Thanks are due to Thomas Cook, MD, for gathering the stunning numbers for his December article. (“The Invasion of the Physician Assistant,” EMN. 2019;41:1; http://bit.ly/37ZBQOv.)
Can I be the only one noticing that while the big shots in the emergency medicine establishment pressed ahead with their insistence that EM board certification for physicians was necessary to ensure quality of care, they were building bulwarks pointed in the wrong direction? Who could have imagined that the actual threat to quality would come from the rear, and that organized medicine would remain silent (and clueless) as we allowed nurse practitioners and physician assistants, who have not even completed medical school, to diagnose and treat patients? I suppose that, as a profession, we will get exactly what we deserve.
On the other hand, Dr. Michelle Johnston's climate change lament got it all upside down. (“In Courage, Hope for a Better Future,” EMN. 2019;41:22; http://bit.ly/34FKEqw.)
She says the climate crisis is “not like faith or political persuasion or any other ideology” because it is “a red, hot fact” and not something you can choose to ignore. Well, faith is something one cannot ignore, mainly because you're going to be dead for a long while, and your choices here and now actually do matter. As for the climate crisis, that is ideology in its purest form and can easily be ignored.
Here is Dr. Johnston's settled science of climate change: The climate is changing. (This is almost certainly correct. Always has been.) Man is causing it. (Now this is a stretch but possible.) We know precisely how to reverse it. (This is laughable.) And this can be accomplished with timely global cooperation. Given that neither India nor China is willing to put their development on hold while the First World saves the planet, this is actually the most ridiculous part of the claim. This isn't science. This is religion.
James Brewer, MD