Doctors returning home from World War II knew that critically ill or injured patients had a better chance of survival if they were treated in a hospital. In 1976, emergency medicine became the country’s 23rd recognized medical specialty. A lot happened between points A and B.
It is a high-tech wonder and the product of generations of heavy investment in trauma care. But the emergency department is also the backdoor of the American health care system—a kind of open wound that is symptomatic of deficiencies of how American health care is organized, delivered, and paid for.
It is a heroic part of the American health system. Lives are saved, the dire consequences avoided. But the air ambulance industry is consolidating, prices are soaring, and insurers and providers continually fight over network issues. One consequence: Surprise billing that leaves patients owing tens of thousands of dollars.
The clinics range in size from a nurse who shows up in a mobile unit a few hours per week to a large-scale, full-service health clinic with multiple primary care providers and clinicians who can provide dental and vision care.