Fig. 3From: Application of systems dynamics and group model building to identify barriers and facilitators to acute care delivery in a resource limited settingSynthesis of Causal Map of Barriers and Facilitators to Acute Care Delivery in the pA&E. R: Reinforcing, B: Balancing. Physician presence: refers to the physical presence of a supervising consultant physician in the pA&E. Faced with competing academic, administrative, and other demands, a consultant may not always be available and present in the pA&EBack to article page