DR Johnson: The emergency department in large centers has usually been staffed by surgeons, surgical specialists, internists, and pediatricians. In the small community hospitals, the responsibility for the emergency department coverage was usually accomplished by rotation among the physicians in the community, regardless of specialty. These physicians performed this task, although they were unhappy because of the inconvenience and lack of training on their part. To further compound the problem, patients soon found the emergency room was the only consistent source of health care and flooded it at hours that were convenient for them, not necessarily for the physicians.
A new group of physicians evolved to meet this health need. The reasons for the doctor entering this new "specialty" were varied, but were usually financial, dissatisfaction with their present position, consistent hours, episodic care with no continued responsibility for the patient, and the excitement of a new venture. Regardless, they