Nonphysicians must follow protocols to the letter.

When performing medical screening examinations (MSEs), nonphysicians must follow strict protocols and work under the supervision of the ED physician. Numerous EMTALA violations have involved failure to follow protocols and comply with scope of practice. Protocols must address at what times a physician is required to be called. Individuals performing MSEs must be formally assessed and approved by the hospital's board of directors and be permitted by licensure to perform this function.