Treating Physician Determines Patient Stability

Originally approved April 2025

The American College of Emergency Physicians (ACEP) asserts that the treating emergency physician at the patient’s bedside is the physician of record and holds the primary responsibility and authority to determine a patient’s medical stability for transfer. This determination must be based on a thorough clinical evaluation, diagnostic findings, and the physician’s professional judgment. ACEP emphasizes that such decisions can only be overridden by a licensed and credentialed physician who has personally and directly evaluated the patient at the bedside and takes medical and legal responsibility for the care of the patient in a timely manner.

ACEP advocates for systems that support and prioritize the treating physician’s real-time assessments, recognizing the importance of direct, bedside evaluation in ensuring patient safety. Any attempts to undermine the treating physician’s decision-making authority, including through the use of remote assessments or administrative pressures, risk compromising the quality of care.

To ensure accountability and transparency, ACEP supports documentation of the treating physician’s reasoning and clinical findings related to patient stability. Such documentation should serve as the definitive record in any dispute regarding patient transfer decisions.