Dr. Saggar responds: Dr. Evans poses some intelligent questions. I think the basic requirement of being an MD or DO was stated in my article, and he is right about new drugs having to prove themselves with evidence. Emergency medicine residency training is the new drug, and the onus is on those who arbitrarily call it the gold standard to prove their statement. You cannot ask the older drug (practice track emergency physicians) to prove it is better. Emergency medicine residency training is not a proxy for skill, as he declares; if it were and if market forces were really allowed to rule, then ABEM would not bar practice-track EPs from taking the exam after an unscientific, arbitrary declared date.
Closed shops are created to manipulate market forces. I stated that all physicians who have been in practice for x number of years should be allowed to prove themselves next to their self-defined superior peers. In a market truly driven by economic forces, those with residency training would have nothing to fear, and competency equivalency studies would be possible and actually mean something. I work in a group where only one of 14 physicians is emergency medicine residency trained, and I think my hospital's administration is far from stupid. This is the case in thousands of hospitals across the U.S., and hopefully it will continue to be the case because hospital administrators are smart enough to see beyond the turf wars and the attempts by some lobby groups to define the specialty in their own image when clearly there is more than one way to skin a cat. That is the bigger picture.
The authors are the principal investigators in the Olive View-UCLA Department of Emergency Medicine/Division of Infectious Diseases, and have been awarded a five-year, $9 million grant from the National Institutes of Health to study the use of off-patent antibiotics for treating uncomplicated skin and soft tissue infections. The study will be conducted at Olive View-UCLA, Johns Hopkins University, Maricopa Medical Center in Phoenix, Truman Medical Center and the University of Missouri in Kansas City, and Temple University Medical Center in Philadelphia.