b'SUMMER 2023EXECUTIVE PRIVILEGE The Tragedy of the Commonsand House Bill 106By Richard J. Hamilton, MD, MBA, FACEP To understand why Emergencyquality and scarcity of grass, are shared Departments often suffer from the bestamong all users of the commons. As a intentions of others, I need to beginresult, the collective action of farmers with a little economic history lesson.pursuing their individual interests leads In medieval towns, sheep grazed onto the depletion and degradation of the Richard J. Hamilton, MD, MBA, FACEP pasture, ultimately harming the entire PACEP President 20232024 common lands. This land, used by allcommunity\'s long-term welfare.without limit, provided farmers access to a shared pasture, known as theThe phrase "The Tragedy of the commons, to graze their sheep. TheCommons" was introduced by ecologist commons were a public commodityGarrett Hardin in his influential 1968 available to all they needed. Of course,essay of the same name published each farmer sought to maximize theirin the journal Science. Hardin usedbenefit and added more sheep to theirthis phrase to describe a concept in flock, knowing that each additionalwhich individuals, acting in their self-sheep provided them with increasedinterest, deplete or degrade a shared .when individuals seek toprofits in terms of wool or meat.resource, leading to its ruin. The tragedy However, the pasture has a limitedof the commons thus serves as a optimize their outcomescarrying capacity, meaning it can onlycautionary tale, emphasizing the need without regard for thesupport a certain number of sheepfor collective action, regulation, and without becoming overgrazed andresponsible management to prevent greater good, the resourcedegraded. the degradation and depletion of becomes overburdened,Since the pasture is not privatelyshared resources.leading to longer wait times,owned, individual farmers have noWhen applied to emergency compromised quality ofincentive to limit the number of sheepdepartment (ED) overcrowding, they graze. Each farmer is driven bythe analogy becomes clear. The ED care, and increased strain ontheir self-interest to increase theirserves as a critical healthcare resource healthcare providers.own flock, as the benefits accrueaccessible to all individuals in need of directly to them. However, the costs ofimmediate medical attention. However, overgrazing, such as reduced pasturewhen individuals seek to optimize continue reading on page 3'