In this engaging discussion, Paul Atkinson, a Professor of emergency medicine at Dalhousie University, and Grant Innes, an emergency physician and health services researcher, tackle the flaws within emergency medicine. They dive into how systemic reforms are crucial to evolving practices, especially for elderly care. The duo critiques current admission protocols, advocating for a shift from the four-hour rule to better prioritize real patient needs. They also address the importance of efficient management strategies to improve emergency department outcomes and patient safety.