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Significant attention has been paid of late to the growing crisis surrounding
emergency medicine in the United States [Abelson 2002; American College of
Emergency Physicians 1998, 1999; Mithers 2001; Shute and Marcus 2001;].
Mishaps resulting from ambulance diversion, emergency room overcrowding,
and a shortage of qualified nurses are frequent subjects of national television
news programs. A large and growing population of people without insurance
continue to make use of emergency rooms for primary care needs (Kilpatrick &
Holsclaw, 1995; Steinhauer 2000; U. S. General Accounting Office, 2001).
Emergency departments, staffed primarily to serve the victims of accidents or
acute illness, are increasingly overburdened by parents and young children
without adequate prenatal and pediatric care; the chronically ill and disabled;
persons with HIV/AIDS; individuals with mental illnesses, including drug and
alcohol addiction; and the homeless.
Scholars from a variety of disciplines have sought to understand the
critical situation faced by emergency medicine and to determine ways in which
this situation might be addressed. The solutions to some problems, (such as
Convention