Dr. Saggar responds: Dr. McUne makes excellent observations about the standard of care in America. I'm sure he would agree that the same standard should exist everywhere, whether you are a patient in a rural, urban, suburban, or academic setting. My message was that core competencies — the skills and knowledge that we as emergency physicians possess — matter more than one's resume. This standard applies to electricians and kindergarten teachers. It is debatable how those core competencies must be defined, but simply declaring that we don't need to worry about the details and just shout “EM residency only” is interesting. I'm happy that Dr. McUne agrees that EPs should be certified in ACLS, PALS, and ATLS. The key is that we shouldn't fragment the specialty by arbitrarily stating that just because someone learned his core competency skills differently, he should be maligned or not allowed to practice. There are many ways to become an emergency physician, and one certain way is to complete an EM residency.
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.