b'As Dr. Robert Bitterman wrote in ACEP Now in 2018 3 , EMTALA forever changed the practice of Emergency Medicine. In essence, Bitterman noted, the law created a federal right to emergency care for anyone in the United States. But the law did more than that. The law required that patients be assessed and stabilized within the capabilities of the hospital simply because they presented there. This not only made the ED a safe place to receive medical attention, it made emergency departments the nations 24/7 safety net. After EMTALA, patients had access to health care without an appointment, and with no other requirement. From that point forward, the onus was on the ED to assess and stabilize patients. In effect, it made the emergency department clinically, legally, andby virtue of our professional vowsethically accountable for patients, simply because they arrived. All this happens irrespective of the reason the patient decided to seek care. The core mission of an EDto provide for the acute treatment of sick and injured patientswas alive and well. Over time, emergency departments became a point of confluence in the health care system for patients. Motivations for care-seeking behavior are many and diffuse, but often include difficulties accessing appropriate primary care, following treatment plans, and understanding medication schedules. Fueled by EMTALA then, the ED became a place where multiple challenges in a health care system were revealed, and where some challenges found refuge. Already a gateway between the outpatient setting and inpatient care, the ED increasingly becamea nexus where a variety of care-seeking motivations converged.It was now a 24/7 entry point for those who perceived a need to see a doctor. This happened irrespective of the patients economic or insurance status, their level of engagement with the medical system, the ability to care for their medical condition at home, or health care literacy. The ED as a Beneficial Resource for Hospitals Meanwhile, despite the considerable economic challenges that resulted from unfunded and under-funded patient populations, other forces worked to position the ED differently. Hospitals recognized the value of the ED as a front door to their suite of health care services. They endeavored to give patients rapid access to doctors (reduced waiting times), better experience of care (patient satisfaction), and better outcomes (quality measures). Hospitals advertised not only the ED itself, but real-time door-to-doctor times on websites and highway billboards. Over time, hospitals were required to report certain performance measures publicly, further spotlighting the ED as one of the hospitals most important interfaces with the community. The ED went from a reluctant after-thought to a 24/7/365 access point with few or no barriers, including: Patients of all ages, all health conditions, all manner of insurance (or non-insurance), and all levels ofhealth literacy. All had rapid access to a continuously improving clinical service, with publicly reported measures of effectiveness. Regulatory and certification bodies scrutinized the ED just as focally as any other element of the hospital, furtherdriving high-quality processes and outcomes.Meanwhile, emergency medicine matured as a clinical specialty. The number of residents graduating from accredited EM residencies dramatically increased. Community physicians increasingly referred their complex patients and potential admissions to the emergency department, rather than seeing them in the office. 4And although a minority of hospital admissions originated in the ED initially, today an average of 70% of the hospitals inpatients are admitted through the emergency department. 5Together, we healTogether, we heal 45Together, we heal SCP HEALTHIFROM INSIGHTS TO INTERVENTIONS'