Emergency medicine

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error, "an average of 8.8 teamwork failures occurred per case more than half of the deaths and permanent disabilities that occurred were judged avoidable." Particular cultural (i.e. "a focus on the errors of others and a 'blame-and-shame' culture") and structural (i.e. lack of standardisation and equipment incompatibilities) aspects of emergency medicine often result in a lack of disclosure of medical error and near misses to patients and other caregivers. While concerns about malpractice liability are one reason why disclosure of medical errors is not made, some have noted that disclosing the error and providing an apology can mitigate malpractice risk. Ethicists uniformly agree that the disclosure of a medical error that causes harm is a care provider's duty. The critical components of the disclosure include "honesty, explanation, empathy, apology, and the chance to lessen the chance of future errors" (represented by the mnemonic HEEAL). The nature of emergency medicine is such that error will likely always be a substantial risk of emergency care. However, maintaining public trust through open communication regarding a harmful error can help patients and physicians constructively address problems when they occur.

905:, nurse practitioners and registered nurses who coordinate with specialists in both inpatient and outpatient facilities to address patients' needs, more specifically in the ED. For all systems, regardless of funding source, EMTALA mandates EDs to conduct a medical examination for anyone that presents at the department, irrespective of paying ability. Non-profit hospitals and health systems – as required by the ACA – must provide a certain threshold of charity care "by actively ensuring that those who qualify for financial assistance get it, by charging reasonable rates to uninsured patients and by avoiding extraordinary collection practices." While there are limitations, this mandate provides support to many in need. That said, despite policy efforts and increased funding and federal reimbursement in urban areas, the triple aim (of improving patient experience, enhancing population health, and reducing the per-capita cost of care) remains a challenge without providers' and payers' collaboration to increase access to preventive care and decrease in ED usage. As a result, many experts support the notion that emergency medical services should only serve immediate risks in urban and rural areas. 885:"uninsured or underinsured patients, women, children, and minorities, all of whom frequently face barriers to accessing primary care". While this still exists today, as mentioned above, it is critical to consider the location in which care is delivered to understand the population and system challenges related to overutilization and high cost. In rural communities where provider and ambulatory facility shortages exist, a primary care physician (PCP) in the ED with general knowledge is likely to be the only source of health care for a population, as specialists and other health resources are generally unavailable due to lack of funding and desire to serve in these areas. As a result, the incidence of complex co-morbidities not managed by the appropriate provider results in worse health outcomes and eventually costlier care that extends beyond rural communities. Though typically quite separated, PCPs in rural areas must partner with larger health systems to comprehensively address the complex needs of their community, improve population health, and implement strategies such as telemedicine to improve health outcomes and reduce ED utilization for preventable illnesses. (See: 1455:"In 2010, there were 157 allopathic and 37 osteopathic emergency medicine residency programs, which collectively accept about 2,000 new residents each year. Studies have shown that attending emergency physician supervision of residents correlates to higher quality and more cost-effective practice, primarily when an emergency medicine residency exists." Medical education is primarily funded through the Medicare program; payments are given to hospitals for each resident. "Fifty-five per cent of ED payments come from Medicare, fifteen per cent from Medicaid, five per cent from private payment and twenty-five per cent from commercially insured patients." However, choices of physician specialities are not mandated by any agency or program, so even though emergency departments see many Medicare/Medicaid patients and thus receive much funding for training from these programs, there is still concern over a shortage of speciality-trained emergency medicine providers. 291: 867:. The US Congress enacted EMTALA in 1986 to curtail "patient dumping", a practice whereby patients were refused medical care for economic or other non-medical reasons. Since its enactment, ED visits have substantially increased, with one study showing a rise in visits of 26% (which is more than double the increase in population over the same period). While more individuals are receiving care, a lack of funding and ED overcrowding may be affecting quality. To comply with the provisions of EMTALA, hospitals, through their ED physicians, must provide medical screening and stabilize the emergency medical conditions of anyone that presents themselves at a hospital ED with patient capacity. EMTALA holds both the hospital and the responsible ED physician liable for civil penalties of up to $ 50,000 if there is no help for those in need. . While both the 921:, a patient-physician relationship is established when "the physician takes an affirmative action with regard to the care of the patient". Initiating such a relationship forms a legal contract in which the physician must continue to provide treatment or adequately terminate the relationship. This legal responsibility can extend to physician consultations and on-call physicians even without direct patient contact. In emergency medicine, termination of the patient–provider relationship prior to stabilization or without handoff to another qualified provider is considered abandonment. In order to initiate an outside transfer, a physician must verify that the next hospital can provide a similar or higher level of care. Hospitals and physicians must also ensure that the patient's condition will not be further aggravated by the transfer process. 797:

engagements or acting as an expert witness; they also saw a 12% increase in salary from 2014 – 2015 (which was not out of line with many other physician specialities that year). While emergency physicians work 8–12 hour shifts and do not tend to work on-call, the high level of stress and need for solid diagnostic and triage capabilities for the undifferentiated, acute patient contributes to arguments justifying higher salaries for these physicians. Emergency care must be available every hour of every day and requires a doctor to be available on-site 24/7, unlike an outpatient clinic or other hospital departments with more limited hours and may only call a physician in when needed. The necessity to have a physician on staff and all other diagnostic services available every hour of every day is thus a costly arrangement for hospitals.

871:(OIG) and private citizens can bring an action under EMTALA, courts have uniformly held that ED physicians can only be held liable if the case is prosecuted by OIG (whereas hospitals are subject to penalties regardless of who brings the suit). Additionally, the Centres for Medicare and Medicaid Services (CMS) can discontinue provider status under Medicare for physicians that do not comply with EMTALA. Liability also extends to on-call physicians that fail to respond to an ED request to come to the hospital to provide service. While the goals of EMTALA are laudable, commentators have noted that it appears to have created a substantial unfunded burden on the resources of hospitals and emergency physicians. As a result of financial difficulty, between the period of 1991–2011, 12.6% of EDs in the US closed. 1120:

training programs for specialists, notably the University of Chile, Pontifical Catholic University of Chile, Clínica Alemana – Universidad del Desarrollo, San Sebastian University – MUE and University of Santiago of Chile (USACH). Currently, and intending to strengthen the speciality at the country level, FOAMed initiatives have emerged (free open access medical education in emergency medicine) and the #ChileEM initiative that brings together the programs of the Universidad San Sebastián / MUE, Universidad Católica de Chile and Universidad de Chile, intend to hold joint clinical meetings between the leading training programs, regularly and open to all the health team working in the field of urgency. The specialists already trained are grouped in the Chilean Society of Emergency Medicine (SOCHIMU).

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provides training to its employees. The nacional emergency medicina association (ABRAMEDE – Associação Brasileira de Medicina de Emergência) was created in 2007. In 2008 the second residency program was started at Messejana Hospital in Fortaleza. Then, in 2015, emergency medicine was formally recognized as a medical specialty by the Brazilian Medical Association. After formal recognition, multiple residency programs were created nationwide (e.g. Universidade Federal de Minas Gerais in 2016 and Universidade de São Paulo in 2017). The residency consists of a three-year program with training in all emergency department specialties (i.e. internal medicine, surgery, pediatrics, orthopedics, OB/GYN), EMS and intensive care.

809:" incentives and penalty measures under commercial and public health programs, including Medicare and Medicaid. This payment reform aims to improve the quality of care and control costs, despite the differing opinions on the existing evidence to show that this payment approach is effective in emergency medicine. Initially, these incentives would only target primary care providers (PCPs), but some would argue that emergency medicine is primary care, as no one refers patients to the ED. In one such program, two specific conditions listed were directly tied to patients frequently seen by emergency medical providers: acute myocardial infarction and pneumonia.(See: 972:

taken to the emergency department. Most developing countries follow the Anglo-American model: the gold standard is three or four-year independent residency training programs in emergency medicine. Some countries develop training programs based on a primary care foundation with additional emergency medicine training. In developing countries, there is an awareness that Western models may not be applicable and may not be the best use of limited health care resources. For example, speciality training and pre-hospital care in developed countries are too expensive and impractical for use in many developing countries with limited health care resources.

821:. Additionally, adjustments based on patient risk-level and multiple co-morbidities for complex patients further complicate attribution of positive or negative health outcomes. It is not easy to assess whether much of the costs directly result from the emergent condition treated in acutely care settings. It is also difficult to quantify the savings due to preventive care during emergency treatment (i.e. workup, stabilizing treatments, coordination of care and discharge, rather than a hospital admission). Thus, ED providers tend to support a modified fee-for-service model over other payment systems. 1504:

is divided into six months each, and the rest six months out of the first two years are spent in the emergency department. In the last three years, trainee residents spend most of their time in the emergency room as senior residents. Certificate courses include ACLS, PALS, ATLS, and research and dissertations are required to complete the training successfully. At the end of five years, candidates become eligible to sit for the FCPS part II exam. After fulfilling the requirement, they become fellows of the College of Physicians and Surgeons Pakistan in emergency medicine (

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ED overuse produces $ 38 billion in wasteful spending each year (i.e. care delivery and coordination failures, over-treatment, administrative complexity, pricing failures, and fraud), Moreover, it unnecessarily drains departmental resources, reducing the quality of care across all patients. While overuse is not limited to the uninsured, the uninsured constitute a growing proportion of non-urgent ED visits. Insurance coverage can help mitigate overutilization by improving access to alternative forms of care and lowering the need for emergency visits.

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admitted. In terms of procedure's they cover a wide and broad range, including treatment to GSW's (Gun Shot Wounds), Head and body traumas, stomach bugs, mental episodes, seizures and much more. They are some of the most highly trained physicians in the world and are responsible for providing immediate recognition, evaluation, care, and stabilisation to adult and paediatric patients in response to acute illness and injury.As well as being the first point of care for many patients in emergency situations.

596:, and there is little scope for private emergency practice. In other countries like Australia, New Zealand, or Turkey, emergency medicine specialists are almost always salaried employees of government health departments and work in public hospitals, with pockets of employment in private or non-government aeromedical rescue or transport services, as well as some private hospitals with emergency departments; they may be supplemented or backed by non-specialist medical officers, and visiting 29: 705: 525:, which refers to primary healthcare for less emergent medical issues, but there is obvious overlap, and many emergency physicians work in urgent care settings. Emergency medicine also includes many aspects of acute primary care and shares with family medicine the uniqueness of seeing all patients regardless of age, gender or organ system. The emergency physician workforce also includes many competent physicians who have medical skills from other specialities. 6461: 5345: 648: 1237:

hospital-based, but the residents are selected and managed by the municipal associations of medical education. These associations are also the authoritative body of setting up their residents' training curriculum. All medical school graduates who want to practice medicine have to undergo five years of residency training at designated training bases, the first three years of general rotation followed by two more years of speciality-centred training.

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other specialists. In many smaller emergency departments, nurses would triage patients, and physicians would be called in based on the type of injury or illness. Family physicians were often on call for the emergency department and recognized the need for dedicated emergency department coverage. Many of the pioneers of emergency medicine were family physicians and other specialists who saw a need for additional training in emergency care.

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pre-hospital setting, providers must exercise appropriate judgement in choosing a suitable hospital for transport. Hospitals can only turn away incoming ambulances if they are on diversion and incapable of providing adequate care. However, once a patient has arrived on hospital property, care must be provided. At the hospital, a triage nurse first contacts the patient, who determines the appropriate level of care needed.

6481: 6471: 518:). This generalist approach can obviate barrier-to-care issues seen in systems without specialists in emergency medicine, where patients requiring immediate attention are instead managed from the outset by speciality doctors such as surgeons or internal physicians. However, this may lead to barriers through acute and critical care specialities disconnecting from emergency care. 855:

chronic diseases can also reduce overutilization and help manage costs of care. Moreover, physician knowledge of prices for treatment and analyses, discussions on costs with their patients, and a changing culture away from defensive medicine can improve cost-effective use. A transition towards more value-based care in the ED is an avenue by which providers can contain costs.

