<p>Although once reserved for the seriously ill (Clancy and Eisenberg 1997), the emergency department (ED) has evolved as the principal provider of primary care with 40 per cent to 50 per cent of patients seeking care that does not require ED services (O’Brien et al 1997; Kellermann 1994). Factors that influence ED use include 24-hour-per-day availability and federal requirements that permit access to emergency assistance for all people (Clancy and Eisenberg 1997; Young and Sklar 1995).</p>