1961: The First Full-time Emergency Physicians Emerge

The cover of the fortnightly magazine Medical Economics was pure tabloid on the week of July 15, 1963. A cartoon on the cover showed a hulking, tattooed laborer with a boo-boo on his index finger. The accompanying headline declared war in stentorian boldface—"OUR ENEMY THE EMERGENCY ROOM."

This issue did nail the medical zeitgeist; it just put the wrong story on the cover. Inside was a profile of an emergency room staffing plan developed by Alexandria, Virginia physician James Mills Jr., M.D. He saw two problems: his family practice did not leave him enough time for his own family, and the hospital needed reliable emergency room staff to cover growing demand.

Mills—ACEP’s eventual second president—wasn’t looking to change medicine. But at the end of yet another 18 hour day he realized that "in emergency service, with regular hours, I would be able to practice much better medicine." In the summer of 1961, after some planning and recruiting, Mills and three others left their practices to become full time emergency docs—an arrangement called the Alexandria Plan. Around the same time, doctors in Michigan created the Pontiac Plan: rotating about 30 doctors, each working between 16 and 32 hours a month, to cover the off hours at Pontiac General.

Establishing a working business model for the growing problem in emergency room coverage helped set the stage for the birth of a discipline.

Next Week: LBJ Funds EMS 

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