The authors thank seminar participants at McGill University, Weill-Cornell Medical School, the University of Chicago, the University of Chile, the University of Connecticut, the University of Illinois Chicago, the University of Illinois Urbana-Champaign, and the University of Washington as well as conference participants at the American Society for Health Care Engineering Conference (Los Angeles, CA), the Highland Health Economics Symposium (Lochailort, Scotland), SIOE (Montreal, Canada), and the Workshop on Healthcare and Industrial Organization (Santiago, Chile). The authors thank Marcelo Olivares and Hummy Song for helpful comments; Michelle Houde and José Pérez at the Département de santé publique de Montréal for data assistance and extraction; Andreas Krull, M.D., and Marie-Josée Ouimet, M.D., for providing institutional details about Montreal emergency departments; and Sebastian Fleitas, Jianjing Lin, Kelli Marquardt, and Yujia Peng for excellent research assistance. Authors are listed alphabetically as study is an equal collaboration between all authors.