Protection of Emergency Physicians from Coercion in Patient Transfers

Originally approved April 2025.


The American College of Emergency Physicians (ACEP) unequivocally opposes any form of coercion, intimidation, or threats of financial or administrative penalties directed at emergency physicians to compel patient transfers against their clinical judgment. Emergency physicians have an ethical obligation to act in the best interests of their patients, prioritizing safety and quality of care over external pressures.

ACEP recognizes that coercion in the context of patient transfers, particularly when the treating physician has determined that the patient is unstable, poses significant risks to patient safety and undermines the physician-patient relationship. Examples of coercion include, but are not limited to:

• Threats of financial penalties to the physician or healthcare institution.
• Administrative pressures or threats of disciplinary action.
• Denial of necessary resources to facilitate appropriate patient care.

ACEP calls for the establishment of clear institutional and regulatory safeguards to protect emergency physicians from coercion and to promote ethical decision-making processes. These safeguards should include:

1. Policy Enforcement: Institutional policies ensuring that no one can override the treating emergency physician’s decision. The only exception is if a licensed and credentialed physician evaluates the patient personally in a timely manner and documents in the medical record that they are assuming responsibility for the patient and the decision that transfer is warranted.
2. Reporting Mechanisms: Transparent and anonymous processes for emergency physicians to report instances of coercion without fear of retaliation.
3. Accountability: Consequences for individuals or entities found to have engaged in coercive practices that compromise patient safety.
4. Education and Advocacy: Education for administrative leaders on the importance of respecting the clinical judgment of bedside physicians and the implications of coercion on patient care outcomes.

By advocating for these protections, ACEP seeks to empower emergency physicians to deliver care that prioritizes patient safety and adheres to the highest ethical standards of the profession.