The editorial by Sonny Saggar, MD, blows my mind. (“The Dermatologist and the Magician.” EMN 2007;29:4.) I am usually open to viewpoints different from mine, but that article was outrageous! He stated that saying he is an emergency physician is equivalent to saying he is a Republican or a Democrat. What hogwash! I am a Republican or Democrat by my beliefs and by checking a box on a form.
I want to be a surgeon. Can I check a box somewhere to make that happen? I see the young man in India becoming a surgeon by reading books and watching videos. He may be a good surgeon, but I bet Dr. Saggar would not let the young man operate on him.
Dr. Saggar was very good at grouping and then slamming all emergency medicine practitioners. Anyone can do this job. You know, I'll bet I could get a quick course set up on the Internet to train garbage collectors with no college education to work as emergency physicians. It is obviously something easy to do.
We have standards that we as Americans count on when we see a physician who calls himself a specialist. Why should the ED be different?
I love his lines about ACLS, ATLS, etc., as not being for profit and only teaching to evidence-based criteria. Right. I have been practicing for only a few years, and have seen multiple changes to the programs. I have seen medicines added that have shown no promise or show promise in only one study. They, like the Joint Commission, have to keep changing things to justify their existence. I do think emergency physicians should be certified in ACLS and PALS, if only to be instructors for others. To require that they be mandatory for all physicians as core competency just negated my years of residency. Yep, that'll keep us all together as a group and less fragmented!
I see nothing wrong with rural hospitals hiring physicians in other specialties to staff the ED, but the public has a right to know who is staffing the ED. Having some basic requirements to be a specialist, and trained emergency physicians are specialists, should be a given. I want to know the certifications for my financial planner, my broker, and my physician. Heck, I know electrical circuits pretty well, but my county won't let me install them. Why? Because they want proof of education and skill. Even my kid's kindergarten teacher has special certification.
Emergency medicine residency is the accepted way to be certified as an emergency medicine specialist. As a consumer, I want to know who is taking care of my family and the level of training they have obtained.
Russ McUne, MD
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.