KevinMD January 27, 2026
The emergency department didn’t suddenly get worse.
The numbers did.
Every shift, emergency clinicians are measured by dashboards that insist on telling a familiar story: Door-to-provider times are too long, length of stay is unacceptable, left-without-being-seen rates are creeping up. The implication is clear. We’re slow. We’re inefficient. We’re failing.
But those numbers are no longer describing clinical performance. They’re describing system saturation.
Emergency departments today operate in conditions that were once considered temporary failures: chronic crowding, prolonged boarding, hallway care, ambulance offload delays, and staffing shortages that never fully resolve. Yet the metrics used to judge performance were designed for a system with open beds, downstream capacity, and predictable flow. That system is gone.
What remains is a dangerous...
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