The claiming of boarding falsely has implications far beyond our specialty, of course. This is especially dangerous, as the sites hosting these claims are licensing and governmental. Communication with some of these boards has resulted in nothing, as our official bodies do not object.

Our ACEP has refused to take up the defense of our “trademark.” In this setting, how can we hold both positions? Anyone can claim to be EM boarded, using a governmental site. But our college would refuse membership to the same physicians who claim boards they don’t have.

The cognitive dissonance boggles the mind.

—Thomas Benzoni, DO, AOBEM, FACEP
Sioux City, Iowa

I read the pro and con arguments for opening ACEP to all physicians who work in EDs vs keeping membership to those who are actual emergency physicians. I understand the advantage of opening membership; it swells numbers. That has its advantages, but who are we as ACEP? Who are our colleagues?

40 years ago, it made sense to open the borders, if you will. However, we are now a recognized specialty. We have a body of knowledge that ostensibly represents our expertise. We have the advantage, in many hospitals, of not being required to maintain “merit badges” such as advanced cardiac life support, basic cardiac life support, advanced trauma life support, and the like. Why is that? Why do the non-EM docs who work in my ED occasionally have to maintain these certs and I don’t? Could it be because, as a board certified EM physician, it is recognized that I have earned the right to be called an emergency physician—a specialist in emergencies and resuscitation? Do general surgeons typically do cardiothoracic surgery or is a cardiothoracic specialist called in?

There was a time, not too long ago, when those who blazed the trail of EM for the rest of us had a window where they could sit for the American Board of Emergency Medicine/American Osteopathic Board of Emergency Medicine board and grandfather in. There was recognition that it was only fair to allow those who never had the chance to train formally in EM to join the ranks of the board certified. A couple of them I am honored to call my colleagues at my home shop, and they are great docs. However, that window closed in 1988. Now there is no excuse for not being residency trained. Board certified means something, doesn’t it? I understand that there are those who work in EDs full time and started after the window closed. I mean no disrespect to these great docs. However, at some point we have to decide what the future will look like. I suspect every new specialty goes through this transition.