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May 16, 1977

Emergency Room Standards

JAMA. 1977;237(20):2189. doi:10.1001/jama.1977.03270470024012

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To the Editor.—  Dr Berger's letter concerning the competency of emergency room physicians demonstrated a parochial ignorance of standards of practice elsewhere, as well as a disregard of proper medical economics and priorities.Having trained in New York (Columbia, 1976), I am well aware of that city's many deficiencies. In other parts of the country, however, the situation is quite different. There are even emergency room physicians who think of themselves as specialists and take pride in their diagnostic acumen. They would no sooner admit a patient in stable condition with chest pain directly to the coronary care unit than they would cast a tender wrist without taking roentgenograms or arrange surgery based on acute abdominal pain without performing a rectal examination and obtaining appropriate laboratory and roentgenologic studies.The emergency department at this hospital is as well-staffed and wellequipped as the coronary care unit or intensive care unit, and