As I was working my way through Virtual ACEP14, a wonderful resource, I was suddenly overtaken with sadness. Since Jerry Franklin died, I am the only doctor I know among all the DOs and MDs who work with critical access hospital (CAH) emergency departments here in West Virginia who gets to be dazzled by rock star master teachers, such as Amal Mattu, and to see all the latest and greatest on the exhibitors’ floor. My colleagues are excluded from ACEP membership because they come from family practice backgrounds, which, as my own and other research shows, is the reality of rural emergency medicine. These physicians are filling the need where no residency-trained emergency physicians want to work but are excluded from the best educational resource in the field. Not only is this sad, it is a betrayal of ACEP’s mission. This policy is sustained by those with no skin in the game.
Back in the Cold War, ’50s and ’60s, when nuclear war was imminent, a social critic, Ping Ferry, proposed a reality check deterrent stating that 200 of the elites’ children should be educated in the capital of opposing power, 100 American children in Moscow, 100 Russians in Washington, D.C. Before “pushing the button” that would incinerate millions of children and adults, the Soviet premier and American president would be required to personally slit the throat of each of the opposing camp’s children. This would remove the idea of nuclear carnage from the abstract. In a similar way, the terrible idea of excluding family practice–trained emergency physicians from ACEP only flourishes in the abstract. If the advocates of this policy actually spent some time visiting CAH EDs, spending some time in our shoes, many would better understand why exclusion from ACEP is clearly a move in the wrong direction if improved ED care in the United States is the goal.
Equally asinine is the sophistry used to rationalize this policy of exclusion. The faulty reasoning goes that since the predominantly family practice–trained MDs and DOs who provide CAH ED care are not EM residency trained, they are not “real emergency physicians” and hence can be excluded from the ethical obligations of ACEP. Not only is this as irrational as declaring the person flying the airplane not to be the pilot, it is insulting to our life’s work. In denying the life of fellow physicians, this exclusionary policy has rejected and abandoned a vital part of the American EM workforce.
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2 Responses to “Opinion: Open ACEP Membership to Non-ABEM Trained Colleagues”
April 25, 2015
Tony GerardThank you, Dr. Leveaux, for your passionate comments. Are you aware of the long ( and often controversial) history of ACEP’s support for non-ABEM board EP’s?
Many of us who are non-ABEM boarded share your passionate feelings about ACEP membership. But this is a difficult issue, since residency trained EM physicians have equally strong feelings, but an opposite viewpoint. Both sides agree that ACEP membership has merit.
Associate membership is important because ACEP should represent all EP’s ( strategically, its a huge mistake for the college to limit it’s membership to residency trained EP’s) But even if this happens, it won’t necessarily fix the issue you describe. Many non-ABEM boarded EP’s will still misunderstand what the college has done on this issue. But re-opening college membership will be symbolic, even tho’ associate membership will not have the same perceived merit as full membership.
Some of us have written extensively about the issues facing non-ABEM boarded EP’s over the last decade, and it’s laudable that these issues are still being discussed/ debated. ( some specialty societies in EM prefer the “Ostrich” solution*).
I’m proud of what ACEP has done for non-ABEM boarded physicians over the last two decades. Specialty societies that have adopted the “Ostrich” solution* put member’s interests ahead of patients, and ACEP has refused this narrow solution.
Let’s hope the Report on opening membership is evidence based and not emotion based. The college needs to open membership for alot of pragmatic reasons. If this happens, we will have one more thing to be proud of on a difficult issue.
( * Ostrich approach: “bury your head in the sand” = ignore the problem. This idiom originates from the habit of ostriches to lower their heads when feeding or turning eggs; they do not actually bury their heads)
June 9, 2015
Terry Mitchell, MD, FAAFP, FACEPI agree with the articles and letters that call for opening ACEP in some way to non emergency medicine residency trained physicians. I also believe they should be given an award to shoot for. I had planned to drop my ACEP membership of many years, when ACEP offered me a brief chance to become a “Legacy” physician. I am now a Fellow of ACEP and have remained a member. Membership dues and political action donations would both increase with opening up the membership, and giving the non-RTEP a title that can be earned. More physicians would be aware of the CME opportunities with receiving ACEP e-mails and lierature, and attendance at events would increase. The ACEP book store would sale more. How does anyone lose by including all the physicians who currently work in emergency departments? I can see the argument about not allowing non-RTEP’s to become eligible for board certification, but I cannot see anyone of reasonable judgement to support denying them membership and some type of merit badge that can be earned. ACEP truely has the ability to substancially raise the quality of emergency medicine in the United States in a very short time by opening the membership once again to non-RTEM physicians. Even if I were BCEM, I would still want membership opened up for both raising the quality of patient care in our nation, and for the substancial money inflow ACEP would experience.
Terry Mitchell, MD, FAAFP, FACEP