THE HE number of admissions to emergency services of general hospitals has risen markedly during recent years. A study of 330 general hospitals by McCarroll and Skudder,1 for example, revealed an increase of 120% in emergency room visits between 1945 and 1958. Shortliffe et al2 surveyed 90 hospitals with emergency services and reported an even larger increase in visits to emergency services. In addition, Shortliffe et al elicited opinions from the staffs of the 90 hospitals surveyed concerning the reasons for this rise. The predominant opinion was that it has become more difficult for patients to reach physicians in private practice during weekends, nights, and holidays. These findings prompted Coleman and Errera to comment:
It seems that at least part of the traditional on-call responsibility of the physician in private practice is being shifted to the general hospital emergency room.3(p1294)
With this rise in admissions has come