ACEP and our specialty have developed progressively over the past 50 years, but the developmental journey wasn’t the same for all. Many contemporary emergency physicians may believe that when milestones were reached and barriers were overcome, such achievements advanced the lines of progress evenly. From a historical perspective, our evolution was not nearly so clean and uniform. Although some states, such as Michigan, enjoyed early recognition of our specialty, other parts of the country did not.
When I was a family medicine resident, emergency medicine was barely recognized as a specialty and there were no emergency medicine residencies in Tennessee. As interest in emergency medicine grew, the unique body of clinical knowledge was matched by the need for strong leadership and expertise to manage ED operations. So, ironically, in 1979, the year when emergency medicine became the 23rd recognized medical specialty, TeamHealth was born in Knoxville, Tennessee.
At that time, I partnered with Lynn Massingale, MD, FACEP, and John Minchey, MD, to form Southeastern Emergency Physicians. John Staley, MD, became a partner in 1987. Our goals were quite simple—to work with area hospitals to find a better way to care for patients with emergencies, a better way to operate emergency departments, and a better way to develop careers in our new specialty. We saw the hospitals around us facing a new challenge. They needed reliable, 24-7 physician coverage in their emergency departments, but no one was ultimately responsible for making sure the shifts were covered. With little or no backup, some hospitals were just one physician’s illness or travel delay away from an unstaffed emergency department and an emergency uncared for. We knew that was not sustainable.
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