Names matter. They shape expectations, guide behavior, and in medicine, determine how systems are built, how resources are allocated, and how clinicians practice. The name "emergency medicine" is one of the most consequential misnomers in American healthcare. It implies a discipline defined by urgency and life-threatening conditions. The reality, borne out by decades of data, is considerably more complicated, and the gap between the name and the reality has quietly become a crisis of its own. [MEDPAGE TODAY]

This is not an indictment of emergency physicians. This is a challenge to the institutional mythology that has calcified around a specialty name, one that legitimizes overutilization and may be doing patients and the system a quiet, compounding harm.

Are Most Emergency Department Visits Actually Emergencies?

The data on how "emergent" most emergency department (ED) visits are is consistent, voluminous, and largely ignored. The U.S. logs approximately 155 million ED visits annually -- at a cost that reached $76.3 billion in 2020 alone. If these were primarily emergencies, such spending might be justified. But the acuity data tell a different story.

A 2025 analysis from Texas A&M's School of Public Health found that nearly 40% of ED visits involved conditions that physicians viewed as non-urgent or issues better suited for primary care. Other research suggests the U.S. sustains an estimated 18 million avoidable ED visits each year, adding $32 billion in costs to our healthcare system annually.

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