Emergency medicine is poised as a specialty to respond to health care changes and to lead the charge in transforming a disconnected, inefficient, and costly system.
Only 42 percent of the 354 million annual visits in the U.S. for acute care—treatment for newly arising health problems—are made to patients' personal physicians. The rest are made to emergency departments (28 percent), specialists (20 percent), or outpatient departments (7 percent).
Strategic decisionmaking about the capacity of emergency departments should be based on measures of patient safety, such as the number of patients who leave without treatment because of ED crowding.
Emergency department physicians are devising an ever-expanding list of workarounds to deal with ED overcrowding, but the author argues that their success in doing so perhaps enables abuse of patients rather than their protection.