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the Mental Health Act, as increasing numbers of suicide attempts and self-harm are seen in the emergency department. The Wooltorton case of 2007, in which a patient arrived at the emergency department post overdose with a note specifying her request for no interventions, highlights the dichotomy that often exists between a physician's ethical obligation to "

847:), is obligated to treat emergency conditions regardless of a patient's ability to pay and therefore faces an economic loss for this uncompensated care. Estimates suggest that over half (approximately 55%) of all quantifiable emergency care is uncompensated and inadequate reimbursement has led to the closure of many EDs. Policy changes (such as the 764:(defined as "visits for conditions for which a delay of several hours would not increase the likelihood of an adverse outcome"). As such, EDs can adjust staffing ratios and designate an area of the department for faster patient turnover to accommodate various patient needs and volumes. Policies have improved to assist better ED staff (such as 1152:

more academically oriented careers, which emphasize administration, research, critical care, disaster medicine, and teaching. They also tend to sub-specialize in toxicology, critical care, pediatric emergency medicine, and sports medicine. Furthermore, the FRCP(EM) residency length allows more time for formal training in these areas.

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essential tasks for patient-physician communication: establishing rapport, gathering information, giving information, providing comfort, and collaboration. The miscommunication of patient information is a crucial source of medical error; minimising shortcoming in communication remains a topic of current and future research.

402:, and other generalist physicians. However, in recent decades it has become recognised as a speciality in its own right with its training programmes and academic posts, and the speciality is now a popular choice among medical students and newly qualified medical practitioners. By contrast, in countries following the 636:. In 1967, the Casualty Surgeons Association was co-established with Maurice Ellis as its first president. In the US, the first of such groups managed by Dr James DeWitt Mills in 1961, along with four associate physicians; Dr Chalmers A. Loughridge, Dr William Weaver, Dr John McDade, and Dr Steven Bednar, at 1431:(BCEM) grants board certification in emergency medicine to physicians who have not completed an emergency medicine residency but have completed a residency in other fields (internists, family practitioners, paediatricians, general surgeons, and anesthesiologists). The BCEM is under the authority of the 1528:

Ethical and medico-legal issues are embedded within the nature of emergency medicine. Issues surrounding competence, end of life care, and the right to refuse care are encountered daily within the emergency department. Of growing significance are the ethical issues and legal obligations that surround

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Emergency medicine as an independent medical speciality is relatively young. Before the 1960s and 1970s, hospital emergency departments (EDs) were generally staffed by physicians on staff at the hospital on a rotating basis, among them family physicians, general surgeons, internists, and a variety of

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CCFP(EM) emergency physicians outnumber FRCP(EM) physicians by a ratio of about 3 to 1, and they tend to work primarily as clinicians with a minor focus on academic activities such as teaching and research. FRCP(EM) Emergency Medicine Board specialists tend to congregate in academic centres and have

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In Chile, emergency medicine begins its journey in Chile with the first speciality program at the beginning of the 1990s, at the University of Chile and the University of Santiago of Chile. Currently, it is a primary speciality legally recognised by the Ministry of Health since 2013. It has multiple

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Emergency medical physicians provide treatments to a range of cases requiring vast knowledge. They deal with patients from mental illnesses to physical and anything in-between. An average treatment process would likely involve, investigation then diagnosis then either treatment or the patient being

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In 1990 the UK's Casualty Surgeons Association changed its name to the British Association for Accident and Emergency Medicine and subsequently became the British Association for Emergency Medicine (BAEM) in 2004. In 1993, an intercollegiate Faculty of Accident and Emergency Medicine (FAEM) became a

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The College of Physicians and Surgeons Pakistan accredited the training in emergency medicine in 2010. Emergency medicine training in Pakistan lasts for five years. The initial two years involve trainees being sent to three major areas: medicine and allied, surgery, and allied and critical care. It

1282:, Universiti Kebangsaan Malaysia, and Universiti Malaya) that offer master's degrees in emergency medicine – postgraduate training programs of four years in duration with clinical rotations, examinations and a dissertation. The first cohort of locally trained emergency physicians graduated in 2002. 1232:

The current post-graduate emergency medicine training process is highly complex in China. The first EM post-graduate training took place in 1984 at the Peking Union Medical College Hospital. Because speciality certification in EM has not been established, formal training is not required to practice

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ambulance. For example, in France and Germany, the physician, often an anesthesiologist, rides in the ambulance and provides stabilising care at the scene. The patient is directed to the appropriate hospital department, so emergency care is much more multidisciplinary than the Anglo-American model.

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As stated above, EMTALA includes provisions that protect patients from being turned away or transferred before adequate stabilisation. Upon making contact with a patient, EMS providers are responsible for diagnosing and stabilising a patient's condition without regard for the ability to pay. In the

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Some patients without health insurance utilize EDs as their primary form of medical care. Because these patients do not utilize insurance or primary care, emergency medical providers often face overutilization and financial loss, especially since many patients cannot pay for their care (see below).

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applied the idea of ambulances, or "flying carriages", for rapid transport of wounded soldiers to a central place where medical care was more accessible and practical. Larrey operated ambulances with trained crews of drivers, corpsmen and litter-bearers and had them bring the wounded to centralized

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Emergency medicine is a medical speciality—a field of practice based on the knowledge and skills required to prevent, diagnose, and manage acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders.

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In recent years, workforce data has led to a recognition of the need for additional training for primary care physicians who provide emergency care. It has led to several supplemental training programs in first-hour emergency care and a few fellowships for family physicians in emergency medicine.,

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respond to out-of-hospital emergencies and transport patients to emergency departments, meaning there is more dependence on these healthcare providers and there is more dependence on paramedics and EMTs for on-scene care. Emergency physicians are therefore more "specialists" since all patients are

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In addition to decreasing the uninsured rate, ED overutilization might reduce by improving patient access to primary care and increasing patient flow to alternative care centres for non-life-threatening injuries. Financial disincentives, patient education, and improved management for patients with

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Since 2005 residency training exists for acute medicine (3 years) or emergency medicine (6 years). At least 50% of the training is in the emergency department; the other part is a rotation between disciplines like pediatrics, surgery, orthopedic surgery, anesthesiology and critical care medicine.

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Despite the practice emerging over the past few decades, the delivery of emergency medicine has significantly increased and evolved across diverse settings related to cost, provider availability and overall usage. Before the Affordable Care Act (ACA), emergency medicine was leveraged primarily by

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The practice of emergency medicine is often quite different in rural areas where there are far fewer other specialities and healthcare resources. In these areas, family physicians with additional skills in emergency medicine often staff emergency departments. Rural emergency physicians may be the

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to patients during off-hours and those who do not have primary care providers. Most patients present to emergency departments with low-acuity conditions (such as minor injuries or exacerbations of chronic disease), but a small proportion will be critically ill or injured. Therefore, the emergency

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India is an example of how family medicine can be a foundation for emergency medicine training. Many private hospitals and institutes have been providing emergency medicine training for doctors, nurses and paramedics since 1994, with certification programs varying from six months to three years.

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Alternative an attending physician with one of following specialities (anesthesiology, internal medicine, cardiology, gastro-enterology, pneumology, rheumatology, urology, general surgery, plastic & reconstructive surgery, orthopedic surgery, neurology, neurosurgery, pediatrics) can follow a

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The Australian College of Rural and Remote Medicine (ACRRM) is the responsible body for the training and upholding of standards for practice and provision of rural and remote medical care. Prospective rural generalists undertaking this four-year fellowship program have an opportunity to complete

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and near misses. One study identified an error rate of 18 per 100 registered patients in one particular academic ED. Another study found that where a lack of teamwork (i.e. poor communication, lack of team structure, lack of cross-monitoring) was implicated in a particular incident of ED medical

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The setting of emergency medicine presents a challenge for delivering high quality, patient-centered care. Clear, effective communication can be particularly difficult due to noise, frequent interruptions, and high patient turnover. The Society for Academic Emergency Medicine has identified five

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Many hospitals and care centres feature departments of emergency medicine, where patients can receive acute care without an appointment. While many patients get treated for life-threatening injuries, others utilize the emergency department (ED) for non-urgent reasons such as headaches or a cold.

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Emergency medicine is still not recognised as a fully-fledged speciality in a country that has only recently grasped the importance of having an organised acute medical speciality (during the COVID-19 outbreak). Many attempts to organize the speciality have resulted in a subspecialists training

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In Saudi Arabia, the Certification of Emergency Medicine takes the four-year Saudi Board of Emergency Medicine (SBEM), which the Saudi Council accredits for Health Specialties (SCFHS). It requires passing the two-part exam: first and final part (written and oral) to obtain the SBEM certificate,

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In Brazil, the first emergency medicine residency program was created at Hospital Pronto Socorro de Porto Alegre in 1996. In 2002, the emergency medical services were standardized nationally with the creation of SAMU (Serviço de atendimento móvel de urgência), inspired by French EMS, which also

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Injury and illness are often unforeseen, and patients of lower socioeconomic status are especially susceptible to being suddenly burdened with the cost of a necessary ED visit. For example, in the event that a patient is unable to pay for medical care received, the hospital, under the Emergency

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Emergency physicians are compensated at a higher rate than some other specialities, ranking 10th out of 26 physician specialities in 2015, at an average salary of $ 306,000 annually. They are compensated in the mid-range (averaging $ 13,000 annually) for non-patient activities, such as speaking

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De Robertis, Edoardo; Böttinger, Bernd W.; Søreide, Eldar; Mellin-Olsen, Jannicke; Theiler, Lorenz; Ruetzler, Kurt; Hinkelbein, Jochen; Brazzi, Luca; Thies, Karl-Christian; et al. (ESA/EBA taskforce on Critical Emergency Medicine) (1 May 2017), "The monopolisation of Emergency Medicine in

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The first residency program in Iran started in 2002 at Iran University of Medical Sciences, and there are now three-year standard residency programs running in Tehran, Tabriz, Mashhad, Isfahan, and some other universities. All these programs work under the supervision of the emergency medicine

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About a decade ago, emergency medicine residency training was centralized at the municipal levels, following the Ministry of Public Health guidelines. Residency programs in all hospitals are called residency training bases, which have to be approved by local health governments. These bases are

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In Belgium there are three recognised ways to practice emergency medicine. Until 2005 there was no accredited emergency medicine program. Emergency medicine was performed by general practitioners (having followed a 240-hour course, Acute Medicine) or by specialists (surgeon, internal medicine,

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Emergency medicine is a primary or first-contact point of care for patients requiring the use of the health care system. Specialists in emergency medicine are required to possess specialist skills in acute illness diagnosis and resuscitation. Emergency physicians are responsible for providing

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group of doctors staffing an emergency department under contract), institutional (physicians with or without an independent contractor relationship with the hospital), corporate (physicians with an independent contractor relationship with a third-party staffing company that services multiple

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The field of emergency medicine encompasses care involving the acute care of internal medical and surgical conditions. In many modern emergency departments, emergency physicians see many patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or

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There are a variety of international models for emergency medicine training. There are two different models among those with well-developed training programs: a "specialist" model or "a multidisciplinary model". Additionally, in some countries, the emergency medicine specialist rides in the

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In emergency departments in Australia, the government utilises an "Activity based funding and management", meaning that the amount of funding to emergency departments are allocated money based on the number of patients and the complexity of their cases or illnesses. However, rural emergency

1443:), international medicine, advanced resuscitation, hospice and palliative care, research, undersea and hyperbaric medicine, sports medicine, pain medicine, ultrasound, pediatric emergency medicine, disaster medicine, wilderness medicine, toxicology, and critical care medicine. 987:

In Argentina, the SAE (Sociedad Argentina de Emergencias) is the leading organisation of emergency medicine. There are many residency programs. Also, it is possible to reach the certification with a two-year postgraduate university course after a few years of ED background.

