Letter to the Editor
EM Has Many Battles to Fight
A big amen to the Viewpoint on sepsis by Mark Mosley, MD. (“Sepsis Is the Hill to Die on,” EMN. 2019;41:3; http://bit.ly/2JHxnFp.) How we as a profession allow CMS, hospitals, and other specialties to direct emergency medicine has always baffled me. It's a reason I gave up my ACEP membership and FACEP title. I was tired of pouring $1000 a year into an organization that didn't seem to be helping me.
The sepsis battle is one front, but we also have the steady devaluation of our specialty with the continued encroachment of PAs and NPs. We are seeing jobs literally disappear. I recently received a job tip from a CA hospital that has 45,000 visits a year and is staffed single-coverage (two 12-hour shifts) with three PA shifts. This is increasingly the model that cost-cutting hospitals and contract management groups are going to use.
There are still many facilities that continue to require merit badges set by outside specialties. Why should I maintain ACLS, PALS, and ATLS to get a job when I am boarded in EM? And how is it that anesthesiology can tell me whether I can safely use propofol in the ED or ketamine as a pain adjunct? I see emergency medicine needing to battle many fronts. We need to stand up and quit rolling over. I think that starts with ACEP getting out of bed with the contract management groups.
Donald Dawes, MD
Santa Barbara, CACopyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.