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Letter to the Editor

AAEM's Concerns about APPs Are Unfounded

doi: 10.1097/01.EEM.0000559989.74973.50
Letter to the Editor


I read with considerable amusement Dr. Andy Mayer's article sounding the alarm about APPs encroaching into his turf. (“AAEM Opposes NP and PA Independent Practice,” EMN 2019;41[4]:2;

Perhaps I would share even a modicum of empathy for AAEM's concerns if I were not one of the many physicians whose (30-year) career was made considerably more difficult as a result of the same alarm he is trying to spread now, which was previously about physicians who trained in a specialty related to emergency medicine and had the audacity to practice EM. I even did post-graduate training. Not pure enough, according to the self-proclaimed guardians of EM, Dr. Mayer's AAEM.

Dr. Mayer tried every argument except the only one that counts: Show the data that demonstrate APPs, especially those with the doctorates he fears (lions and tigers and bears, oh, my!), or physicians who trained in a related specialty and then got EM experience provide inferior care!

As Dr. Mayer and AAEM know, the data would demonstrate superior care and patient satisfaction. And what do they make of the Canadian experiment of 45 years in which the vast majority of EPs do EM fellowship instead of EM residency and provide care at a much lower cost?

Dr. Mayer's concerns have never been and are not now about patient care quality. The AAEM bed was made some time ago. Time to sleep in it.

Geoffrey L. Ruben, MD

Washington, PA

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