Hi,
I've worked in several ED's and have never been involved with a department that requires the Director to staff the ED full time. I have seen Directors try to both though and usually one area suffers. If they worked enough in the department to keep their skills at a comfortable level the management side suffered and vice versa. Seems like it would be tough to be involved with the Director side of the department, maybe not right there in the actual ED, when the department has immediate urgent needs.
Nomad