There is no doubt that the best way to develop the skills to practice emergency medicine is through EM residency training and board certification.  However, unless there is a significant increase in the number of EM residency positions ACEP will never be able to accomplish its mission of advancing emergency care. In addition, non-EM certified physicians can benefit from resources such as educational opportunities and research endeavors that are aimed at their type of practice. ACEP’s advocacy resources can also empower them to champion emergency medicine in their communities. It is by enhancing the skills and supporting the work of all physicians who are able to demonstrate a dedication to emergency medicine that ACEP’s mission can be realized.

Whether or not these physicians are ACEP members, they are the backbone for emergency care in certain areas—they are part of the emergency medicine workforce.

They should be part of ACEP.

—Donald L. Lum MD FACEP
Chair, Emergency Medicine Workforce Section

I am a family medicine board certified fulltime, life-long legacy ER physician. I am also ER medical director and hospital chief of staff and facility ER director for our 54,000/ year high acuity ER. I am an ACEP, but not ABEM, member, as I have been excluded in spite of my lifelong work in a high acuity, high volume, and high intensity ER in Phoenix, Arizona. I’m confused by the discussion, as I am a non-ER boarded ACEP member (although I lack the ABEM pedigree) but certainly believe the association, not the college, represents all dedicated fulltime ER practitioners based upon quality of ER and acute or critical care expertise and skills, and support those with similar clinical competency being included in ACEP.

—Mark E. Sexton, MD
Phoenix, Arizona

Sorry, Dr. Radtke, but I have to vote for the big tent approach. I come to this position not by reading the words but by watching the actions of leadership.

I am one of those 30-year veterans of the early days. I boarded many years ago and have maintained my knowledge base. I am proud of our specialty and contribute to it in time, talent, and treasure.

I noticed over a decade ago that non-EM boarded physicians were claiming to be EM boarded by declaring EM as their specialty. (These same non-EM boarded physicians deliver babies but do not claim OB/GYN specialty.) These claims reside on state and federal sites, including members of Federation of State Medical Boards and the Centers for Medicare and Medicaid Services. The American Board of Medical Specialties is aware.