Many have been saying for quite some time that the practice of emergency medicine should evolve to widely transcend the traditional “bricks and mortar” of hospital-based emergency departents. Board-certified emergency physicians should be seen as physicians to all patients with acute, undifferentiated illness or injury in any setting. We believe in exploring opportunities for the practice of emergency medicine within ED-based ICUs, free-standing emergency departments, hospital satellite departments, and physician-owned hospitals, particularly in rural areas. Coupled with the evolving physical and digital infrastructure to predict outcomes and ensure follow-up care, the time is right to broaden our practice.
- Expand the reach of emergency medicine to ensure that no community is left behind
With strong diversity of practice among our members, ACEP recognizes the value of collaborative practice models between academic and rural/community sites to support mutual appreciation of different practice challenges and reduce feelings of isolation of among rural emergency physicians. Furthering the development of blended practice models could meet the needs of the emergency physician, the community, and the hospital while enhancing quality and reducing geographic disparities of care.
Conclusion
In sum, these considerations are a starting point to outline pressing issues and potential solutions proposed to date. Very importantly, your perspectives and approaches are critical to these ongoing deliberations. Differing opinions are still needed and welcomed, as it is vital all consequences, whether intended and unintended, are considered in advance. Feedback, via email or on a discussion forum, can be provided at acep.org/workforce.
ACEP remains dedicated to working together with those who share our commitment to identify data-driven solutions that promote both patient safety and emergency physician opportunities.
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3 Responses to “Workforce Considerations: ACEP’s Commitment to You and Emergency Medicine”
April 21, 2021
Johnny the EM guySo if I understand this correctly you want to restrict the pipeline (residency) of future EM physicians, restrict independent practice by mid-level providers, while simultaneously admitting there aren’t enough EM physicians in rural communities.
I am curious as to how you reconcile these obviously opposing goals?
You cannot force EM physicians into rural practices or hospitals. Nor can you force private corporate hospital system to pay rural EM physicians more in order to lure them there.
April 24, 2021
Eric sI don’t think that stopping the proliferation of emergency residencies is enough. All existing residencies will have to cut down on spots (perhaps 20-25%) because it is unreasonable to close some down. There are too many EM docs. The corporate jobs are already lowering pay because they can because there is a surplus. The only way to protect us and allowing us to work is to cut the surplus.
April 25, 2021
Robert McNamara, MDThis is an excellent document with great suggestions. To extend some of the themes above let me plead that the ACEP also endorse two items very closely aligned with the views stated here:
1) Ensure business interests are not superseding the needs of our patients.
2) Declare it unacceptable to have the contract for emergency services held by a lay for profit corporation. (this of course gives them the power to make staffing decisions)
Each of these goals can be obtained by advocating for enforcement of existing prohibitions on the corporate practice of medicine and by seeking such regulations where they do not exist or restoring those that have been weakened. It is for our patients after all.