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Institutions providing this training include Shifa International Hospitals Islamabad, Aga Khan University Hospital Karachi, POF Hospital Wah, Lady Reading Hospital Peshawar, Indus Hospital Karachi and Jinnah Post Graduate Medical Center Karachi, and Mayo Hospital, Lahore.

2857:"Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2003 and Inclusion of Registered Nurses in the Personnel Provision of the Critical Access Hospital Emergency Services Requirement for Frontier Areas and Remote Locations" 784:, urgent care clinics or detoxification facilities. The emergency department, welfare programs, and healthcare clinics serve as a critical part of the healthcare safety net for uninsured patients who cannot afford medical treatment or adequately utilize their coverage. 321:, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency medical physicians generally practice in 1147:(Advanced Competency Certification). The CFPC also allows those are having worked a minimum of four years at a minimum of 400 hours per year in emergency medicine to challenge the examination of special competence in emergency medicine and thus become specialized. 1494:

Emergency medicine residencies last four years in Turkey. These physicians have a two-year obligatory service in Turkey to be qualified to have their diploma. After this period, EM specialists can choose to work in private or governmental emergency departments.

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Weber, Ellen J.; Showstack, Jonathan A.; Hunt, Kelly A.; Colby, David C.; Grimes, Barbara; Bacchetti, Peter; Callaham, Michael L. (2008). "Are the Uninsured Responsible for the Increase in Emergency Department Visits in the United States?".

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Sharma, Aabha I.; Dresden, Scott M.; Powell, Emilie S.; Kang, Raymond; Feinglass, Joe (2016). "Emergency Department Visits and Hospitalizations for the Uninsured in Illinois Before and After Affordable Care Act Insurance Expansion".

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There are some challenges with implementing these quality-based incentives in emergency medicine in that patients are often not given a definitive diagnosis in the ED, making it challenging to allocate payments through

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For medical doctors not (and not wishing to be) specialists in emergency medicine but have a significant interest or workload in emergency departments, the ACEM provides non-specialist certificates and diplomas.

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A common misconception pegs frequent ED visitors as a significant factor in wasteful spending. However, frequent ED users make up a small portion of those contributing to overutilization and are often insured.

3301: 4683: 1257:. Emergency physicians usually work on a volunteering basis and are often anesthesiologists but maybe specialists of any kind. Especially there is a specialization training in pediatric intensive care. 3749:

Risser, Daniel T; Rice, Matthew M; Salisbury, Mary L; Simon, Robert; Jay, Gregory D; Berns, Scott D (1999). "The Potential for Improved Teamwork to Reduce Medical Errors in the Emergency Department".

1475:. Speciality training takes six years to complete, and success in the assessments and a set of five examinations results in the award of Fellowship of the Royal College of Emergency Medicine (FRCEM). 788:

departments of Australia are funded under the principle of providing the necessary equipment and staffing levels required to provide safe and adequate care, not necessarily on the number of patients.

2264:"Emergency Medical Technicians Use Checklist To Identify Intoxicated Individuals who Can Safely Go to Detoxification Facility Rather Than Emergency Department | AHRQ Health Care Innovations Exchange" 868: 3714:

Fordyce, James; Blank, Fidela S.J.; Pekow, Penelope; Smithline, Howard A.; Ritter, George; Gehlbach, Stephen; Benjamin, Evan; Henneman, Philip L. (2003). "Errors in a busy emergency department".

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emergency departments), or governmental (for example, when working within personal service military services, public health services, veterans' benefit systems or other government agencies).

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During this period, physicians began to emerge who had left their respective practices to devote their work entirely to the ED. In the UK in 1952, Maurice Ellis was appointed as the first "

679:. The second residency program in the United States soon followed at what was then called Hennepin County General Hospital in Minneapolis, with two residents entering the program in 1971. 933:

Many circumstances, including the regular transfer of patients in emergency treatment and crowded, noisy and chaotic ED environments, make emergency medicine particularly susceptible to

4202: 1421: 317:(often called "ER doctors" in the United States) specialize in providing care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with 3825: 3437:

Peterson, Lars E.; Dodoo, Martey; Bennett, Kevin J.; Bazemore, Andrew; Phillips, Robert L. (2008). "Nonemergency Medicine-Trained Physician Coverage in Rural Emergency Departments".

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Venkatesh, Arjun K.; Schuur, Jeremiah D. (2013). "A 'Top Five' list for emergency medicine: A policy and research agenda for stewardship to improve the value of emergency care".

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in England and Scotland to arrange professional examinations and training. In 2005, the BAEM and the FAEM became a single unit to form the College of Emergency Medicine, now the

1000:(ACEM). The training program is nominally seven years in duration, after which the trainee is awarded a Fellowship of ACEM, conditional upon passing all necessary assessments. 1478:

Historically, emergency specialists were drawn from anaesthesia, medicine, and surgery. Many established EM consultants were surgically trained; some hold the fellowship of

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Sasson, Comilla; Wiler, Jennifer L.; Haukoos, Jason S.; Sklar, David; Kellermann, Arthur L.; Beck, Dennis; Urbina, Chris; Heilpern, Kathryn; Magid, David J. (2012).

2263: 1253:(medical association, responsible for licensing of physicians). Service as an emergency physician in an ambulance service is part of the specialization training of 449:

It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development.

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Most programs are three years in duration, but some programs are four years long. There are several combined residencies offered with other programs, including

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that emergency medicine became a recognized medical speciality in the US. The first emergency medicine residency program in the world began in 1970 at the

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Fischer, Miriam; Hemphill, Robin R.; Rimler, Eva; Marshall, Stephanie; Brownfield, Erica; Shayne, Philip; Di Francesco, Lorenzo; Santen, Sally A. (2012).

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Bullock, Kim A.; Gerard, W. Anthony; Stauffer, Arlen R. (2007). "The Emergency Medicine Workforce and the IOM Report: Embrace the Legacy Generation".

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has a role in setting professional standards and assessing trainees. Emergency medical trainees enter speciality training after five or six years of

3990: 2154: 2015: 600:. Rural emergency departments are sometimes run by general practitioners alone, sometimes with non-specialist qualifications in emergency medicine. 4729: 3287: 1417: 844: 3784:

Fairbanks, Rollin J.; Crittenden, Crista N.; o'Gara, Kevin G.; Wilson, Matthew A.; Pennington, Elliot C.; Chin, Nancy P.; Shah, Manish N. (2008).

1922: 1249:), but any licensed physician can acquire an additional qualification in emergency medicine through an 80-hour course monitored by the respective 580:

Patterns vary by country and region. In the United States, the employment arrangement of emergency physician practices are either private (with a

5181: 2799: 1386:. The US is well known for its excellence in emergency medicine residency programs, leading to some controversy about speciality certification. 5185: 3786:"Emergency Medical Services Provider Perceptions of the Nature of Adverse Events and Near-misses in Out-of-hospital Care: An Ethnographic View" 2543:"Recent Studies and Reports on Physician Shortages in the US: Emergency Medicine (2009) – "Emergency Care System Remains in Serious Condition"" 715: 4199: 1984: 1366:

pathway, but to this day, internal medicine, anesthesiology and surgery are still vocally opposed to an emergency medicine specialist title.

612:, after seeing the speed with which the carriages of the French flying artillery maneuvered across the battlefields, French military surgeon 462:

and advanced airway management. They must have some of the core skills from many medical specialities—the ability to resuscitate a patient (

5201: 4945: 3833: 1428: 5307: 5196: 4138: 2885:

Langland-Orban, B; Pracht, E; Salyani, S (2005). "Uncompensated care provided by emergency physicians in Florida emergency departments".

997: 2129: 5990: 3147:

Lee, T. M. (2004). "An EMTALA primer: The impact of changes in the emergency medicine landscape on EMTALA compliance and enforcement".

2669: 848: 691:, which conducts membership and fellowship examinations and publishes guidelines and standards for the practice of emergency medicine. 458:

physician requires broad knowledge and procedural skills, often including surgical procedures, trauma resuscitation, advanced cardiac

6331: 5173: 4584: 261: 255: 947:

immediate recognition, evaluation, care, and stabilisation to adult and pediatric patients in response to acute illness and injury.

805:

American health payment systems are undergoing significant reform efforts, Which include compensating emergency physicians through "

5387: 5191: 1004: 810: 656: 5930: 5211: 1432: 4684:"Legal and ethical aspects of refusing medical treatment after a suicide attempt: the Wooltorton case in the Australian context" 3966:"Emergency Medicine – Medical Specialties – Medical Specialties – Explore Options – Choose Your Specialty – Careers in Medicine" 5221: 5061: 4877: 4463:"Financing of Emergency Medicine Graduate Medical Education Programs in an Era of Declining Medicare Reimbursement and Support" 4294: 4080: 2046: 1479: 1144: 4184: 4171: 2990:

Schilling, Ulf Martin (2010). "Cutting costs: The impact of price lists on the cost development at the emergency department".

5472: 4802: 4783: 2938: 2439: 1410: 668: 621:

units. Dominique Jean Larrey is sometimes called the Father of Emergency Medicine for his strategies during the French wars.

6230: 5216: 5033: 3965: 1398: 5380: 5301: 5231: 5206: 4588: 4431: 1610: 1464: 1326: 1193: 1054: 688: 4558: 2542: 2200: 6366: 5708: 4055: 1520:

speciality board committee. There are now more than 200 (and increasing) board-certified Emergency Physicians in Iran.

1008: 2374: 2349: 4756: 3695: 2335: 1599: 1352: 1219: 1080: 745: 676: 4023: 3583:"Resuscitating the physician-patient relationship: Emergency department communication in an academic medical center" 2965:"New report projects a $ 5.7 billion drop in hospitals' uncompensated care costs because of the Affordable Care Act" 1989:. Josiah Macy, Jr. Foundation Conference on the Future of Emergency Medicine. Williamsburg, Virginia. Archived from 1334: 1201: 1062: 5056: 4998: 4938: 1563: 973: 806: 664: 431: 3255: 5295: 5235: 5008: 2155:

http://www.collemergencymed.ac.uk/CEM/History%20of%20the%20specialty/Emergency%20Medicine%20Landmarks/default.asp

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Rhodes, K. V.; Vieth, T; He, T; Miller, A; Howes, D. S.; Bailey, O; Walter, J; Frankel, R; Levinson, W (2004).

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Oster, Ady; Bindman, Andrew B. (2003). "Emergency Department Visits for Ambulatory Care Sensitive Conditions".

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Jesus, John; Grossman, Shamai A; Derse, Arthur R; Adams, James G; Wolfe, Richard; Rosen, Peter, eds. (2012).

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Epstein, Arnold M. (2012). "Will Pay for Performance Improve Quality of Care? The Answer is in the Details".

2224:"Deciding to Visit the Emergency Department for Non-Urgent Conditions: A Systematic Review of the Literature" 968: 618: 443: 1948:

Williams, Janet M.; Ehrlich, Peter F.; Prescott, John E. (2001). "Emergency medical care in rural America".

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Several ABMS fellowships are available for emergency medicine graduates, including pre-hospital medicine (

6525: 5980: 5655: 5573: 5545: 5535: 5530: 5462: 5434: 5348: 4931: 3994: 2866:. Department of Health and Human Services, Centers for Medicare & Medicaid Services. 31 December 2002 2222:

Uscher-Pines, Lori; Pines, Jesse; Kellermann, Arthur; Gillen, Emily; Mehrotra, Ateev (28 November 2016).

