Emergency medicine, because of its broad, general scope of activity, adapted itself to meet the medical demands of a changing society. Access for all, 24-hour availability, primary care, critical care, social services, and care for indigent patients are but a few of the factors that have created the present emergency department environment. In 1993, several important issues—violence affecting patients and emergency care providers, the occurrence of natural disasters, the need to limit futile care in the prehospital and hospital environment, and the uncertainty surrounding health system reform—all changed the profile of emergency medicine in substantial ways.
As the primary interface between the population and acute medical care, emergency medicine is at the forefront of the medical community's response to the nation's violence epidemic. Violence directed against men, women, and children, and even against physicians, nurses, and emergency medical technicians, has become an everyday part of the practice of emergency medicine.
Sklar DP. Emergency Medicine. JAMA. 1994;271(21):1665-1666. doi:10.1001/jama.1994.03510450037020