What happens when the Emergency Department Physician (EDP) may recommend or believe that a patient should be admitted to the hospital and the “back-up” or “on-call” physician suggests discharge?

In this situation, it is appropriate for the EDP to voice his/her concerns (for the benefit of the patient whom he/she has personally evaluated) and suggest/request that the on-call physician personally come to the Emergency Department to evaluate the patient before discharge. This reflects the standard of care in Emergency Medicine: the EDP must be comfortable with the disposition plan and stability of the patient. When a disagreement exists, the attending/on-call physician must present to the Emergency Department to make a final disposition.