate reason. Some such reasons could include:

  • When the doctor is outside of the patient's insurance network
  • When a doctor's clinic is not accepting new patients
  • When a patient cannot pay for treatment
  • When a doctor has chosen not to treat specific conditions or injuries
  • When a patient has failed to pay for a past treatment
  • When a doctor decides to stop taking a patient's health insurance
  • When a patient has previously displayed destructive or abusive behavior
  • When a patient has presented drug-seeking behavior
  • When a doctor decides not to provide treatment due to his or her religious or moral beliefs

A Doctor Cannot Discriminate

While private doctors may not be subject to federal laws stating they must treat patients, they cannot illegally discriminate against people. Illegal discrimination includes discriminating against a patient based on his or her age, gender, sexual orientation, nationality, race, or religion. 

When Can I Sue a Doctor for Refusing to Treat Me?

As a general rule, if a delay in treatment causes severe injury, doctors may face liability. If a patient is in need of emergency medical care and the physician denies him or her treatment, the patient may have a legitimate medical malpractice claim. 

According to the EMTALA, emergency medical treatment must be provided in certain circumstances. The law defines an emergency medical condition as any “condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs." 

If a doctor, especially one associated with a hospital or emergency room, has denied you medical treatment in the case of an emergency or injury that may lead to a more serious injury, you may have a medical malpractice case. We advise you to schedule an initial consultation with our medical malpractice attorney to get legal guidance in your specific set of circumstances. Know that every case is unique, and it's difficult to determine a valid claim without taking all facts into account – the first step should be a legal consultation. 

Potential Damages in Medical Malpractice Claims

Many states place limits on the amount of damages that plaintiffs can recover in medical malpractice lawsuits. Utah has established a cap of $450,000 on non-economic damages, however, there is no current limit on economic damages in these types of cases. Plaintiffs may collect the following types of legal remedies in medical malpractice lawsuits:

  • Economic Damages - Monetary damages that may include medical expenses, lost wages, loss of earning capacity, rehabilitation costs, physical therapy bills, medication expenses, etc. These damages are easy to calculate in monetary terms. 
  • Non-Economic Damages - These are non-monetary damages that may include emotional trauma, loss of consortium, loss of enjoyment of life, PTSD, anxiety, depression, pain and suffering, wrongful death, etc. Talk to a medical malpractice attorney for guidance in calculating these types of damages. 
  • Punitive Damages - These damages are intended to punish the defendant by increasing the amount of compensation owed to the plaintiff. For medical malpractice claims, Utah places no limit on the amount of punitive damages a plaintiff may be awarded. If punitive damages are awarded to the plaintiff, the amount will depend on the defendant's financial assets, type of misconduct, and the level of overall plaintiff damages. Utah Code § 78B-3-410.   

Talk to Our Medical Malpractice Attorney Today

If you've been injured because a doctor refused to treat you, you may have grounds for a medical malpractice claim. It is important that you discuss your unique case with an experienced and trusted medical malpractice attorney. Randy Andrus and his team have given injured patients a voice for over 37 years. To schedule an initial and confidential consultation with Randy today, call 801-535-4645 or fill out our secure online contact form here

Note that the content on our blog and website is for general information purposes only. If you have specific questions and concerns, we urge you to reach out to our medical malpractice lawyer to discuss your case. 

Andrus Law Firm is located in Salt Lake City at 

299 S Main St

Ste 1395

Salt Lake City, UT 84111

We serve Salt Lake City, Layton, Ogden, Orem, Provo, Sandy, St George, West Valley City, West Jordan, and the entire state of Utah. 

About the Author

Randy Andrus

BIO   Education University of the Pacific, McGeorge School of Law (LL.M. 1987) Business and Taxation – Transnational Practice Courses and International Bar Association Convention, Salzburg, Austria Southwestern University School of Law (J.D. 1984) Dean's List American Jurisprudence...

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