2032: 2012: 675:. Furthermore, the first department of emergency medicine at a US medical school occurred in 1971 at the 572:

only health care providers in the community and require skills that include primary care and obstetrics.

411: 2694: 6530: 5960: 5403: 4973: 3472: 3118:"42 U.S. Code § 1395dd – Examination and treatment for emergency medical conditions and women in labor" 1926: 1817:"Advanced Practice' Family Physicians as the Foundation for Rural Emergency Medicine Services (Part I)" 1543: 1440: 368: 333: 318: 2806: 996:

The specialist medical college responsible for emergency medicine in Australia and New Zealand is the

863:

Doctors that work in the EDs of hospitals receiving Medicare funding are subject to the provisions of

6389: 5442: 1279: 637: 491: 3280: 2899: 2176: 6181: 6103: 6098: 6018: 5778: 5513: 5452: 3622:"Patient Communication During Handovers Between Emergency Medicine and Internal Medicine Residents" 3494: 3183:"America's Unraveling Safety Net: EMTALA's Effect on Emergency Departments, Problems and Solutions" 1315: 1267: 1182: 1043: 672: 4585:"The College of Emergency Medicine. A trainee's guide to Specialty Training in Emergency Medicine" 4406: 3507: 1990: 1482:

in accident and emergency – FRCSEd (A&E). trainees in emergency medicine may dual accredit in

6161: 6135: 4837: 1483: 1319: 1186: 1047: 851:) are expected to decrease the number of uninsured people and thereby reduce uncompensated care. 780:

and nurse practitioners direct patients towards more appropriate medical settings, such as their

727: 633: 593: 463: 406:

model, the speciality does not exist, and emergency medical care is instead provided directly by

99: 4657: 1094:

neurologist, anesthesiologist) with or without supra-speciality training in emergency medicine.

897:

Alternatively, emergency medicine in urban areas consists of diverse provider groups, including

5753: 5701: 5578: 4988: 3556: 3028:"Cutting costs – the impact of price-lists on the cost development in the emergency department" 2894: 1558: 1420:(AOBEM) certifies only emergency physicians with a DO degree. It is under the authority of the 781: 773: 684: 537: 507: 364: 148: 4258: 1733:"A very warm welcome to the website of the International Federation for Emergency Medicine.". 528:

Physicians specializing in emergency medicine can enter fellowships to receive credentials in

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American Sirens: The Incredible Story of the Black Men Who Became America's First Paramedics

2293:"The Changing Landscape of America's Health Care System and the Value of Emergency Medicine" 963:

In countries such as the US, the United Kingdom, Canada and Australia, ambulances crewed by

723: 6424: 6384: 6251: 6065: 6060: 6040: 5975: 5827: 5540: 5503: 5106: 4983: 4968: 1472: 1155: 644:, established 24/7 year-round emergency care, which became known as the "Alexandria Plan". 641: 399: 360: 325: 212: 176: 4826: 4592: 2831: 818: 16:

Medical specialty concerned with care for patients who require immediate medical attention

8: 6504: 6446: 6429: 6088: 5805: 5675: 5482: 5085: 5079: 5067: 3937: 3182: 1583: 1390: 902: 777: 565: 372: 337: 314: 166: 3855:

Gallagher, Thomas H.; Waterman, A. D.; Ebers, A. G.; Fraser, V. J.; Levinson, W (2003).

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Bebber, R. J.; Liberman, A (2005). "Reimbursement challenges for emergency physicians".

1923:"Critical Challenges: Family Physicians in Emergency Medicine 2006, AAFP Position Paper" 1875:"Trends in Emergency Department Use by Rural and Urban Populations in the United States" 390:

Various models for emergency medicine exist internationally. In countries following the

6394: 6351: 6341: 6083: 6050: 6045: 5795: 5773: 5593: 5419: 5259: 5163: 4711: 4699: 4388: 4383: 4366: 4342: 4317: 4267: 4242: 3914: 3897: 3646: 3621: 3383: 3371: 3302:"CMS Question and Answer Program Memorandum on EMTALA On-Call Responsibilities // ACEP" 3054: 3027: 3015: 2920: 2781: 2240: 2223: 1899: 1874: 1798: 1711: 1686: 1662: 1637: 1402: 541: 475: 384: 356: 243: 4506:(6th ed.). Burlington, Massachusetts: Jones & Bartlett Learning. p. 131. 3762: 3727: 3598: 2733: 2573: 2428:(6th ed.). Burlington, Massachusetts: Jones & Bartlett Learning. p. 264. 1890: 1851: 6490: 6464: 6346: 6316: 6295: 6258: 6241: 6156: 6120: 6110: 6005: 5925: 5869: 5832: 5817: 5758: 5725: 5694: 5670: 5650: 5634: 5624: 5565: 5158: 4993: 4978: 4798: 4779: 4762: 4752: 4703: 4638: 4540: 4484: 4347: 4272: 4084: 3919: 3878: 3807: 3802: 3785: 3766: 3731: 3691: 3651: 3602: 3560: 3454: 3450: 3375: 3340: 3156: 3094: 3059: 3007: 2912: 2908: 2773: 2737: 2577: 2524: 2486: 2482: 2314: 2245: 1965: 1904: 1855: 1790: 1716: 1667: 1568: 1530: 1379: 1003:

Dual fellowship programs also exist for paediatric medicine (in conjunction with the

629: 609: 557: 434:

programs offer hope of improving primary emergency care where resources are limited.

415: 352: 302: 84: 4715: 4392: 4318:"Family Physicians in Emergency Medicine: New Opportunities and Critical Challenges" 3387: 3117: 3019: 2785: 2309: 2292: 2050: 1816: 6474: 6166: 6151: 6028: 5903: 5859: 5560: 5487: 4695: 4634: 4630: 4530: 4474: 4378: 4337: 4329: 4262: 4254: 4222:

Cho, E; Akkapeddi, V; Rajagopalan, A. "Developing Emerg Med Through Primary Care".

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supra-speciality program of two years to become an emergency medicine specialist.

430:

as appropriate. Emergency medicine is still evolving in developing countries, and

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Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli))

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The two routes to emergency medicine certification can be summarized as follows:

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Hyman, D. A. (1998). "Patient dumping and EMTALA: Past imperfect/future shock".

2924: 1266:

However, emergency medicine was only recognized as a separate speciality by the

1011:). These programs nominally add one or more years to the ACEM training program. 976:

provides a critical global perspective and hope for improvement in these areas.

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Kutscher B. Hospitals fall short on ACA charity-care rules. Modern Healthcare.

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Baumann, Michael R.; Vadeboncoeur, Tyler F.; Schafermeyer, Robert W. (2004).

3402:"Improving efficiency and preserving access to emergency care in rural areas" 2546: 2399: 1815:

Bullock, Kim; MacMillan Rodney, William; Gerard, Tony; Hahn, Ricardo (2000).

934: 529: 403: 28: 4141:. Associação Brasileira de Medicina de Emergência – ABRAMEDE. Archived from 3873: 3856: 1961: 6414: 6399: 6225: 5950: 5800: 5785: 5731: 5629: 5583: 5447: 5414: 5013: 4707: 4642: 4544: 4488: 4351: 4276: 3882: 3811: 3770: 3735: 3655: 3606: 3564: 3458: 3379: 3344: 3205:"Jones v. Wake County Hosp. System, Inc., 786 F. Supp. 538 (E.D.N.C. 1991)" 3160: 3098: 3063: 3011: 2916: 2777: 2741: 2581: 2528: 2490: 2318: 2249: 1969: 1908: 1859: 1794: 1720: 1671: 1615: 1605: 1139:

A one-year emergency medicine enhanced skills program following a two-year

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Blake, V (2012). "When is a Patient-Physician Relationship Established?".

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Emergency physicians and registered nurses conducting a trauma evaluation.

6273: 6218: 6115: 5970: 5945: 5763: 5148: 5112: 3826:"When Doctors Admit Mistakes, Fewer Malpractice Suits Result, Study Says" 2520: 1653: 1136:(Emergency Medicine Board Certification – emergency medicine consultant). 869:

Office of Inspector General, U.S. Department of Health and Human Services

522: 511: 427: 345: 1702: 1638:"Casualty, accident and emergency, or Emergency Medicine, the evolution" 453:

releasing them after treatment as necessary. They also provide episodic

6361: 6246: 6213: 5985: 5935: 5920: 5915: 5908: 5893: 5883: 5525: 5324: 5133: 5047: 1771: 1383: 1158:

are currently practising in the field of emergency medicine in Canada.

1132:

A five-year residency leads to the designation of FRCP(EM) through the

964: 769: 647: 533: 503: 495: 479: 143: 128: 2013:

http://www.collemergencymed.ac.uk/temp/1026-cec_maurice_ellis_info.pdf

659:(ACEP) the recognition of emergency medicine training programs by the 6434: 6176: 6171: 6035: 6013: 5888: 5852: 5598: 5508: 5477: 5243: 5128: 5095: 4923: 4616:"Ethics Curriculum for Emergency Medicine Graduate Medical Education" 4333: 2805:. The Henry J. Kaiser Family Foundation. October 2007. Archived from 1588: 1573: 1553: 898: 515: 487: 133: 104: 4899:

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Report to the Congress: Medicare and the Health Care Delivery System

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Circuit., United States Court of Appeals, Fourth (7 October 1992).

2971:. U.S. Department of Health & Human Services. 24 September 2014 2172:

Royal College of Emergency Medicine – Excellence in Emergency Care

1687:"Emergency medical care in developing countries: Is it worthwhile?" 1245:

In Germany, emergency medicine is not handled as a specialization (

322: 278: 224: 2560:

Sikka, Rishi (2007). "Pay for Performance in Emergency Medicine".

1986:

What is clinical emergency medicine? A family practice perspective

1422:

American Osteopathic Association Bureau of Osteopathic Specialists

6419: 5879: 5847: 5740: 4407:"The Department of Family Medicine Emergency Medicine Fellowship" 4367:"CALS Training Provides Solution to Emergency Provider Shortages" 4115:. Australian College of Rural and Remote Medicine. Archived from 3895: 2221: 1814: 1447:

and few fellowships for family physicians in emergency medicine.

617:

field hospitals, effectively creating a forerunner of the modern

395: 306: 153: 4561:. Association of American Medical Colleges. 2012. Archived from 4116: 4098: 3495:

https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/

3473:"$ 22.1 Million to Improve Access to Health Care in Rural Areas" 5023: 4460: 3508:

http://www.modernhealthcare.com/article/20151028/news/151029886

1505: 864: 483: 310: 282: 109: 89: 2668:. New England Healthcare Institute. March 2010. Archived from 4872: 4559:"Recent Studies and Reports on Physician Shortages in the US" 4022:. Australasian College for Emergency Medicine. Archived from 3619: 2072: 1486:

or seek sub-specialisation in paediatric emergency medicine.

1143:

residency leading to the designation of CCFP(EM) through the

714:

deal primarily with the United States and do not represent a

4908: 4623:

The Journal of Emergency Medicine Graduate Medical Education

4243:"Emergency medicine in the United States: A systemic review" 4083:. Australasian College of Emergency Medicine. Archived from 4054:. Australasian College of Emergency Medicine. Archived from 3854: 3436: 3256:"977 F2d 872 Baber v. Hospital Corporation of America Hca B" 2659:"A Matter of Urgency: Reducing Emergency Department Overuse" 2093: 5686: 4913: 4316:

Gerard, W. A.; Staffer, A.; Bullock, K.; Pugno, P. (2010).

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Advanced Specialised Training (AST) in emergency medicine.

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Rosen's Emergency Medicine: concepts and clinical practice

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EMTALA. Centers for Medicare & Medicaid Services.

