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DALLAS, Aug. 16, 2068 —“Good morning, Mr. Smith,” the nursing home’s artificial intelligence bot chimes. “Your heart rate and respiratory rate have been trending upwards overnight. I also noticed that you were coughing and your oxygen levels are a bit low. Would you like me to call the ED?”

A moment later, the hologram of an emergency physician appears. “Place the auscultation sticker on your back. It sounds like you have some fluid in your lungs, which could be secondary to a variety of conditions. You don’t look so hot, and you’re 72, so I think you should come in for a 3-D ultrasound and possibly some IV antibiotics.”

Emergency medicine has come a long way since ACEP was founded in 1968, from the first training program at the University of Cincinnati in 1970 to the founding of the Emergency Medicine Residents’ Association (EMRA) in 1974 to finally being recognized as the 23rd medical specialty by the American Board of Medical Specialties (ABMS) in 1979. Fifty years later, TV shows like “M*A*S*H” and “ER” have been produced, EMTALA and the prudent layperson standard have been enacted, and more than 140 million patients seek care from us annually.

Our nation has gone from dermatologists treating our sickest and most vulnerable patients in emergency rooms to specialist emergency physicians providing care in sophisticated departments. We’ve transformed America’s acute care system. However, as the residents who lead EMRA, it’s our job to imagine and prepare for the future. Fifty years from now, emergency medicine will be as different from today’s specialty as we are currently from our 1968 roots.

By the time Mr. Smith arrives at his local freestanding emergency department, his vitals have been uploaded by EMS, he has been preregistered, and his copay has been automatically deducted from his virtual wallet. He skips the waiting room, and the Internet of Health Care Things–enabled ultrasound rolls itself to his stretcher. The operational software has used his transport time to preschedule an appointment with the ED ultrasound technician. Twenty minutes later, Dr. Casillas, his board-certified emergency physician, sits down on Mr. Smith’s bed and holds his hand as she delivers the difficult news of a new lung mass and likely malignant effusion. At the same time, a virtual natural language processing scribe documents their conversation, codes the encounter, submits it to a national clearinghouse for reimbursement, and prompts her to place orders that had been previously placed for patients with similar presentations.

Dr. Casillas is a first-generation American who might not have had the opportunity to attend medical school in the 20th century, but by 2040, medical school had become significantly more affordable by shortening the time spent to 2.5 years and through funding from local counties and states to produce physicians who would serve their communities. Residency programs had also dramatically changed, transitioning from time-based to competency-based curricula, resulting in training lasting a variable number of years. Though the news Dr. Casillas delivers is heartbreaking, it is another example of the human connections made and compassionate care provided every day in emergency departments around the world.