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You are the manager of the emergency department of a large private hospital in a metropolitan area served by several hospitals, including a public teaching hospital affiliated with a medical school. Your hospital earned profits of $120 million the previous year and you know that the teaching hospital is losing over $20 million a year. The Chief Operating Officer of the hospital to whom you report has discussed with you the need to reduce the number of non-paying patients who are accessing the hospital’s emergency department. One of the ideas he has proposed is to instruct non-paying patients being discharged from your emergency room to seek their future care at the teaching hospital, thereby passing on the costs of treating those patients to the other hospital. The COO notes to you that this is perfectly legal since the patient is being treated before being told to seek future care at the teaching hospital. What would you say to the Chief Operating Officer and why?

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