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 IssueACEP Now: Vol 33 – No 08 – August 2014
To 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.