1734: 694: 4504:

Delivering health care in America: A systems approach

2426:

Delivering health care in America: A systems approach

1837: 1409:(DO) degrees. The ABEM is under the authority of the 490:), work-up a pregnant patient with vaginal bleeding ( 3991:"Health Insurance Regulations 1975 (Cth) Schedule 4" 2444:

American College of Emergency Physicians | News Room

2325: 4853:

American Association of Physician Specialists, Inc.

4411:

University of Tennessee Graduate School of Medicine

4221: 3580: 3230:"Delaney v. Cade, 756 F. Supp. 1476 (D. Kan. 1991)" 1533:" and the legality of a patient's right to refuse. 351:Sub-specializations of emergency medicine include; 4909:Emergency Physicians' Association of Turkey (EPAT) 4101:. Australian College of Rural and Remote Medicine. 3830:Health News / Tips & Trends / Celebrity Health 1134:Royal College of Physicians and Surgeons of Canada 979:A brief review of some of these programs follows: 655:It was not until Dr. John Wiegenstein founded the 4914:Australasian College of Emergency Medicine (ACEM) 3510:. Published 28 October 2015. Accessed 2016-11-16. 1523: 908: 394:model, emergency medicine initially consisted of 6517: 3896:Schneider; Hamilton; Moyer; Stapczynski (1998). 2128:. Hennepin County Medical Center. Archived from 2123:"Graduate Resources Manual – Emergency Medicine" 1684: 1418:American Osteopathic Board of Emergency Medicine 560:, tactical medicine, ultrasound, pain medicine, 5182:International Federation for Emergency Medicine 4904:Emergency Medicine Association of Turkey (EMAT) 4833:International Federation for Emergency Medicine 4681: 4516: 3076: 2596:"Emergency Medicine and Payment Reform // ACEP" 5402: 5186:International Conference on Emergency Medicine 4778:(7th ed.). Philadelphia: Mosby/Elsevier. 4658:"Emergency Mental Health: Crisis and Response" 2832:"Uncompensated Care – HealthCare.gov Glossary" 2468: 5702: 5388: 4939: 4919:European Council for Disaster Medicine (ECDM) 4682:Ryan, Callaghan, Christopher, Sascha (2010). 4436:AAEM – American Academy of Emergency Medicine 2502: 2500: 2375:"Medscape Physician Compensation Report 2015" 2350:"Medscape Physician Compensation Report 2015" 712:The examples and perspective in this section 474:), set a fractured bone or dislocated joint ( 5202:Canadian Association of Emergency Physicians 4843:Canadian Association of Emergency Physicians 4728:: CS1 maint: multiple names: authors list ( 4185:"Notfallmedizin, Ärztekammer Sachsen-Anhalt" 3357: 1429:Board of Certification in Emergency Medicine 991: 5308:Care of the Critically Ill Surgical Patient 5197:Australasian College for Emergency Medicine 4813:"WikEM: The Global Emergency Medicine Wiki" 1873:Greenwood-Ericksen, Kocher K (April 2019). 1333:. Unsourced material may be challenged and 1200:. Unsourced material may be challenged and 1061:. Unsourced material may be challenged and 998:Australasian College for Emergency Medicine 5991:Reproductive endocrinology and infertility 5709: 5695: 5395: 5381: 4946: 4932: 4792: 3557:10.1001/virtualmentor.2012.14.5.hlaw1-1205 3525:, vol. 283, 26 July 2012, p. 904 3079:The American Journal of Emergency Medicine 2545:. October 2012. p. 13. Archived from 2497: 1767: 1765: 1748:"Emergency Medicine Specialty Description" 730:, or create a new section, as appropriate. 6332:Bachelor of Medicine, Bachelor of Surgery 4534: 4478: 4382: 4341: 4266: 4259:10.5847/wjem.j.issn.1920-8642.2012.01.001 3913: 3872: 3801: 3645: 3286:CS1 maint: multiple names: authors list ( 3180: 3053: 3043: 3025: 2989: 2898: 2308: 2239: 2049:. Yale School of Medicine. Archived from 1982: 1898: 1710: 1691:Bulletin of the World Health Organization 1685:Razzak, J. A.; Kellermann, A. L. (2002). 1661: 1353:Learn how and when to remove this message 1220:Learn how and when to remove this message 1081:Learn how and when to remove this message 746:Learn how and when to remove this message 414:resuscitation), surgeons, specialists in 262:Bachelor of Medicine, Bachelor of Surgery 256:Bachelor of Medicine, Bachelor of Surgery 5192:American College of Emergency Physicians 4873:College of Emergency Physician, Malaysia 4868:American College of Emergency Physicians 4501: 4432:"American Academy of Emergency Medicine" 3253: 2423: 1005:Royal Australasian College of Physicians 843:Medical Treatment and Active Labor Act ( 811:Hospital Quality Incentive Demonstration 657:American College of Emergency Physicians 646: 510:), and conduct and interpret x-rays and 289: 5212:European Society for Emergency Medicine 4894:Hong Kong College of Emergency Medicine 4889:Society for Academic Emergency Medicine 4884:European Society for Emergency Medicine 4863:American Board of Physician Specialties 4746: 4655: 4162: 4160: 2506: 2336:"Activity based funding and management" 1762: 1629: 1450: 1433:American Board of Physician Specialties 313:requiring immediate medical attention. 6518: 5222:American Academy of Emergency Medicine 4953: 4848:American Academy of Emergency Medicine 4614:Marco, Catherine; et al. (2011). 4364: 3680:Ethical Problems in Emergency Medicine 2992:European Journal of Emergency Medicine 2033:"Commemoration of the Alexandria Plan" 1480:Royal College of Surgeons of Edinburgh 1145:College of Family Physicians of Canada 875:Care delivery in different ED settings 5690: 5473:Advanced emergency medical technician 5376: 4927: 4677: 4675: 4613: 4240: 3960: 3958: 3709: 3707: 3673: 3671: 3669: 3667: 3665: 3626:Journal of Graduate Medical Education 3576: 3574: 3542: 3330: 3176: 3174: 3172: 3170: 3142: 3140: 3138: 3112: 3110: 3108: 2699:Health Affairs – Health Policy Briefs 2653: 2651: 2559: 2286: 2284: 1411:American Board of Medical Specialties 837: 669:American Board of Medical Specialties 667:, and in 1979 a historic vote by the 521:Emergency medicine may separate from 6470: 6231:Physical medicine and rehabilitation 5217:Asian Society for Emergency Medicine 4858:American Board of Emergency Medicine 4773: 4517:Hatley, T; Patterson, P. D. (2007). 4157: 2939:"Costs of Emergency Care Fact Sheet" 2400:"Physician Compensation Report 2015" 2228:The American Journal of Managed Care 2120: 2030: 1773:Europe: the flipside of the medal", 1635: 1399:American Board of Emergency Medicine 1331:adding citations to reliable sources 1298: 1198:adding citations to reliable sources 1165: 1059:adding citations to reliable sources 1026: 698: 6480: 5302:Advanced Life Support in Obstetrics 5207:Royal College of Emergency Medicine 4838:Association of Emergency Physicians 4797:. New York: McGraw-Hill Companies. 4589:Royal College of Emergency Medicine 4247:World Journal of Emergency Medicine 4200:"Pädiatrische Intensivmedizin, LMU" 3411:. MEDPAC. June 2016. Archived from 3146: 1775:European Journal of Anaesthesiology 1611:Royal College of Emergency Medicine 1465:Royal College of Emergency Medicine 695:Financing and practice organization 689:Royal College of Emergency Medicine 651:Maurice Ellis Blue Plaque Unveiling 13: 6367:Medical Scientist Training Program 4740: 4700:10.5694/j.1326-5377.2010.tb03880.x 4672: 4384:10.1097/01.EEM.0000361892.01557.a0 4139:"Medicina de Emergência no Brasil" 3955: 3915:10.1111/j.1553-2712.1998.tb02720.x 3898:"Definition of emergency medicine" 3704: 3662: 3571: 3372:10.1097/01.mlr.0000045021.70297.9f 3167: 3135: 3105: 2648: 2281: 2197:Clinical & Practice Management 2193:"Definition of Emergency Medicine" 2153:BAEM-Emergency Medicine Landmarks 2096:"Department of Emergency Medicine" 2094:Department of Emergency Medicine. 1983:Edmundson, L. H. (18 April 1994). 1009:College of Intensive Care Medicine 824: 800: 592:in emergency medicine work in the 14: 6542: 4820: 4815:. Los Angeles: OpenEM Foundation. 4224:National Medical Journal of India 3938:"Emergency Medicine: What is it?" 3599:10.1016/j.annemergmed.2004.02.035 3122:LII / Legal Information Institute 2734:10.1016/j.annemergmed.2008.01.327 2574:10.1016/j.annemergmed.2006.06.032 1891:10.1001/jamanetworkopen.2019.1919 1852:10.1016/j.annemergmed.2007.05.025 1600:Prehospital and Disaster Medicine 1458: 677:University of Southern California 494:), control a patient with mania ( 6499: 6489: 6479: 6469: 6460: 6459: 5355: 5344: 5343: 4999:International emergency medicine 3832:. 17 August 2010. Archived from 3803:10.1111/j.1553-2712.2008.00147.x 3451:10.1111/j.1748-0361.2008.00156.x 3155:(1): 145–78, table of contents. 