Explore This IssueACEP Now: Vol 34 – No 04 – April 2015
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.