Emergency medicine has evolved far beyond what its founders envisioned. Once an afterthought of the health care system, it is now the gateway to care for millions. Every day, our emergency departments serve as the front door of the hospital and, for many, the only door into health care.
This is why I argue that emergency medicine safeguards human rights.
Consider the patient mix of any emergency department: we care for the indigent, the uninsured, the underinsured. We care for every patient regardless of race, creed, gender, pronouns, or political beliefs. We treat children, the elderly, the disabled, the addicted, the fearful. We meet patients without judgment, without prerequisites, without the power to choose who is “worthy.” This universality is not just a federal mandate but a duty; it is the very definition of human rights in practice.
Yet too often, we in emergency medicine lament what our specialty has become. “I rarely practice at the top of my license.” “This is not an emergency.” “Why are they even here?”
I have said these things myself. But I admit they miss the point. Emergency medicine has already grown far beyond its original boundaries. We have absorbed orphaned areas of medicine (toxicology, ultrasound, wilderness medicine, global health) because our specialty is uniquely flexible, malleable, and adaptable to the needs of society. We are a place where “broken” pieces find a new purpose and that is exactly our strength.
Now it is time to fully embrace what we are.
The crises we face today (relentless boarding, overwhelming capacity, endless wait times) are symptoms of a deeper reality: access to health care in this country is profoundly unequal. Horizontal equity (the idea that everyone gets the same care at the entry point) is what the emergency department provides. Anyone can walk through our doors. But vertical equity (access to higher levels of care when illness requires it) is still out of reach for far too many. Critical care, surgery, rehabilitation, palliative services: these remain privileges, not rights.
And yet, in the emergency department, we initiate these processes every day. We resuscitate. We stabilize. We connect. We stand at the hub of a complicated health care wheel, with specialists, hospitals, and community resources spinning around us. Too often, the wheel only turns because we push it.
That is why emergency medicine must reclaim its new identity, not as a stopgap, not as a dumping ground, but as a human rights specialty.
If you want to see the true conscience of health care, stand in an emergency department for a single night. Watch clinicians care for patients who have nowhere else to go, who have fallen through every other crack. You will see compassion without conditions, access without barriers, humanity without hierarchy.
Kintsugi is the art of pottery repair using glue and gold to reassemble the broken pieces, often creating something wonderful and more beautiful in the process. That is what emergency medicine already is. It is time we said so out loud.
Matthew Ryan is an emergency physician.