2909:10.1097/00004010-200510000-00005 2483:10.1097/00126450-200504000-00009 1564:International emergency medicine 1401:(ABEM) is for those with either 1369: 1303: 1170: 1031: 974:International emergency medicine 928: 758: 703: 575: 470:), suture a complex laceration ( 432:international emergency medicine 294:SÖHNGEN® aluminum emergency case 27: 6500: 5356: 5296:Pediatric Advanced Life Support 5009:Pre-hospital emergency medicine 4649: 4607: 4577: 4551: 4510: 4495: 4454: 4424: 4399: 4358: 4309: 4283: 4234: 4215: 4193: 4178: 4131: 4113:"Advanced Specialised Training" 4105: 4091: 4073: 4041: 4009: 3983: 3930: 3889: 3848: 3818: 3777: 3742: 3613: 3536: 3513: 3500: 3487: 3465: 3430: 3394: 3351: 3324: 3294: 3247: 3222: 3197: 3070: 3032:Scand J Trauma Resusc Emerg Med 2983: 2957: 2931: 2878: 2849: 2824: 2792: 2748: 2712: 2695:"Reducing Waste in Health Care" 2687: 2618: 2588: 2553: 2535: 2509:New England Journal of Medicine 2462: 2432: 2417: 2392: 2367: 2342: 2310:10.1111/j.1553-2712.2012.1446.x 2256: 2215: 2185: 2166: 2147: 2114: 2087: 2065: 2039: 2024: 2005: 1976: 1941: 1594:Pre-hospital emergency medicine 1389:There are three ways to become 1285: 791: 562:pre-hospital emergency medicine 340:. Still, they may also work in 6357:Doctor of Osteopathic Medicine 5791:Oral and maxillofacial surgery 5284:Acute Care of at-Risk Newborns 5278:Neonatal Resuscitation Program 4793:Tintinalli, Judith E. (2010). 4635:10.1016/j.jemermed.2010.05.076 4523:North Carolina Medical Journal 4049:"HB10 Joint Training Programs" 3942:Australian Medical Association 2098:. Keck.usc.edu. Archived from 1915: 1866: 1831: 1808: 1750:. American Medical Association 1740: 1727: 1678: 1524:Ethical and medicolegal issues 1407:Doctor of Osteopathic Medicine 1294: 1278:There are three universities ( 909:Patient–provider relationships 466:), manage a difficult airway ( 250:Doctor of Osteopathic medicine 1: 5266:Advanced cardiac life support 5249:Cardiopulmonary resuscitation 4878:College of Emergency Medicine 4322:The Annals of Family Medicine 3763:10.1016/s0196-0644(99)70134-4 3728:10.1016/s0196-0644(03)00398-6 2887:Health Care Management Review 2047:"What is Emergency Medicine?" 1821:Texas Journal of Rural Health 1622: 1233:emergency medicine in China. 969:emergency medical technicians 941: 766:emergency medical technicians 444:Outline of emergency medicine 361:point-of-care ultrasonography 315:Emergency medicine physicians 6337:Bachelor of Medical Sciences 6104:Neurosurgical anesthesiology 5716: 5468:Emergency medical technician 5458:Emergency medical dispatcher 5290:Pediatric basic life support 5272:Advanced trauma life support 5255:Mouth-to-mouth resuscitation 5004:Pediatric emergency medicine 4751:. New York: Hachette Books. 4688:Medical Journal of Australia 4291:"Subspecialty Certification" 4081:"EM Certificate and Diploma" 3751:Annals of Emergency Medicine 3716:Annals of Emergency Medicine 3587:Annals of Emergency Medicine 3522:Mead v. Legacy Health System 3004:10.1097/MEJ.0b013e32833651f0 2722:Annals of Emergency Medicine 2562:Annals of Emergency Medicine 1950:Annals of Emergency Medicine 1840:Annals of Emergency Medicine 1787:10.1097/EJA.0000000000000599 1579:Pediatric emergency medicine 1549:Emergency medical technician 982: 919:Mead v. Legacy Health System 550:pediatric emergency medicine 498:), stop a severe nosebleed ( 185:Emergency medicine physician 7: 5656:Critical emergency medicine 5574:Kendrick extrication device 5546:Nontransporting EMS vehicle 5536:Light horse field ambulance 5463:Emergency medical responder 4591:. July 2015. Archived from 4467:Academic Emergency Medicine 4190:Retrieved 18 February 2017. 4017:"HB03 Elements of Training" 3902:Academic Emergency Medicine 3790:Academic Emergency Medicine 3439:The Journal of Rural Health 3181:Dollinger, Tristan (2015). 2758:Journal of Community Health 2297:Academic Emergency Medicine 2031:Zink, Brian (August 2011). 1536: 1498: 1463:In the United Kingdom, the 1291:equivalent to a doctorate. 1273: 954: 726:, discuss the issue on the 588:In the United Kingdom, all 305:concerned with the care of 10: 6547: 5404:Emergency medical services 4974:Emergency medical services 4656:Procter, Nicholas (2011). 3091:10.1016/j.ajem.2013.07.019 3045:10.1186/1757-7241-17-s2-p2 1642:Emergency Medicine Journal 1544:Emergency medical services 1441:emergency medical services 1240: 1022: 683:"daughter college" of six 603: 492:obstetrics and gynaecology 441: 369:emergency medical services 334:emergency medical services 319:emergency medical services 6455: 6377: 6315: 6076: 6004: 5959: 5868: 5739: 5724: 5643: 5617: 5559: 5496: 5443:Certified first responder 5433: 5410: 5338: 5317: 5230: 5172: 5121: 5032: 4961: 4502:Shi, L; Singh, D (2015). 4480:10.1197/j.aem.2004.04.003 4168:"Emergency Medicine (EM)" 3638:10.4300/JGME-D-11-00256.1 2770:10.1007/s10900-016-0293-4 2424:Shi, L; Singh, D (2015). 1489: 1471:followed by two years of 1280:Universiti Sains Malaysia 1123: 1105: 992:Australia and New Zealand 858: 478:), treat a heart attack ( 270: 235: 230: 218: 206: 194: 189: 172: 162: 118: 74: 51: 38: 26: 6291:Transplantation medicine 6182:Clinical neurophysiology 6099:Obstetric anesthesiology 6019:Interventional radiology 5779:Digestive system surgery 5453:Emergency care assistant 5149:Epinephrine / Adrenaline 4365:Carter, Darrell (2009). 4241:Suter, Robert E (2012). 1268:Medical Council of India 1260: 1161: 1114: 892: 879: 673:University of Cincinnati 437: 6162:Intensive care medicine 6136:Mass gathering medicine 5981:Maternal–fetal medicine 4747:Hazzard, Kevin (2022). 4371:Emergency Medicine News 4212:Retrieved 20 June 2017. 3874:10.1001/jama.289.8.1001 3026:Schilling, Ulf (2009). 2471:The Health Care Manager 2160:3 November 2008 at the 1962:10.1067/mem.2001.115217 1514: 1484:intensive care medicine 1393:in emergency medicine: 634:Leeds General Infirmary 594:National Health Service 464:intensive care medicine 100:Acute coronary syndrome 5754:Cardiothoracic surgery 4827:Emergency medicine MUE 4293:. ABEM. Archived from 4205:18 August 2017 at the 3497:. Accessed 2016-11-15. 3275:Cite journal requires 2179:13 August 2015 at the 2174:http://www.rcem.ac.uk/ 782:primary care physician 685:royal medical colleges 652: 538:critical care medicine 508:cardiothoracic surgery 365:critical care medicine 295: 149:Projection radiography 6405:Personalized medicine 6264:Reproductive medicine 6189:Occupational medicine 6143:Evolutionary medicine 5425:Advanced life support 5330:Injury Severity Score 5101:Nasopharyngeal airway 5074:Intraosseous infusion 4645:– via Elsevier. 4536:10.18043/ncm.68.4.259 3688:10.1002/9781118292150 2018:27 April 2015 at the 650: 614:Dominique Jean Larrey 598:general practitioners 400:general practitioners 330:pre-hospital settings 326:emergency departments 293: 6425:Traditional medicine 6385:Alternative medicine 6252:Addiction psychiatry 6066:Transfusion medicine 6061:Medical microbiology 5976:Gynecologic oncology 5828:Reproductive surgery 5541:Motorcycle ambulance 5504:Air medical services 5107:Oropharyngeal airway 4984:Emergency psychiatry 4969:Emergency department 4174:on 27 February 2009. 4087:on 12 November 2013. 3187:Marquette Law Review 3149:Annals of Health Law 2521:10.1056/NEJMe1212133 2268:innovations.ahrq.gov 2121:Zink, Brian (2013). 2073:"Emergency Medicine" 2011:Maurice Ellis Award 1885:(4). JAMA: e191919. 1654:10.1136/emj.17.5.314 1451:Funding for training 1327:improve this section 1194:improve this section 1156:Physician assistants 1055:improve this section 903:physician assistants 778:physician assistants 724:improve this section 642:Alexandria, Virginia 338:intensive care units 177:Glossary of medicine 6447:History of medicine 6430:Veterinary medicine 6237:Preventive medicine 6089:Adolescent medicine 5931:Infectious diseases 5676:Wilderness medicine 5483:Emergency physician 5086:Tracheal intubation 5080:Intravenous therapy 4774:Marx, John (2010). 4595:on 15 February 2016 4297:on 6 September 2011 3836:on 28 November 2016 3312:on 28 November 2016 2812:on 28 November 2016 2675:on 23 November 2016 2666:NEHI Research Brief 2636:on 29 November 2016 2606:on 29 November 2016 2549:on 21 October 2016. 2203:on 28 November 2016 2053:on 19 November 2010 1993:on 5 September 2015 1929:on 16 December 2011 1735:http://www.ifem.cc/ 1584:Physician assistant 1473:foundation training 849:Affordable Care Act 807:pay for performance 638:Alexandria Hospital 630:casualty consultant 566:hyperbaric medicine 546:wilderness medicine 476:orthopaedic surgery 373:hyperbaric medicine 186: 167:Emergency physician 23: 6526:Emergency medicine 6395:Molecular oncology 6352:Doctor of Medicine 6342:Master of Medicine 6259:Radiation oncology 6131:Emergency medicine 6084:Addiction medicine 6051:Clinical chemistry 6046:Clinical pathology 5838:Transplant surgery 5796:Orthopedic surgery 5774:Colorectal surgery 5666:Emergency medicine 5594:Spinal precautions 5420:Basic life support 5260:Basic life support 5164:Sodium bicarbonate 4962:Emergency medicine 4955:Emergency medicine 4565:on 21 October 2016 4145:on 22 January 2023 4119:on 27 January 2023 4061:on 6 November 2013 4029:on 6 November 2013 3997:on 4 November 2013 3418:on 3 February 2017 3038:(Suppl 2): 337–9. 