Emergency care is a central plank of America's healthcare system, offering essential aid for patients in crisis. Emergency departments treat time-sensitive, unexpected illnesses or injuries and provide nonurgent health services for those who don't, or can't, receive health assistance elsewhere.
Despite its critical role in healthcare, an emergency department is a relatively recent occurrence. The first emergency department opened just over six decades ago—founded in Alexandria, Virginia, in 1961. That facility offered emergency care in a 450-square-foot basement room of Alexandria Hospital. There are now more than 150 million emergency room visits annually in the US, amounting to costs of more than $80B. By definition, an emergency department is a hospital facility staffed 24 hours a day, seven days a week, providing unscheduled services to patients requiring immediate assistance.
Federal law bars hospitals that receive Medicare funding from turning away any emergency patient. If a hospital has an emergency department, it must stabilize the patient before discharging them—regardless of the patient's insurance status or ability to pay.
Hours of research by our editors, distilled into minutes of clarity.
A federal law called the Emergency Medical Treatment and Labor Act, which was passed in 1986, requires any Medicare-participating hospital with an emergency room to provide emergency medical care—including if the patient is in labor—until the patient is stable. That requirement applies regardless of the patient's ability to pay, insurance status, or, in some cases, immigration status.
Watch this documentary about the Freedom House Ambulance Service—the foundation for all paramedic training in America. Founded in 1967, this emergency care force composed of Black men and women from Pittsburgh sought to respond to Pittsburgh's Black community emergencies when the Black community couldn't rely on the police and fire departments to consistently respond to their emergency calls.
It was a 450-square-foot basement room with four stretchers staffed by four doctors inside Alexandria Hospital, in Alexandria, Virginia. Patients there were charged $5 per visit. The first emergency medicine residency followed in 1970, in Cincinnati.
Emergency room care teams must make fast and crucial decisions. They must determine if patients need to be admitted or discharged and when to order more tests or not. Researchers have been exploring how often patients died in the week after they were sent home and evaluating how this and other aspects of emergency care decision-making could be improved with AI algorithms to assist decision-makers.
Of those emergency incidents, the largest share of patients were between the ages of 25 and 44 and were in the southern part of the US. More than 43 million of the visits involved injuries, including poisonings.
An Associated Press analysis of federal hospital investigation data concluded that more than 100 pregnant women in medical distress were turned away from emergency rooms or treated negligently since 2022.
A board-certified emergency medicine physician working in the Bronx writes about what her workweeks look like and what attracted her to this fast-paced medical specialty, including being able to help suffering patients quickly, treating a wide range of ailments, and tending to disadvantaged communities.
This dashboard from Virginia's health department provides a detailed look at various aspects of its emergency care services from January 2019 to December 2024, when there were more than 575,000 emergency incidents. More than 40% of its emergency services were devoted to slips and falls.
That was the 2021 prediction of the American College of Emergency Physicians, which led to a sudden steep decline in the field among medical students and residents. (Some users may encounter a paywall.)
State lawmakers and hospitals are scrambling to protect the nurses, doctors, and other healthcare workers that are increasingly experiencing workplace violence. Dozens of states have passed laws or are working on bills that aim to curb hospital and clinic violence by requiring detailed violence prevention plans from employers, increasing legal penalties for those who attack healthcare workers, or taking steps like requiring hospitals to have a law enforcement officer—not just a security officer—on-site.
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