Subcommittee backs bill requiring a physician on-site whenever emergency departments are open

The Medical and Health Affairs Subcommittee voted unanimously to send House Bill 4067, which would require an emergency department to have at least one physician on duty whenever the department is open, to the full committee with a favorable recommendation.

House Bill 4067 would require an emergency department to have at least one physician on duty at all times the emergency department is open; the physician is not required to be physically located inside the emergency department but must be on the facility premises, staff summarized for the panel.

Trey, the subcommittee staff member, told the panel: "This bill will require an emergency department to have at least 1 physician on duty at all times the emergency department is open. The physician is not required to be physically located in the emergency department of the facility, but shall be on the premises." Chairwoman Celeste Davis, the bill sponsor for the item, said the measure was prompted by concerns from physicians and physician associations and was intended to "make sure we pass this fairly simple bill just to ensure that in the future we have an emergency physician in the emergency room."

Several emergency physicians provided two-minute testimonies supporting the bill and describing clinical scenarios they said support a requirement for on-site physician coverage. Dr. Kat Moore, president of the South Carolina College of Emergency Physicians, said the measure is intended to "keep the standard of care for all of the patients in South Carolina no matter what emergency department they may go into." Dr. Kelly Johnson recounted treating a teenager in anaphylactic shock and said "I have no doubt that we were able to have that child return to his family" because a physician was on site. Dr. Logan Wolford described working solo coverage in a freestanding emergency department and said that having an emergency-medicine-trained physician "is that there is an emergency medicine trained physician that has a certain level of knowledge, expertise, training and quality assurance that's associated with that person." Dr. Matt Bittner noted time-critical conditions such as heart attack, saying that "every minute counts and you want somebody who is ready, and able to care for you." Several testified that physician presence is a patient-safety issue, particularly in rural and freestanding emergency departments.

Legislators asked clarifying questions about shift length and rural coverage. Representative Thomas Beach asked what a typical physician shift length would be; Dr. Johnson said 8 to 10 hours is typical in her system with some overlap and noted that some very rural sites may have longer coverage windows. Representative Beach and other members thanked the physicians for their testimony and then, by roll call, the subcommittee recorded unanimous support. The clerk recorded votes of Representatives Thomas Beach, Celeste Davis, Chris Hart, Scott Montgomery, (Representative) Moore, and Subcommittee Chair Heath Sessions in favor; the clerk announced, "All are in favor of the bill."

The transcript contains no recorded amendments or conditions attached to the favorable recommendation. The bill will proceed to the full committee for further consideration.