1403:Doctor of Medicine 838:Uncompensated care 653: 564:, or undersea and 542:medical toxicology 385:aerospace medicine 357:medical toxicology 303:medical speciality 299:Emergency medicine 296: 244:Doctor of Medicine 237:Education required 184: 46:illness and injury 22:Emergency medicine 21: 6531:Medical mnemonics 6513: 6512: 6347:Master of Surgery 6311: 6310: 6296:Tropical medicine 6242:Prison healthcare 6157:Hospital medicine 6121:Disaster medicine 6111:Aviation medicine 5926:Hospital medicine 5833:Surgical oncology 5818:Pediatric surgery 5812: 5759:Endocrine surgery 5684: 5683: 5671:Military medicine 5651:Aviation medicine 5635:Search and rescue 5625:Ambulance station 5370: 5369: 5159:Magnesium sulfate 5068:Electrocardiogram 4994:Medical emergency 4979:Emergency nursing 4804:978-0-07-148480-0 4785:978-0-323-05472-0 2102:on 26 August 2011 1879:JAMA Network Open 1569:Medical emergency 1380:internal medicine 1363: 1362: 1355: 1230: 1229: 1222: 1091: 1090: 1083: 756: 755: 748: 610:French Revolution 558:disaster medicine 416:internal medicine 408:anesthesiologists 353:disaster medicine 344:settings such as 288: 287: 182: 181: 6538: 6503: 6502: 6493: 6483: 6482: 6473: 6472: 6463: 6462: 6167:Medical genetics 6152:General practice 6029:Nuclear medicine 5904:Gastroenterology 5860:Vascular surgery 5810: 5737: 5736: 5711: 5704: 5697: 5688: 5687: 5561:Casualty lifting 5488:Medical director 5397: 5390: 5383: 5374: 5373: 5359: 5358: 5347: 5346: 4948: 4941: 4934: 4925: 4924: 4880:(United Kingdom) 4816: 4808: 4789: 4770: 4734: 4733: 4727: 4719: 4679: 4670: 4669: 4653: 4647: 4646: 4620: 4611: 4605: 4604: 4602: 4600: 4581: 4575: 4574: 4572: 4570: 4555: 4549: 4548: 4538: 4514: 4508: 4507: 4499: 4493: 4492: 4482: 4458: 4452: 4451: 4449: 4447: 4442:on 20 March 2018 4438:. 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209: 208:Occupation type 158: 120: 114: 76: 69: 34: 17: 12: 11: 5: 6544: 6534: 6533: 6528: 6511: 6510: 6508: 6507: 6497: 6487: 6477: 6467: 6456: 6453: 6452: 6450: 6449: 6444: 6443: 6442: 6432: 6427: 6422: 6417: 6412: 6407: 6402: 6397: 6392: 6387: 6381: 6379: 6378:Related topics 6375: 6374: 6372: 6371: 6370: 6369: 6359: 6354: 6349: 6344: 6339: 6334: 6329: 6327:Medical school 6323: 6321: 6313: 6312: 6309: 6308: 6306: 6305: 6304: 6303: 6293: 6288: 6283: 6281:Sleep medicine 6278: 6277: 6276: 6266: 6261: 6256: 6255: 6254: 6244: 6239: 6234: 6228: 6223: 6222: 6221: 6211: 6206: 6201: 6196: 6191: 6186: 6185: 6184: 6174: 6169: 6164: 6159: 6154: 6145: 6140: 6139: 6138: 6128: 6123: 6118: 6113: 6108: 6107: 6106: 6101: 6094:Anesthesiology 6091: 6086: 6080: 6078: 6074: 6073: 6071: 6070: 6069: 6068: 6063: 6058: 6053: 6048: 6043: 6033: 6032: 6031: 6026: 6024:Neuroradiology 6021: 6010: 6008: 6002: 6001: 5999: 5998: 5993: 5988: 5983: 5978: 5973: 5967: 5965: 5961:Obstetrics and 5957: 5956: 5954: 5953: 5948: 5943: 5938: 5933: 5928: 5923: 5918: 5913: 5912: 5911: 5901: 5896: 5891: 5886: 5876: 5874: 5866: 5865: 5863: 5862: 5857: 5856: 5855: 5845: 5843:Trauma surgery 5840: 5835: 5830: 5825: 5820: 5815: 5814: 5813: 5806:Otolaryngology 5803: 5798: 5793: 5788: 5783: 5782: 5781: 5776: 5766: 5761: 5756: 5751: 5745: 5743: 5734: 5732:subspecialties 5722: 5721: 5714: 5713: 5706: 5699: 5691: 5682: 5681: 5679: 5678: 5673: 5668: 5663: 5658: 5653: 5647: 5645: 5644:Related fields 5641: 5640: 5638: 5637: 5632: 5627: 5621: 5619: 5615: 5614: 5612: 5611: 5606: 5601: 5596: 5591: 5586: 5581: 5576: 5570: 5568: 5557: 5556: 5554: 5553: 5548: 5543: 5538: 5533: 5528: 5523: 5518: 5517: 5516: 5506: 5500: 5498: 5494: 5493: 5491: 5490: 5485: 5480: 5475: 5470: 5465: 5460: 5455: 5450: 5445: 5439: 5437: 5431: 5430: 5428: 5427: 5422: 5417: 5411: 5408: 5407: 5400: 5399: 5392: 5385: 5377: 5368: 5367: 5365: 5364: 5352: 5339: 5336: 5335: 5333: 5332: 5327: 5321: 5319: 5315: 5314: 5312: 5311: 5305: 5299: 5293: 5287: 5281: 5275: 5269: 5263: 5257: 5252: 5246: 5240: 5238: 5228: 5227: 5225: 5224: 5219: 5214: 5209: 5204: 5199: 5194: 5189: 5178: 5176: 5170: 5169: 5167: 5166: 5161: 5156: 5151: 5146: 5141: 5136: 5131: 5125: 5123: 5119: 5118: 5116: 5115: 5110: 5104: 5098: 5093: 5091:Laryngeal tube 5088: 5083: 5077: 5071: 5065: 5059: 5053:Defibrillation 5050: 5045: 5042:Bag valve mask 5038: 5036: 5030: 5029: 5027: 5026: 5021: 5016: 5011: 5006: 5001: 4996: 4991: 4986: 4981: 4976: 4971: 4965: 4963: 4959: 4958: 4951: 4950: 4943: 4936: 4928: 4922: 4921: 4916: 4911: 4906: 4901: 4896: 4891: 4886: 4881: 4875: 4870: 4865: 4860: 4855: 4850: 4845: 4840: 4835: 4830: 4822: 4821:External links 4819: 4818: 4817: 4809: 4803: 4790: 4784: 4771: 4757: 4742: 4739: 4736: 4735: 4694:(4): 239–242. 4671: 4648: 4606: 4576: 4550: 4509: 4494: 4453: 4423: 4398: 4357: 4308: 4282: 4233: 4214: 4192: 4177: 4156: 4130: 4104: 4090: 4072: 4040: 4008: 3982: 3954: 3929: 3908:(4): 348–351. 3888: 3847: 3817: 3776: 3741: 3703: 3696: 3661: 3612: 3570: 3545:Virtual Mentor 3535: 3512: 3499: 3486: 3464: 3429: 3393: 3366:(2): 198–207. 3350: 3323: 3293: 3277:|journal= 3246: 3221: 3196: 3166: 3134: 3104: 3085:(10): 1520–4. 3069: 2982: 2956: 2930: 2877: 2848: 2836:HealthCare.gov 2823: 2791: 2764:(3): 591–597. 2747: 2711: 2686: 2647: 2617: 2587: 2552: 2534: 2515:(19): 1852–3. 2496: 2461: 2431: 2416: 2391: 2366: 2341: 2324: 2280: 2255: 2214: 2184: 2165: 2146: 2113: 2086: 2064: 2038: 2023: 2004: 1975: 1940: 1914: 1865: 1830: 1807: 1781:(5): 251–253, 1761: 1739: 1726: 1677: 1627: 1626: 1624: 1621: 1619: 1618: 1613: 1608: 1603: 1596: 1591: 1586: 1581: 1576: 1571: 1566: 1561: 1556: 1551: 1546: 1540: 1538: 1535: 1525: 1522: 1516: 1513: 1500: 1497: 1491: 1488: 1469:Medical school 1460: 1459:United Kingdom 1457: 1452: 1449: 1437: 1436: 1425: 1414: 1371: 1368: 1361: 1360: 1311: 1309: 1302: 1296: 1293: 1287: 1284: 1275: 1272: 1270:in July 2009. 1262: 1259: 1242: 1239: 1228: 1227: 1178: 1176: 1169: 1163: 1160: 1149: 1148: 1137: 1125: 1122: 1116: 1113: 1107: 1104: 1089: 1088: 1039: 1037: 1030: 1024: 1021: 993: 990: 984: 981: 956: 953: 943: 940: 930: 927: 910: 907: 894: 891: 881: 878: 876: 873: 860: 857: 839: 836: 826: 823: 802: 799: 793: 790: 760: 757: 754: 753: 718:of the subject 716:worldwide view 711: 709: 702: 696: 693: 605: 602: 577: 574: 530:subspecialties 500:otolaryngology 468:anesthesiology 442:Main article: 439: 436: 420:paediatricians 392:Anglo-American 286: 285: 276: 271: 268: 267: 266: 265: 259: 253: 247: 239: 236: 233: 232: 228: 227: 222: 219: 216: 215: 210: 207: 204: 203: 202: 201: 196: 192: 191: 180: 179: 174: 170: 169: 164: 160: 159: 157: 156: 151: 146: 141: 136: 131: 125: 123: 116: 115: 113: 112: 107: 102: 97: 92: 87: 81: 79: 72: 71: 68: 67: 62: 56: 53: 49: 48: 40: 36: 35: 32: 15: 9: 6: 4: 3: 2: 6543: 6532: 6529: 6527: 6524: 6523: 6521: 6506: 6498: 6496: 6492: 6488: 6486: 6478: 6476: 6468: 6466: 6458: 6457: 6454: 6448: 6445: 6441: 6438: 6437: 6436: 6433: 6431: 6428: 6426: 6423: 6421: 6418: 6416: 6413: 6411: 6410:Public health 6408: 6406: 6403: 6401: 6398: 6396: 6393: 6391: 6390:Allied health 6388: 6386: 6383: 6382: 6380: 6376: 6368: 6365: 6364: 6363: 6360: 6358: 6355: 6353: 6350: 6348: 6345: 6343: 6340: 6338: 6335: 6333: 6330: 6328: 6325: 6324: 6322: 6320: 6314: 6302: 6299: 6298: 6297: 6294: 6292: 6289: 6287: 6284: 6282: 6279: 6275: 6272: 6271: 6270: 6267: 6265: 6262: 6260: 6257: 6253: 6250: 6249: 6248: 6245: 6243: 6240: 6238: 6235: 6232: 6229: 6227: 6224: 6220: 6217: 6216: 6215: 6212: 6210: 6207: 6205: 6202: 6200: 6199:Oral medicine 6197: 6195: 6194:Ophthalmology 6192: 6190: 6187: 6183: 6180: 6179: 6178: 6175: 6173: 6170: 6168: 6165: 6163: 6160: 6158: 6155: 6153: 6149: 6146: 6144: 6141: 6137: 6134: 6133: 6132: 6129: 6127: 6124: 6122: 6119: 6117: 6114: 6112: 6109: 6105: 6102: 6100: 6097: 6096: 6095: 6092: 6090: 6087: 6085: 6082: 6081: 6079: 6075: 6067: 6064: 6062: 6059: 6057: 6056:Cytopathology 6054: 6052: 6049: 6047: 6044: 6042: 6039: 6038: 6037: 6034: 6030: 6027: 6025: 6022: 6020: 6017: 6016: 6015: 6012: 6011: 6009: 6007: 6003: 5997: 5996:Urogynecology 5994: 5992: 5989: 5987: 5984: 5982: 5979: 5977: 5974: 5972: 5969: 5968: 5966: 5964: 5958: 5952: 5949: 5947: 5944: 5942: 5939: 5937: 5934: 5932: 5929: 5927: 5924: 5922: 5919: 5917: 5914: 5910: 5907: 5906: 5905: 5902: 5900: 5899:Endocrinology 5897: 5895: 5892: 5890: 5887: 5885: 5881: 5878: 5877: 5875: 5873: 5867: 5861: 5858: 5854: 5851: 5850: 5849: 5846: 5844: 5841: 5839: 5836: 5834: 5831: 5829: 5826: 5824: 5821: 5819: 5816: 5809: 5808: 5807: 5804: 5802: 5799: 5797: 5794: 5792: 5789: 5787: 5784: 5780: 5777: 5775: 5772: 5771: 5770: 5767: 5765: 5762: 5760: 5757: 5755: 5752: 5750: 5747: 5746: 5744: 5742: 5738: 5735: 5733: 5727: 5723: 5719: 5712: 5707: 5705: 5700: 5698: 5693: 5692: 5689: 5677: 5674: 5672: 5669: 5667: 5664: 5662: 5659: 5657: 5654: 5652: 5649: 5648: 5646: 5642: 5636: 5633: 5631: 5628: 5626: 5623: 5622: 5620: 5616: 5610: 5607: 5605: 