Who Invented the Emergency Room

Who Invented the Emergency Room

Television shows like ER have helped to romanticize the field of emergency medicine to the US public. However, the emergency room is at the center of a vicious battle. There are those that view the emergency field of medicine as a sinkhole that keeps sucking in money.  

How it began

The emergency room began after the Second World War. One of the reasons it rose was because of the baby boom and urban sprawl; the medical sector was forced to adapt. Physicians venturing away from the office to make home visits became increasingly hard.

After a while, house calls became impractical. Additionally, the federal government began to offer more support for hospital-based care rather than care offered at the home or the office. Another factor was that specialists began to increase. More specialists were spawned out of WW II.

Hospitals began to be viewed as life-sustaining centers. Besides that, there was the development of increasingly sophisticated diagnostic equipment such as the CT scan and cardiac monitoring. These devices allowed for emergency interventions to take place.

Besides that, experienced gained from the war on pre-hospital care made it feasible to have an emergency room. The Korean War brought on the realization that emergency care was seriously underfunded. It was usually a small room with a single overworked nurse.

In 1961, a group of four physicians from Alexandria, Virginia, left their practices and began to offer full-time service in the emergency department. Soon, other physicians in Flint and Pontiac, Michigan followed suit.

Later in that decade, the American College of Emergency Physicians was established by eight physicians in 1968. It helped to establish the process of educating future physicians of the emergency department.

The University of Cincinnati was the first to establish a residency program for the field in 1970. By 1975, the number of approved residencies had grown to 23. There were two academic departments handling emergency department with 100 residents.

On that year, emergency medicine became a permanent section after approval by the American Medical Association House of Delegates. The American Board of Emergency Medicine was approved in 1979 by the American Board of Medical Specialties. With that, it became the 23rd specialty recognized in US medicine. Certification for the specialty began the following year.

Shortly after, the requirements for joining an emergency residency training program were approved. Since 1982, the specialty has branched out into three subspecialties. These are medical toxicology, sports medicine, and emergency medicine.

Emergency medicine has experienced some phenomenal growth since the 80s. One of the things that spurred emergency medicine into the limelight was the attempted assassination of President Reagan in 1981.

Research published in 1985 helped to shed a spotlight on the need for in-hospital trauma care. The COBRA law passed in 1986 made it mandatory for hospitals to provide emergency care and stabilization without regard to a patient’s payer capability.

How Far the Emergency Room Has Come

In the early days, residency programs for emergency room doctors were not quite effective. In most cases, the trainees would learn through trial and error. When they rotated to other services, they were often viewed as oddities pursuing an unrecognized field of medicine.

The first emergency room doctors had to fight in the emergency room as well as with politicians to receive recognition. Although it took quite long, it helped to open the door for the approval of other fields of medicines. The struggle led to the creation of an official system for the approval of new fields of medicine.

Unlike the emergency room doctors of today, those of that era did not know their future. They had no certification board and had no guarantee that they would have a job in the next few years. They were mavericks who persevered amidst all the stress and anguish that it must have caused them.

Despite the lack of specializing equipment and funding, they managed to learn from each other. They helped each other by staying in constant communication with their peers.

Since then, visits to the emergency room have continued to grow. There was a small drop in visits in 1995, but the figure continued to grow. It is estimated that the emergency room receives around 100 million cases each year.

A significant number of these patients are the 41 million uninsured Americans who cannot afford regular care.  For them, it is the only way they can access modern medicine. The emergency room is increasingly seen as the only option for the uninsured and underinsured in the country.

The Current Numbers

In the US, there are about 5,000 emergency departments such as Bellaire ER. Besides that, an estimated 25,000 physicians are working in these departments. There are about 2700 physicians undergoing training to become certified emergency room doctors in the country.

The emergency medicine department is one of the most competitive for medical student applicants for over a decade. ACEP, which had just eight doctors in 1968 now has about 20,000 members. Additionally, there are over 4,000 members in the organization of academic emergency medicine.

Within the country’s medical schools, 50 departments teach emergency medicine. Additionally, there are over 20 sections and divisions that handle this field of medicine.