You need only look at the internet to see that as a medical speciality A&E is still a spotty teenager when compared to such venerable institutions as the Royal College of Physicians and the Royal College of Surgeons. While rival websites are obviously produced by professionals, bristling with fancy graphics, the official site for accident and emergency medicine looks as if someone threw it together in their bedroom one wet Sunday afternoon.

But change is afoot. Britain's hospital A&E units are to be rebranded "emergency departments" next year. Consultants and trainees are, apparently, to be balloted on this. The hope is that the change of name may deter people with minor complaints or injuries from wasting doctors' time. The faculty of accident and emergency medicine at the Royal College of Surgeons is to be renamed the College of Emergency Medicine. The hope is that the Queen can then be persuaded that training doctors how to treat medical emergencies properly is really quite a good thing, and to grant the college a royal charter. The Royal College of Emergency Medicine can then have a website as posh as everyone else's.

So will this make any difference to how long you have to wait in A&E - or what kind of treatment you get?

Emergency medicine has had a long and troubled childhood. Some claim that casualty departments originally got their name because this is where "casual attenders" (those without a referral from a doctor) could get hospital treatment, although "casualty" in the meaning of an injured person had been in use long before. In 1967 the Casualty Surgeons Association began a long struggle to change its name to the British Association for Accident and Emergency Medicine. Not until 1977 was the speciality recognised as separate to other branches of medicine for training purposes, and as recently as the mid-80s many district hospitals had no A&E consultant. The department would usually be looked after by one of the orthopaedic consultants. Fine if you had a broken pelvis, but annoying if you had just occluded your right coronary artery. Of the few A&E consultants there were, many were failed surgeons, whose knowledge of acute medical emergencies was sketchy at best.

When I first entered a central London A&E department as a fully-fledged doctor in 1986, it was common practice for us to treat such complete non-emergencies as ingrown toenails and unsightly moles. One of the senior doctor's favourite pastimes was ear syringing. We certainly dealt with a fair amount of the more serious stuff, but a lot of the time we played happily at being a walk-in GP centre.

As a student at a large teaching hospital I had seen an 18-year-old bleed to death without even a drip up, simply because no one knew what to do or who to ring. Thanks to the advent of trauma teams, this sort of thing no longer goes on. Other things have changed since then, and the term casualty has been frowned on within the speciality for some years now by those who rightly regard themselves as specialists in the treatment of any kind of medical or surgical emergency. The treatment of heart attacks has brought acute medicine into the middle of A&E departments. One of the most important things we do now is administer clot-busting drugs to patients with myocardial infarctions (otherwise known as heart attacks). It has to be done as soon as possible, and is a treatment that simply did not exist 15 years ago. The management then was to stand by with a cup of tea and a defibrillator.

I now work at a medium-sized hospital in a fairly impoverished area of northern England. The department did not have its own consultant until 1988; it now has four. We see nearly 70,000 new attendances every year, from life- and limb-threatening conditions to cases where you need the eye of extreme faith to spot even the smallest suggestion of anything wrong. Most emergency departments (if that is what we are to be called) are like this, all over the country. No matter what they are called, no matter how many consultant emergency physicians are given offices within the building, to a generation of local people it is still "casualty", or more commonly, simply "the hospital".

"Oh, the doctor was closed so my neighbour/gran/doctor's receptionist/hairdresser said I should just pop up the hospital," is something we hear every day. Not so long ago, the department would be staffed by local GPs during the night, so the chances were you might even end up seeing your own family doctor with your sore throat. Not any more. But for thousands of local residents, many of whom have little or no spoken English, the natural source for out- of-hours medical advice is the local hospital. Add to that the fact that there are still quite a few single-handed GP practices around, whose night-time and weekend cover is sometimes stretched to invisibility, and the trivial presentations to our new, shiny, emergency department become a little less baffling.

At times even searing sociological insight is not enough to calm the spirit, or explain the plainly stupid things that people use their local A&E for a six-month-old corn on Christmas day morning; a change of batteries for the hearing aid; lingering air-sickness (we are a 45-minute drive from Manchester airport); the guy who thought his McDonald's milkshake was "off" and wanted us to "test it"; sore knees for exactly 36 years. And the brand new entry at number one is the girl who rang 999 because she had some chewing gum stuck in her hair.

It would be nice to think that the thousands of pounds spent on re-branding, new letterheads and signage, will mean our emergency departments are less clogged by non-emergency patients. Nice, but if history is anything to go by, a little naive. The fact is that whatever we call the A&E, our patients are still going to call it casualty or the hospital or whatever they choose, and dropping the word "accident" from stationary is not necessarily going to make a difference to how many people turn up, and what kind of experience you have there. Of course, all this rebranding might help A&E's standing within medicine, and that might ultimately affect you, but that's something we will have to wait and see about.

· Ed Walker is a specialist in emergency medicine and part-time tutor in communications skills in West Yorkshire.