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Letter to the Editor

Thank You for Shining a Light on Rural EM Issues

doi: 10.1097/01.EEM.0000616520.58173.23
Letter to the Editor


Thank you for featuring two articles on rural emergency medicine from two of the best emergency medicine leaders and authors! The articles by Anne Zink, MD, and Edwin Leap, MD, are essential reading for leaders in EM and anyone who is interested in emergency medicine's future. (“Rural Residents Deserve Good Emergency Care,” EMN. 2019;41[10]:3,; “Rural America, Already Feeling Marginalized, Needs Real Solutions, Not Just Telemedicine,” EMN. 2019;41[10]:15,

I challenge the ACEP and AAEM leadership to stop the chess game on rural EM issues. ACEP considered a resolution on rural EM at the 2018 Scientific Assembly, but rural EM issues are generally a low priority. The workforce policies of ACEP and AAEM keep those organizations specialty-centric (instead of patient-centric) because neither has addressed the mandate from the Institute of Medicine to work collaboratively on workforce issues. Emergency medicine has matured enough as a specialty to acknowledge that family physicians are part of the rural EM workforce. Patients in rural areas have been pawns for too long. Maybe EMRA needs to resolve this by moving the specialty past our grandfathers' turf wars.

As I described in a recent article on rural EM, “We have arrived at a stalemate as the health policy debate on rural EM has been ‘specialty centric,’ not ‘patient centric.’ Collaboration—not competition—is needed to solve rural ED workforce issues and improve patient care. Health policy recommendations have emphasized the importance of a partnership between specialties to solve the rural EM issue, but due to the politics of medicine, these recommendations have largely been ignored.” (J Am Board Fam Med. 2019;32[3]:292;

We need more residency-trained emergency physicians in leadership roles in rural EM, and we also need to recognize that family medicine is an ally, not an opponent, in solving rural EM issues.

W. Anthony Gerard, MD

Palmyra, PA

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