Letter to the Editor
I was interested to read Dr. Andy Mayer's article concerning APP independent practice. (“AAEM Opposes NP and PA Independent Practice,” EMN 2019;41:2; http://bit.ly/2Ka5XuP.) This issue is acutely pertinent to our local situation. I am in a group of independent physicians, and a contract management group took over our contract surprisingly in November.
They just notified us of some of the changes they will make, which include decreasing physician hours to make room for midlevel providers because they are cheaper to employ. This means full-time doctors will have to decrease their hours, and part-time doctors will not be used anymore. We are board-certified, experienced physicians who have lost our jobs to non-physicians. I was told by the CMG exec (also my former residency advisor) that it was just business. So emergency medicine is just down to business now.
We need help to advocate for all emergency physicians. This also helps advocate for patients because they are mostly unaware that this change is taking place. There are multiple problems with the encroachment of APPs into our specialty, as Dr. Mayer pointed out. At this point, how can we recommend being ABEM-certified (with all of the MOC hoops to jump through, etc.) when those who have done none of this can take our jobs?
APPs were originally started to help doctors, not to replace them. Job security is a thing of the past.
Deborah Fletcher, MD