The Times, They Begin Changing

The decades after World War II featured great prosperity and myriad cultural shifts, all surfing the great demographic wave of the Baby Boom. In the emergency room, visits were growing faster than antiquated staffing schemes could handle. One of the first signs that the medical establishment was taking notice was "The Emergency Room and the Changing Pattern of Medical Care," published in the January 2, 1958 issue of the New England Journal of Medicine. Lead author Ernest Shortliffe, M.D. was associate director at Hartford Hospital, which studied its own emergency room patterns to justify expansion.

Looking beyond, Shortliffe saw that from 1940 to 1955, ER visits increased by almost 400% nationwide. "This study reflects an apparent change in thinking upon the part of physicians and public and suggests that physicians and hospitals should plan for the future by increasing emergency-room facilities," he concluded. "It is believed that this trend is dictated by the public."

The journal editorialized in the same issue that "in the last analysis the experience and judgment of the physician who directs this care is the indispensable sine qua non."

Next Week: "Our Enemy: The Emergency Room"

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