Emergency medical care in rural America

The delivery of high-quality emergency care in a rural setting requires a c onceptual framework quite different from that required in urban and suburba n environments, given that available resources are limited in the rural set ting. The intermittent and episodic nature of seriously ill and injured pat ients who present to rural emergency departments makes it difficult to plan , staff, and equip in order to provide emergency medical care at the same l evel seen at higher volume urban or suburban institutions. The objective of this article is to describe the distinctive nature and widely unrecognized features of emergency medicine in rural and remote areas, with a focus on clinical, workforce, and economic issues. We present recommendations for a shift in thinking and a call to action an behalf of all emergency medicine professionals that are based on a realistic assessment of the current statu s of emergency medicine and that are needed to develop and sustain high-qua lity emergency medical care in rural America.