Reflections: Addressing the quadruple aim in social emergency medicine

Hsieh argues that the ED should serve as a nexus of treatment for the whole patient, inclusive of social factors, by bringing together the expertise of medicine, public health, and social work. Fundamentally transforming the medical encounter in this way will require a paradigm shift in emergency care. Rather than seeing patients’ social needs as superfluous, or even as a burden to our care, we can envision reframing these needs as integral to our evaluation and treatment. One participant equated the importance of social determinants screening to that of our routine review of systems or inquiries on cardiac risk. Others evoked the intuitive motivation that all clinicians have toward providing quality care, which necessarily includes the skill of understanding circumstances that provoked or exacerbated the disease process. This shift in our scope of care has to begin in the early stages of training. Emergency medicine is poised to spearhead this transformation in medical education.

This article is part of a special supplement: Inventing Social Emergency Medicine: A Consensus Conference to Establish the Intellectual Underpinnings of Social Emergency Medicine.