What? You mean to tell me that even if I began practicing in some rural area where no specialist wants to go, performing successful cardiac caths, appendectomies, etc., I still wouldn’t be “accepted” into their college? Strange, that is.

The fact is all other specialties would (appropriately) scoff at the idea that I be accepted as an equal into their college without formal training. You can’t lower your standards just because there is a shortage of board-certified physicians—in any specialty. If we did, it would basically undermine everything our predecessors fought for (and we still do) in order to be considered something beyond simple triage monkeys. To do otherwise essentially says that anyone can do this job. And if that’s true, then why go through residency? And if you’re the hospital, why spend extra money on a “board-certified physician” when it’s own College states that non-emergency medicine–certified physicians have the same rights and privileges as those that are?

—Kurt Kaczander, DO
Laingsburg, Michigan

YES! Open membership to all those who practice EM.

—Saul F. Weinstein, MD, FACS
Jacksonville, Florida

I do not think that we should allow nonboarded physicians to be members of ACEP. I am not a member of the College of Surgeons or any other specialty because I am not a surgeon or any other specialist. Do we think that EM board certification stands for nothing? Why have it if it means nothing? Start another group called doctors who staff EDs if you want every licensed physician to join. Emergency medicine is a specialty and should be maintained as one, and our College should be just that—our College.

—Charlene A. Doyle, MD
Johnson City, Tennessee

The major reason to consider opening ACEP membership to non-boarded physicians is that it is best for the specialty and for our patients. The editorials by Dr. Smith and Dr. Radtke are both articulate and rational. They both wisely recognize that the issue is not about board certification, it’s about membership. Debates over board certification are part of our past and shouldn’t affect this issue.^1,2 In the early years of our specialty’s development, there may have been reason to be paranoid about our scope of practice, but we should now be proactive about what is best for the specialty and for our patients.

The question is not what is best for me or you or for these physicians. (They don’t care. I can say this for certain because I am, or at least was, one of them.)³ Most see ACEP—and all other EM professional organizations—as self-serving and self-protecting. But if ACEP wants to do what is best for our specialty, and for ED patients, there are compelling reasons to reopen membership.