Hospital manager Robert Gonzales emphasised yesterday that no decisions had been made and charging was only one option.
The possibility of charges being imposed was raised at a health forum in Oamaru on Tuesday night.
Mr Gonzales said that before any changes were made, the community would be consulted.
He was preparing a report on options for the company's board (which operates the hospital) which would be discussed with the Otago District Health Board, Ministry of Health and the local community.
The issue of increasing numbers using hospital emergency departments is not unique to Oamaru - it is a national and international problem.
Oamaru Central Medical doctor Jon Scott, who had worked in the United Kingdom, said all hospitals were trying to come to terms with that.
He acknowledged that doctors' fees could be part of the problem, but it was far wider than just that.
In Oamaru in the financial year to the end of June, 7224 people attended the emergency department for treatment - 158% more than the hospital was contracted to provide.
Mr Gonzales said a number of options would be put to the board to ensure the emergency department remained sustainable and viable.
Charging patients was one of those.
He could not say what the extra cost of more patients was.
The hospital was bulk-funded under contract with the Otago DHB, which included the emergency department.
Mr Gonzales also pointed out the difficulty in determining who should be treated by the department or by doctors.
Already, the hospital was educating those patients it felt should have gone to a doctor.
If charges were looked at, it would be for treating injuries and illnesses which could have been attended to by a doctor.
"We won't be turning anyone away. At the end of the day, it is about the welfare of patients and ensuring risk is minimised and they are not compromised," he said.
Dr Scott said [the problem of] the numbers using hospital emergency departments "had been going on for decades".
"It's a worldwide problem," Doctors' fees were only part of the problem.
Another was adequately funding hospitals.
"One is a business issue - practices are businesses - and the other is taxpayers," he said.
Oamaru doctors ran a rostered after-hours service, listed in the phone book.
The charge was $80 up to midnight and $135 after midnight.
Doctors' fees varied, but Central Medical charged $37 a visit.
