Non–emergency-trained physicians working in an emergency department often say, “I am an emergency physician who does the same work as you; I just don’t have the residency training.” Endorsing this mentality sends the wrong message. In our department, we have physician assistants and nurse practitioners working alongside us who also do “emergency physician” work; they work under our supervision while the non–emergency medicine boarded physicians work independently. Just because I set fractures in the emergency department, deliver babies, and interpret ECGs doesn’t make me an orthopedist, obstetrician, or cardiologist. Likewise, there is a distinction between being an emergency medicine physician and being a physician who practices emergency medicine.
Explore This Issue
ACEP Now: Vol 33 – No 08 – August 2014To state that ACEP needs to incorporate non–residency-trained physicians into emergency medicine discounts the effort, knowledge, and dedication of emergency medicine–trained residents. It also sets a dangerous standard for the care of our patients.
Fortunately, we have reached a point where the medical community at large understands this distinction. Many hospitals already require emergency medicine–trained and –boarded physicians for staffing their departments, and when it comes to good jobs for our residents completing training, they are out there. Until we reach a point where there are enough emergency physicians available to fill every emergency department across the country, it is still necessary for non–emergency physicians to fill these positions in underserved areas. So why is it important that we continue to recognize the difference between “us” and “them”? And, more important, why not embrace them into our ranks?
If we allow non–emergency physicians the benefit of membership, what is it that they would hope to gain? They are already able to come to our conferences. They can receive our publications. They can publish in our journal. They already receive the benefits of our advocacy efforts even if they are not held to our standards. They will not provide a financial windfall to the College through their membership. The only reason to invite them is that we feel we need them at the table when we make decisions about the future of our specialty. I would argue, however, that we don’t.
Where the line must be drawn is the final remaining benefit that affiliation with the College would bring: a seat at the table. ACEP is recognized as the voice of emergency medicine, and our advocacy efforts put us in a position to make our voice heard when policies affecting us are being made. The important thing for us now is to make sure “our” message is the one being heard. No one is better equipped to determine the needs of our specialty than we are. No one is better able to develop clinical guidelines that we should follow than us.
Pages: 1 2 3 | Single Page
3 Responses to “Maintain Emergency Medicine Certification as Requirement for ACEP Membership”
August 17, 2014
edboudreauIt would be helpful to recognize that ACEP is not solely a political organization advocating for those who are being trained by the current model. I believe it short sighted to assert that learning can only occur one way. Training is not the only way to create a mindset and approach to quality. I believe ACEP should be advocating for the physician on the front line at the critical access hospital who was trained as a family physician but felt the pull to do Emergency Medicine. Does ACEP become stronger by excluding that physician from membership or dialogue.To suggest that Emergency Medicine can not be learned any way but the way I learned it is dangerous for our patients and our college. I suggest that those advocating an isolation position walk in the shoes of those they wish to exclude. Probably can’t be done in the halls of a big city academic institution.
Ed Boudreau,DO, FACEP, FAAEM
August 17, 2014
benzonitSorry, Dr.Radtke, but I have to vote for the big tent approach. I come to this position not by reading the words but by watching the actions of leadership.
I am one of those 30 year veterans of the early days. I boarded many years ago and have maintained my knowledge base. I am proud of our specialty and contribute to it in time, talent and treasure.
I noticed over a decade ago that non EM boarded physicians were claiming to be EM boarded by declaring EM as their specialty. (These same non EM boarded physicians deliver babies but do not claim OB/Gyn specialty.) These claims reside on State and Federal sites, including members of FSMB and CMS. ABMS is aware.
The claiming of boarding falsely has implications far beyond our specialty, of course. This is especially dangerous as the site hosting these claims are licensing and governmental. Communication with some of these boards has resulted in nothing, as our official bodies do not object.
Our ACEP has refused to take up the defense of our “trademark.” In this setting, how can we hold both positions? Anyone can claim to be EM boarded, using a governmental site. But our college would refuse membership to the same physicians who claim boards they don’t have.
The cognitive dissonance boggles the mind.
Thomas Benzoni, DO, AOBEM, FACEP
Sioux City, IA US
August 25, 2014
Anoop KumarWhat’s missing in this conversation is the topic of what the core skill is in emergency medicine. Consummate emergency physicians are masters of management as a whole, not just differential diagnosis or doing procedures. Leadership and management define the core of EM, but our residency programs and professional societies have so far not embraced this philosophy. Because we haven’t done so, we are a fractured specialty. We argue over who really is an EP and who deserves to be boarded without being clear on who we are to begin with.
If we embrace this philosophy and act on it, we will take our specialty to new heights as leaders in healthcare. It is something we sorely need in today’s healthcare climate.
I commented extensively on this is an article written last year:
http://www.kevinmd.com/blog/2013/09/leadership-management-define-core-emergency-medicine.html
Cheers,
Anoop Kumar, MD