5602: 5600: 5597: 5595: 5592: 5590: 5587: 5585: 5582: 5580: 5577: 5575: 5572: 5571: 5569: 5567: 5562: 5558: 5552: 5549: 5547: 5544: 5542: 5539: 5537: 5534: 5532: 5529: 5527: 5524: 5522: 5521:Ambulance bus 5519: 5515: 5512: 5511: 5510: 5507: 5505: 5502: 5501: 5499: 5495: 5489: 5486: 5484: 5481: 5479: 5476: 5474: 5471: 5469: 5466: 5464: 5461: 5459: 5456: 5454: 5451: 5449: 5446: 5444: 5441: 5440: 5438: 5436: 5432: 5426: 5423: 5421: 5418: 5416: 5413: 5412: 5409: 5405: 5398: 5393: 5391: 5386: 5384: 5379: 5378: 5375: 5363: 5362: 5353: 5351: 5350: 5341: 5340: 5337: 5331: 5328: 5326: 5323: 5322: 5320: 5316: 5309: 5306: 5303: 5300: 5297: 5294: 5291: 5288: 5285: 5282: 5279: 5276: 5273: 5270: 5267: 5264: 5261: 5258: 5256: 5253: 5250: 5247: 5245: 5242: 5241: 5239: 5237: 5233: 5229: 5223: 5220: 5218: 5215: 5213: 5210: 5208: 5205: 5203: 5200: 5198: 5195: 5193: 5190: 5187: 5183: 5180: 5179: 5177: 5175: 5174:Organisations 5171: 5165: 5162: 5160: 5157: 5155: 5152: 5150: 5147: 5145: 5142: 5140: 5137: 5135: 5132: 5130: 5127: 5126: 5124: 5120: 5114: 5111: 5108: 5105: 5102: 5099: 5097: 5094: 5092: 5089: 5087: 5084: 5081: 5078: 5075: 5072: 5069: 5066: 5063: 5060: 5058: 5054: 5051: 5049: 5046: 5043: 5040: 5039: 5037: 5035: 5031: 5025: 5022: 5020: 5019:Trauma center 5017: 5015: 5012: 5010: 5007: 5005: 5002: 5000: 4997: 4995: 4992: 4990: 4987: 4985: 4982: 4980: 4977: 4975: 4972: 4970: 4967: 4966: 4964: 4960: 4956: 4949: 4944: 4942: 4937: 4935: 4930: 4929: 4926: 4920: 4917: 4915: 4912: 4910: 4907: 4905: 4902: 4900: 4897: 4895: 4892: 4890: 4887: 4885: 4882: 4879: 4876: 4874: 4871: 4869: 4866: 4864: 4861: 4859: 4856: 4854: 4851: 4849: 4846: 4844: 4841: 4839: 4836: 4834: 4831: 4828: 4825: 4824: 4814: 4810: 4806: 4800: 4796: 4791: 4787: 4781: 4777: 4772: 4768: 4764: 4760: 4758:9780306926075 4754: 4750: 4745: 4744: 4731: 4725: 4717: 4713: 4709: 4705: 4701: 4697: 4693: 4689: 4685: 4678: 4676: 4667: 4663: 4659: 4652: 4644: 4640: 4636: 4632: 4628: 4624: 4617: 4610: 4594: 4590: 4586: 4580: 4564: 4560: 4554: 4546: 4542: 4537: 4532: 4529:(4): 259–61. 4528: 4524: 4520: 4513: 4505: 4498: 4490: 4486: 4481: 4476: 4472: 4468: 4464: 4457: 4441: 4437: 4433: 4427: 4412: 4408: 4402: 4394: 4390: 4385: 4380: 4376: 4372: 4368: 4361: 4353: 4349: 4344: 4339: 4335: 4331: 4327: 4323: 4319: 4312: 4296: 4292: 4286: 4278: 4274: 4269: 4264: 4260: 4256: 4252: 4248: 4244: 4237: 4230:(3): 154–156. 4229: 4225: 4218: 4208: 4204: 4201: 4196: 4186: 4181: 4173: 4169: 4163: 4161: 4144: 4140: 4134: 4118: 4114: 4108: 4100: 4094: 4086: 4082: 4076: 4057: 4050: 4044: 4025: 4018: 4012: 3996: 3992: 3986: 3971: 3967: 3961: 3959: 3943: 3939: 3933: 3925: 3921: 3916: 3911: 3907: 3903: 3899: 3892: 3884: 3880: 3875: 3870: 3867:(8): 1001–7. 3866: 3862: 3858: 3851: 3835: 3831: 3827: 3821: 3813: 3809: 3804: 3799: 3796:(7): 633–40. 3795: 3791: 3787: 3780: 3772: 3768: 3764: 3760: 3757:(3): 373–83. 3756: 3752: 3745: 3737: 3733: 3729: 3725: 3722:(3): 324–33. 3721: 3717: 3710: 3708: 3699: 3697:9781118292150 3693: 3689: 3685: 3681: 3674: 3672: 3670: 3668: 3666: 3657: 3653: 3648: 3643: 3639: 3635: 3631: 3627: 3623: 3616: 3608: 3604: 3600: 3596: 3592: 3588: 3584: 3577: 3575: 3566: 3562: 3558: 3554: 3550: 3546: 3539: 3524: 3523: 3516: 3509: 3503: 3496: 3490: 3474: 3468: 3460: 3456: 3452: 3448: 3444: 3440: 3433: 3414: 3410: 3403: 3397: 3389: 3385: 3381: 3377: 3373: 3369: 3365: 3361: 3354: 3346: 3342: 3338: 3334: 3333:Health Matrix 3327: 3311: 3307: 3303: 3297: 3289: 3282: 3269: 3261: 3257: 3250: 3235: 3231: 3225: 3210: 3206: 3200: 3192: 3188: 3184: 3177: 3175: 3173: 3171: 3162: 3158: 3154: 3150: 3143: 3141: 3139: 3123: 3119: 3113: 3111: 3109: 3100: 3096: 3092: 3088: 3084: 3080: 3073: 3065: 3061: 3056: 3051: 3046: 3041: 3037: 3033: 3029: 3021: 3017: 3013: 3009: 3005: 3001: 2997: 2993: 2986: 2970: 2966: 2960: 2945:on 5 May 2019 2944: 2940: 2934: 2926: 2922: 2918: 2914: 2910: 2906: 2901: 2896: 2893:(4): 315–21. 2892: 2888: 2881: 2865: 2858: 2852: 2837: 2833: 2827: 2808: 2801: 2795: 2787: 2783: 2779: 2775: 2771: 2767: 2763: 2759: 2751: 2743: 2739: 2735: 2731: 2728:(2): 108–15. 2727: 2723: 2715: 2700: 2696: 2690: 2671: 2667: 2660: 2654: 2652: 2635: 2631: 2627: 2621: 2605: 2601: 2597: 2591: 2583: 2579: 2575: 2571: 2568:(6): 756–61. 2567: 2563: 2556: 2548: 2544: 2538: 2530: 2526: 2522: 2518: 2514: 2510: 2503: 2501: 2492: 2488: 2484: 2480: 2477:(2): 159–64. 2476: 2472: 2465: 2450:on 5 May 2019 2449: 2445: 2441: 2440:"Fact Sheets" 2435: 2427: 2420: 2405: 2401: 2395: 2380: 2376: 2370: 2355: 2351: 2345: 2337: 2331: 2329: 2320: 2316: 2311: 2306: 2302: 2298: 2294: 2287: 2285: 2269: 2265: 2259: 2251: 2247: 2242: 2237: 2233: 2229: 2225: 2218: 2202: 2198: 2194: 2188: 2182: 2178: 2175: 2169: 2163: 2159: 2156: 2150: 2131: 2124: 2117: 2101: 2097: 2090: 2074: 2068: 2052: 2048: 2042: 2034: 2027: 2021: 2017: 2014: 2008: 1992: 1988: 1987: 1979: 1971: 1967: 1963: 1959: 1955: 1951: 1944: 1928: 1924: 1918: 1910: 1906: 1901: 1896: 1892: 1888: 1884: 1880: 1876: 1869: 1861: 1857: 1853: 1849: 1845: 1841: 1834: 1826: 1822: 1818: 1811: 1804: 1800: 1796: 1792: 1788: 1784: 1780: 1776: 1768: 1766: 1749: 1743: 1736: 1730: 1722: 1718: 1713: 1708: 1704: 1700: 1697:(11): 900–5. 1696: 1692: 1688: 1681: 1673: 1669: 1664: 1659: 1655: 1651: 1647: 1643: 1639: 1632: 1628: 1617: 1614: 1612: 1609: 1607: 1604: 1602: 1601: 1597: 1595: 1592: 1590: 1587: 1585: 1582: 1580: 1577: 1575: 1572: 1570: 1567: 1565: 1562: 1560: 1557: 1555: 1552: 1550: 1547: 1545: 1542: 1541: 1534: 1532: 1521: 1512: 1508: 1506: 1496: 1487: 1485: 1481: 1476: 1474: 1470: 1466: 1456: 1448: 1444: 1442: 1434: 1430: 1426: 1423: 1419: 1415: 1412: 1408: 1404: 1400: 1396: 1395: 1394: 1392: 1387: 1385: 1381: 1377: 1370:United States 1367: 1357: 1354: 1346: 1336: 1332: 1328: 1322: 1321: 1317: 1312:This section 1310: 1306: 1301: 1300: 1292: 1283: 1281: 1271: 1269: 1258: 1256: 1252: 1251:"Ärztekammer" 1248: 1238: 1234: 1224: 1221: 1213: 1203: 1199: 1195: 1189: 1188: 1184: 1179:This section 1177: 1173: 1168: 1167: 1159: 1157: 1153: 1146: 1142: 1138: 1135: 1131: 1130: 1129: 1121: 1112: 1103: 1099: 1095: 1085: 1082: 1074: 1064: 1060: 1056: 1050: 1049: 1045: 1040:This section 1038: 1034: 1029: 1028: 1020: 1016: 1012: 1010: 1006: 1001: 999: 989: 980: 977: 975: 970: 966: 961: 952: 948: 939: 936: 935:medical error 929:Medical error 926: 922: 920: 917:According to 915: 906: 904: 900: 890: 888: 872: 870: 866: 856: 852: 850: 846: 835: 831: 822: 820: 814: 812: 808: 798: 789: 785: 783: 779: 775: 772:). Mid-level 771: 767: 759:Reimbursement 750: 747: 739: 729: 725: 719: 717: 710: 701: 700: 692: 690: 686: 680: 678: 674: 670: 666: 662: 658: 649: 645: 643: 639: 635: 631: 626: 622: 620: 615: 611: 601: 599: 595: 591: 586: 583: 576:Work patterns 573: 569: 567: 563: 559: 555: 551: 547: 543: 539: 535: 531: 526: 524: 519: 517: 513: 509: 505: 501: 497: 493: 489: 485: 481: 477: 473: 469: 465: 461: 456: 450: 445: 435: 433: 429: 425: 424:cardiologists 421: 417: 413: 409: 405: 404:Franco-German 401: 397: 393: 388: 386: 382: 378: 374: 370: 366: 362: 358: 354: 349: 347: 343: 339: 335: 331: 327: 324: 320: 316: 312: 308: 304: 300: 292: 284: 280: 277: 269: 263: 260: 257: 254: 251: 248: 245: 242: 241: 240: 234: 229: 226: 223: 217: 214: 211: 205: 199: 198: 197: 193: 188: 178: 175: 171: 168: 165: 161: 155: 152: 150: 147: 145: 142: 140: 137: 135: 132: 130: 127: 126: 124: 117: 111: 108: 106: 103: 101: 98: 96: 93: 91: 88: 86: 83: 82: 80: 73: 70: 66: 63: 61: 58: 57: 54: 50: 47: 45: 41: 37: 30: 25: 19: 6415:Rural health 6400:Nanomedicine 6130: 5951:Rheumatology 5882: / 5801:Hand surgery 5786:Neurosurgery 5665: 5630:Rescue squad 5584:Spinal board 5448:Combat medic 5415:Paramedicine 5354: 5342: 5236:Life support 5014:Major trauma 4954: 4794: 4775: 4748: 4724:cite journal 4691: 4687: 4665: 4661: 4651: 4629:(5): 550–6. 4626: 4622: 4609: 4597:. Retrieved 4593:the original 4579: 4567:. Retrieved 4563:the original 4553: 4526: 4522: 4512: 4503: 4497: 4473:(7): 756–9. 4470: 4466: 4456: 4444:. Retrieved 4440:the original 4435: 4426: 4414:. Retrieved 4410: 4401: 4374: 4370: 4360: 4328:(6): 564–5. 4325: 4321: 4311: 4299:. Retrieved 4295:the original 4285: 4250: 4246: 4236: 4227: 4223: 4217: 4195: 4180: 4172:the original 4147:. Retrieved 4143:the original 4133: 4121:. Retrieved 4117:the original 4107: 4093: 4085:the original 4075: 4063:. Retrieved 4056:the original 4043: 4031:. Retrieved 4024:the original 4011: 3999:. Retrieved 3995:the original 3985: 3973:. Retrieved 3969: 3945:. Retrieved 3941: 3932: 3905: 3901: 3891: 3864: 3860: 3850: 3838:. Retrieved 3834:the original 3829: 3820: 3793: 3789: 3779: 3754: 3750: 3744: 3719: 3715: 3679: 3632:(4): 533–7. 3629: 3625: 3615: 3593:(3): 262–7. 3590: 3586: 3551:(5): 403–6. 3548: 3544: 3538: 3527:, retrieved 3521: 3515: 3502: 3489: 3477:. 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