Editing Emergency medicine (section)

==Scope==
{{Main|Outline of emergency medicine}}

Emergency medicine is a medical specialty—a field of practice based on the knowledge and skills required to prevent, diagnose, and manage acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders. It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development.<ref>"A very warm welcome to the website of the International Federation for Emergency Medicine.". http://www.ifem.cc/. 18 March 2011.</ref><ref>{{cite web | title = Emergency Medicine Specialty Description | publisher = American Medical Association | url = https://www.ama-assn.org/specialty/emergency-medicine-specialty-description | access-date = 16 September 2020}}</ref>

The field of emergency medicine encompasses care involving the acute care of internal medical and surgical conditions. In many modern emergency departments, emergency physicians see many patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them after treatment as necessary. They also provide episodic [[primary care]] to patients during off-hours and those who do not have primary care providers. Most patients present to emergency departments with low-acuity conditions (such as minor injuries or exacerbations of chronic disease), but a small proportion will be critically ill or injured.<ref name="flipside">{{Citation
 | last1 = De Robertis| first1 = Edoardo
 | last2 = Böttinger | first2 = Bernd W.
 | last3 = Søreide | first3 = Eldar
 | last4 = Mellin-Olsen | first4 = Jannicke
 | last5 = Theiler | first5 = Lorenz
 | last6 = Ruetzler | first6 = Kurt
 | last7 = Hinkelbein | first7 = Jochen
 | last8 = Brazzi | first8 = Luca
 | last9 = Thies | first9 = Karl-Christian
 | collaboration = ESA/EBA taskforce on Critical Emergency Medicine
 | title = The monopolisation of Emergency Medicine in Europe: the flipside of the medal
 | journal = European Journal of Anaesthesiology
 | volume = 34
 | issue = 5
 | pages = 251–253
 | date = 1 May 2017
 | doi = 10.1097/EJA.0000000000000599
 | pmid = 28375978| s2cid = 2287221
}}</ref> Therefore, the emergency physician requires broad knowledge and procedural skills, often including surgical procedures, trauma resuscitation, advanced cardiac [[life support]] and advanced airway management. They must have some of the core skills from many medical specialities—the ability to resuscitate a patient ([[intensive care medicine]]), manage a difficult airway ([[anesthesiology]]), suture a complex laceration ([[plastic surgery]]), set a fractured bone or dislocated joint ([[Orthopedic surgery|orthopaedic surgery]]), treat a heart attack ([[cardiology]]), manage [[stroke]]s ([[neurology]]), work-up a pregnant patient with vaginal bleeding ([[Obstetrics and gynecology|obstetrics and gynaecology]]), control a patient with mania ([[psychiatry]]), stop a severe nosebleed ([[otolaryngology]]), place a [[chest tube]] ([[cardiothoracic surgery]]), and conduct and interpret x-rays and [[ultrasounds]] ([[radiology]]). This generalist approach can obviate barrier-to-care issues seen in systems without specialists in emergency medicine, where patients requiring immediate attention are instead managed from the outset by specialty doctors such as surgeons or internal physicians. However, this may lead to barriers through acute and critical care specialities disconnecting from emergency care.<ref name="flipside"/>

Emergency medicine may separate from [[urgent care]], which refers to primary healthcare for less emergent medical issues, but there is obvious overlap, and many emergency physicians work in urgent care settings. Emergency medicine also includes many aspects of acute primary care and shares with family medicine the uniqueness of seeing all patients regardless of age, gender or organ system.<ref>{{Cite journal|url = http://www.ttuhsc.edu/ruralhealth/tjrh/XVIII1.htm|date=2000|title = Advanced Practice' Family Physicians as the Foundation for Rural Emergency Medicine Services (Part I)|last1 = Bullock|first1 = Kim|last2=MacMillan Rodney|first2=William|last3=Gerard|first3=Tony|last4=Hahn|first4=Ricardo|journal = Texas Journal of Rural Health|volume=18|issue=1|pages=19–29}}</ref> The emergency physician workforce also includes many competent physicians who have medical skills from other specialities.<ref>{{cite journal |doi=10.1016/j.annemergmed.2007.05.025 |pmid=17963988 |title=The Emergency Medicine Workforce and the IOM Report: Embrace the Legacy Generation |journal=Annals of Emergency Medicine |volume=50 |issue=5 |pages=622–3 |year=2007 |last1=Bullock |first1=Kim A. |last2=Gerard |first2=W. Anthony |last3=Stauffer |first3=Arlen R.}}</ref>

Physicians specializing in emergency medicine can enter fellowships to receive credentials in [[Subspeciality|subspecialties]] such as [[palliative]] care, [[critical care medicine]], [[medical toxicology]], [[Wilderness medicine (practice)|wilderness medicine]], [[pediatric emergency medicine]], [[sports medicine]], [[disaster medicine]], tactical medicine, ultrasound, pain medicine, [[pre-hospital emergency medicine]], or undersea and [[hyperbaric medicine]].

The practice of emergency medicine is often quite different in rural areas where there are far fewer other specialities and healthcare resources.<ref>{{cite journal | vauthors = Greenwood-Ericksen, Kocher K | title = Trends in Emergency Department Use by Rural and Urban Populations in the United States | journal = JAMA Network Open | publisher = JAMA | date = April 2019 | volume = 2 | issue = 4 | pages = e191919 | doi=10.1001/jamanetworkopen.2019.1919 | pmid = 30977849 | pmc = 6481434}}</ref> In these areas, family physicians with additional skills in emergency medicine often staff emergency departments.<ref>{{Cite web|url = http://www.aafp.org/online/en/home/policy/policies/e/emposition.html|title = Critical Challenges: Family Physicians in Emergency Medicine 2006, AAFP Position Paper|access-date = 22 September 2015|archive-date = 16 December 2011|archive-url = https://web.archive.org/web/20111216194551/http://www.aafp.org/online/en/home/policy/policies/e/emposition.html|url-status = dead}}</ref> Rural emergency physicians may be the only health care providers in the community and require skills that include primary care and obstetrics.<ref>{{cite journal |doi=10.1067/mem.2001.115217 |pmid=11524654 |title=Emergency medical care in rural America |journal=Annals of Emergency Medicine |volume=38 |issue=3 |pages=323–7 |year=2001 |last1=Williams |first1=Janet M. |last2=Ehrlich |first2=Peter F. |last3=Prescott |first3=John E.}}</ref>

===Work patterns===
Patterns vary by country and region. In the United States, the employment arrangement of emergency physician practices are either private (with a [[co-operative]] group of doctors staffing an emergency department under contract), institutional (physicians with or without an independent contractor relationship with the hospital), corporate (physicians with an independent contractor relationship with a third-party staffing company that services multiple emergency departments), or governmental (for example, when working within personal service military services, public health services, veterans' benefit systems or other government agencies).{{cn|date=December 2023}}

In the United Kingdom, all [[Consultant (medicine)|consultants]] in emergency medicine work in the [[National Health Service]], and there is little scope for private emergency practice. In other countries like Australia, New Zealand, or Turkey, emergency medicine specialists are almost always salaried employees of government health departments and work in public hospitals, with pockets of employment in private or non-government aeromedical rescue or transport services, as well as some private hospitals with emergency departments; they may be supplemented or backed by non-specialist medical officers, and visiting [[general practitioners]]. Rural emergency departments are sometimes run by general practitioners alone, sometimes with non-specialist qualifications in emergency medicine.