But wait—it didn’t stop there! We discussed what it means to be a Fellow in the College and the criteria used to determine recipients of this designation, which we consider truly an honor. Ours are actually more stringent criteria than many specialties use to confer fellow designation. ACS COT leadership was so impressed with FACEP that they inserted the following language:

If a physician has not been certified within the time frame by the certifying board after successful completion of an [Accreditation Council for Graduate Medical Education] or Canadian residency, the physician is not eligible for inclusion in the trauma team. Such a physician may be included when given recognition as a fellow by a major professional organization (for example, the American College of Emergency Physicians). The only recognized organization is the American College of Emergency Physicians.

This essentially means that if physicians are Fellows in the College but not boarded, they still meets the trauma center criteria. We believe this is another huge win for ACEP members and their patients.

“States may request national ACS to provide verification, but they may also modify national criteria and verify centers themselves. As you might expect, this is quite variable from state to state and many states do it entirely themselves without national involvement.”

It is important to understand these are national criteria employed when ACS COT sends review teams into states for verification visits. However, trauma verification is largely a state-run process. States may request national ACS to provide verification, but they may also modify national criteria and verify centers themselves. As you might expect, this is quite variable from state to state, and many states do it entirely themselves without national involvement.

Another concern raised at times is that emergency physicians are not part of the verification team. This is not completely true. There are many states where emergency physicians are an integral part of the team. For instance, in my home state of Virginia, I have been doing trauma verification visits for more than 10 years. Generally, the authority for trauma center designation rests with state health departments. They set the standards locally. If an emergency physician is not included on the team in your state, that is the place to start advocating for inclusion. The verification team from national ACS traditionally includes two trauma surgeons. However, it was noted that certain states require an emergency physician as part of the site visit team. When verifying in those states, the national ACS team includes an emergency physician as requested by the state. The surgeons at our discussion felt having an emergency physician added an important dimension and noted that, “they caught things we would have missed.” Discussions are ongoing in this regard at the national level. However, advocating for emergency physician inclusion at a state level may be more productive since the requirements are actually set by each state.

More Collaboration Ahead

Further demonstrating this new era of cooperation, a joint task force has been formed with representatives from the ACEP Medical Services Committee, the National Association of EMS Physicians, and ACS COT to develop a guidance document on use of tranexamic acid in the field.