The healthcare landscape from the viewpoint of a worker.
In Texas the patients win and if I remember correctly it is about the patients.I recently donated a shift to NEMPAC and I wonder if I could get my money back?Dr. Gardner you need to be reminded that you represent ALL ACEP members.
Consider me reminded. I DO represent all ACEP members. I also have a duty to uphold the policies of the College. When members disagree, the forum for change is the Council. That is the great joy of a democratic organization - reasonable people can have reasonable discussions of issues and come to agreement using the democratic process. Please remember this: the true test of a servant leader is to carry out the directions of the policy-making body, regardless of personal conviction.
Does this mean, Dr. Gardner, that your PERSONAL opinion is that BCEM is equivalent to ABEM? Even though BCEM is recognized by neither the ABMS nor the AOA? Even though, most importantly, BCEM does not require completion of a residency in emergency medicine before taking board exams? If that is your opinion, how can you justify a different set of rules for emergency medicine as compared to EVERY other specialty? The only justification I can think of for that belief is that its holder must also believe emergency medicine is not a legitimate specialty, and should never have been granted its status as an independent specialty. No matter how conscientiously you carry out the Council's policies, I hope that is not the personal opinion of ACEP's president.
The answer is that my personal thoughts on this issue are irrelevant. I uphold, speak for, and promulgate ACEP Policy....."It is the role and responsibility of the American Board of Emergency Medicine and the American Osteopathic Board of Emergency Medicine to set and approve the training standards, assess competency through board certification processes and establish professional practice principles for emergency physicians."
Dr. Gardner:I find it most interesting that ACEP, who considers themselves the "voice of emergency medicine physicians," continue to do battle with the American Board of Physician Specialties (ABPS).ABPS, and its parent organization the AAPS, were founded in 1950 ---fully 18 years before ACEP was founded.I understand that one of ACEP's major complaint against ABPS board certified EM docs, if not the only complaint, is that ABPS doesn't require residencies in EM.If this is ACEP's major complaint against ABPS' BCEM, why is it OK for ACEP's president-elect, Sandra M. Schneider, MD, FACEP, to not have completed a residency in EM?Why is it OK for Andrew E. Sama, MD, FACEP, ACEP's Secretary-Treasurer not to have a residency in EM?Why is it OK for Michael J. Gerardi, MD, FAAP, FACEP, ACEP board member not to have his residency in EM?Why is it OK for Jay A. Kaplan, MD, FACEP, ACEP board member not to have his residency in EM?Lastly, why is it OK for Robert C. Solomon, MD, FACEP, ACEP board member not to be residency trained?You may retort that when these physicians did their residency training that EM residencies were not available. That is NOT the case --- several EM residencies were in place in the mid-70s.There are other "leaders" in the EM field that don't have their residencies in EM --- Members of the board of ABEM itself, for example:Robert E. Collier, MD, Director, American Board of Emergency Medicine --- no residency in EM.Joel M. Geiderman, MD, Director, American Board of Emergency Medicine --- no residency in EM?Do I have to go on?
In my experience the hallmark of all world class organizations is an overriding commitment to something bigger than self. In medical organizations the order of priority for me would be something like this:1. Patient welfare2. High quality care3. Ethical business practices4. The welfare of the specialty5. The capability of its practitioners to deliver theseLike many teenagers, the specialty of EM seemed to lose its way in its teens in the 1990s when both ACEP and AAEM reversed this order, each in an effort to prove that they were more the provider’s advocate than the other. What got lost was the overriding commitment to the specialty itself.I don’t see how any emergency medicine professional society can claim leadership of the specialty while simultaneously ignoring or actively lobbying against the interests of 40% of its practitioners who fill a critical specialty need. A need that residency trained emergency physicians are unlikely to want to fill or be able to fill anytime soon.
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