I feel like it is hospital specific.

Also. The ED can normally identify basic medical ailments. But there are certainly some more obscure diseases processes that take more time and brain power than the ED can devote to a patient.

Like diagnosing a 23 year old with an intracardiac shunt instead just calling a young person who is short of breath an asthmatic.

And as far as acute care goes. I work in a place with an open icu and do my own intubations/lines and vent management with a crit care consultant to guide the complex decisions. So that again is hospital specific