Listen, I don't care who you are--MD or no MD.
If you come into the ED at 4 pm on a very busy day complaining of "strange feelings" in your chest, your EKG is normal, and your first set of labs are normal, and insist that you must leave by 5 pm:
we are not going to be thrilled that you want to leave before your second set of troponins, but OK.
we will call the cardiac fellow, but will not "make" him come down to place a holter monitor on you before 5 pm because you are "too busy" to follow up with a cardiologist.
we will discharge you with instructions to follow up with a cardiologist.
We're all busy people. Find time to take care of your health, doc.