I read the article “Merit Badge Madness” with interest, and agree with its main points. (EMN 2011;33:5.) At the same time, because merit badges have been a problem for more than 20 years, we need to have a better understanding of “why” than the authors offer.
Arguably, the reason we continue to have this problem is our apparent reluctance to take a definitive stand on who is an emergency physician. In the absence of our offering this clear definition, hospitals and others spin their own definition out of merit badges.
Our reluctance to define “emergency physician” seems to be out of fear of offending anyone working in an ED by declining to include them in the definition, even when they are not qualified to join ACEP and AAEM. Why? Do general surgeons refer to family practitioners who do surgical procedures as surgeons? No. Why are we skittish about defining “emergency physician” in such a way that excludes those not eligible to join our specialty organizations?
Yes, we should demand respect for our specialty from those promulgating merit badge requirements. But the road to respect begins with us, and the first step is to stop calling anyone who works in an ED an emergency physician. Only after the world understands this distinction can we expect to be released from these sorts of requirements.
Robert E. Suter, DO