Last year, the American College of Emergency Physicians celebrated its 50th anniversary with a campaign entitled “Bring ’em all: Chaos. Care. Stories from medicine’s front line.” There were posters, a book and testimonials about the history of this relatively young specialty and the advances made in the care provided in emergency departments over the recent decades.

But it was the title that really stuck with me because it encapsulates precisely the daunting and rewarding task that we, as emergency care providers, embark upon every day: a specialty that seeks to provide immediate medical care to anyone with any problem at any time. This is the ethos with which we meet patients in their time of need in places such as Lewiston and countless other cities on any given day.

Lewiston has not one but two portals to expert emergency care; two organizations whose final product represents layers upon layers of organizations and bureaucracy at work to protect the public and assure a high quality, consistent, patient experience. The recent, well-publicized citation by the Centers for Medicare and Medicaid to Central Maine Medical Center is an example of this system working well. However, it really only scratches the surface of the behind-the-scenes machinery functioning to secure our well-being as each of us enters the medical system.

Think of this: Right now, you or one of your family members can go to either CMMC or St. Mary’s Regional Medical Center and walk into the emergency department for any reason. As soon as you step foot on the property, you fall under the protection of the Emergency Medical Treatment and Active Labor Act. That is a federal law that mandates anyone, regardless of financial capacity, must receive basic screening and stabilizing care (which could include a three week ICU stay). You cannot be turned away. Once in the front door, you are within the confines of a building that is frequently inspected by and assured to be in compliance with state, federal and independent agencies for quality and safety.

You are then met by a system that seeks to quickly organize incoming patients by the presumed severity of their illness (triage). Since no appointment is necessary, you may arrive at the same time as 10 other patients. All patients must be evaluated as quickly and efficiently as possible. This system must absorb a range of patient acuity, from a 5-year-old in cardiac arrest to a 30-year-old with a month of ankle pain.

Irrespective of the complaint, every patient must be evaluated by an emergency physician or advanced practice provider. Both hospitals in Lewiston have committed to staffing their emergency departments with emergency medicine specialists and nurses — which is not the case elsewhere in this state. All are well-trained and closely monitored throughout their career. As an example, an emergency physician has completed medical school (four years), residency (3-4 years, conservatively estimated at 10,000 patient-care hours where I trained). They have obtained (and maintained) a state medical license. They have then passed the emergency medicine boards (written and oral examinations). All providers have been reviewed and approved by the hospital’s internal credentialing committee. All must complete many hours of continuing education every year. Any unusual cases or complaints are rigorously reviewed by an internal peer-review process. The board of medicine in each state reviews cases as requested by patients or hospitals.

For many patients, emergency medicine is but the first stop on a path through a hospital staffed by other equally scrutinized medical specialists, support staff and physical plants. Emergency patients are often evaluated and treated on an urgent basis by trauma surgeons, interventional cardiologists, intensivists and hospitalists, to name a few.

So where does that leave you, the about-to-be emergency patient, living in a community where CMS has found a deficiency and the hospital has devised an acceptable plan of correction? My answer: Minutes away from unscheduled, expert-level care, delivered by a group of caring individuals with world-renowned training and experience, working at institutions that strive far beyond a response to a CMS complaint in their continuous quality assurance and patient safety initiatives.

Sheldon Stevenson is associate medical director of emergency medicine at Central Maine Medical Center.