I work in a rural Minnesota ED with up to three physicians and a nurse practitioner on duty at many times. I started staffing my hometown ED in 1992, with the objective of staffing it with residency-trained emergency physicians. Even today, with a pay scale at the 90th percentile, there are only two American Board of Emergency Medicine–certified physicians working there. The rest are family practice trained and do a wonderful job. They may not possess all the knowledge of those trained in EM in recent years, but this situation illustrates two points: there is an ongoing shortage of residency-trained emergency physicians in rural America, and emergency care is delivered effectively every day by those not trained in emergency medicine.

Imagine our membership and lobbying numbers if we somehow included these physicians as members of ACEP in some unique category. We have many sections within ACEP, but they don’t add numbers or dollars because existing members are the only pool for section membership. A new section/category could be a substantive portion of ACEP membership. When Washington or Sacramento looks out on the horizon and sees a bigger group of physicians all rowing the boat together, our strength and influence will be notably enhanced while ACEP’s mission of continuing to improve emergency care will be more completely actualized.

We are recognized as a big player in the house of medicine as evidenced by the recent election of an emergency physician, Steven Stack, MD, FACEP, as president-elect of the AMA.

Any fear that we would lose what we have achieved by adding members who practice our specialty but are not EM trained is no longer applicable, in my opinion. Quite the contrary, I think our stature and effectiveness would grow.

As a past president, I’m often silent on such issues as I watch the College and specialty grow and develop. It’s time to break the silence. I ask that you consider my thoughts carefully as we move into the future as an established, well-respected specialty. We are only benefited by strength in numbers.

Dr. Stennes was ACEP president from 1985 to 1986.