When a pediatric patient has been evaluated and treated in the emergency department (ED) and needs to be admitted to a hospital, the private physician may request that the child be transferred to another hospital. This may be done because the private doctor has staff privileges at another hospital or because the HMO has a contract with another hospital. This request to transfer the child presents a dilemma for the emergency physician.

The emergency physician must be sure the child is "stable" prior to transfer. Of course, he or she must realize that the condition of a "stable patient," such as a child with asthma, may change at any time. Thus, the emergency physician and the private physician must consider that every transported patient is put at some risk when he or she leaves the ED to go to another facility.

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