When someone comes through the doors of a hospital emergency department, it is often one of the worst days of their life—a heart attack, a stroke, a serious injury, a child struggling to breathe. In those moments, no one is thinking about staffing models or regulations. They are thinking about one thing: Is there a doctor here who can help me right now?
Most Alabamians assume the answer is yes. They would be surprised to learn that, under current law, that assumption is not always correct.
Senate Bill 80 would require every hospital emergency department in Alabama to have a physician physically present on site, 24 hours a day, seven days a week. It is a straightforward bill that simply aligns the law with what patients already expect when there is not a moment to lose.
Emergency medicine is unpredictable and high-risk by nature. Patients do not arrive on a schedule, and they rarely arrive with a clear diagnosis. In true emergencies, the difference between life and death can hinge on seconds—and on the training and experience of the professional leading the care team.
Physicians accumulate more than 12,000 hours of supervised patient care during medical school and residency. That depth of training matters most during complex, rapidly evolving emergencies. When emergency departments operate without a physician present, patient outcomes suffer and disparities widen—especially in rural hospitals where surgeons, obstetricians and other specialists are not immediately available. Allowing unsupervised emergency care in these settings creates two standards of care based solely on geography.
Some critics argue that SB80 would place an undue burden on rural hospitals and cause closures. But Alabama is investing heavily in rural health care. This year, the Rural Health Transformation Program will invest $203 million in rural healthcare, alongside $20 million through the Alabama Rural Hospital Investment Program. Rural Emergency Hospitals also receive more than $3 million annually in federal support. Alabamians expect these investments to raise the standard of emergency care, not lower it. SB80 does not close hospitals—it closes a loophole.
Other largely rural states, including South Carolina, Indiana and Virginia, have already adopted similar physician presence requirements. No hospitals in those states have closed as a result. In fact, evidence suggests that having a physician on site can reduce costs by avoiding unnecessary tests, delays and transfers that occur when uncertainty replaces expertise.
If it were your loved one on that stretcher, you would want a physician in the room. Senate Bill 80 ensures that expectation is met for every Alabamian, every time.
When seconds matter, patients deserve nothing less.
