Talk:Emergency medicine

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WikiProject Medicine / Emergency medicine and EMS (Rated C-class, High-importance)
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Heading[edit]

First Emergency Care is done by many other physicians that do not need to be board certified by "Emergency Specailists" from Primary Care to Tertiary Care there are also important Emergency Medical Sevices! An all should better cordinate themselves in an whole Integrated (Public Health) Emergency Medical System.


Second The big problem in "EMS" with the american restricted sense, is the tendency of demedicalization in the sense of non participation of Care Medical Professionals , in the sense of Freidson Definition of a Professional.

In many Jurisdictions prehospital-ambulance care providers are evolving toward independent practice and even they call it Paramedecine! . They may have limited contact with other health care providers and can develop more allegiance to security service agencies, such as the police and fire services. The Canadian AAEMSP believes that collaboration between emergency medical technicians and knowledgeable, committed physicians providing medical control and regulation is essential for the provision of high-quality care based on sound, current scientific knowledge. Our belief, and that of others, is that abdication of or exclusion of physicians from this role increases the risk of conflictual, inappropriate, cost-ineffective and potentially dangerous prehospital medical care.


ABEM vs BCEM[edit]

I just read your content on Emergency Medicine, the content appears to have a distinct bias toward the the ABEM. It is obvious that your editors don't have insight into to ongoing controversy in emergency medicine,board certification or the current physician workforce in the United States. This article misinforms the public and misrepresents the facts. Your free encyclopedia service has been used for spin and political gain. The question is who wrote this "crap"..."Patients should be wary of anyone who represents themselves to be "Board Certified" in Emergency Medicine, but the board is not ABEM or AOBEM. The problem of Sham board certification is not unique to Emergency Medicine, and patients should be careful to check that any physician be "board certified," by one of the medical specialty boards of the American Board of Medical Specialties or the American Board of Physician Specialties. As mentioned the ABPS certification is controversial." Here are some facts your article did not contain.....Information from Emergency Physicians' Monthly newspaper Vol.8, No.9 Sept.2001 p.19 (Katz Report)

ACEP Statistics (and information accumulated by Katz) ~32,000 EP's in USA currently ~17,300 are ABEM boarded ~1,078 are AOBEM boarded <12,500 are EM residency trained Given these numbers:

~13,622 EP's in practice currently are not ABEM or AOBEM boarded = 42.5% ~19,500 are not EM-residency trained (~61%) Status of BCEM certification- In February 2002, the Florida Board of Medicine made a specific finding of fact that AAPS:

. . . is a legitimate and bona fide organization, whose specialty certification boards have been providing recognition to allopathic and osteopathic physicians for over fifty years. In order to obtain specialty certification, licensed physicians must meet rigorous requirements of the appropriate certification board. Eligibility requires advanced training, significant experience, good moral character and successful completion of a specialty examination. In addition, in order to maintain such certification, every physician is required to complete recertification every eight (8) years.

The Florida Board of Medicine ultimately concluded that AAPS should be granted approval as a specialty recognizing agency. As a result of the Board of Medicine’s action, any AAPS allopathic board certified Diplomate may now hold himself or herself out to the public in Florida as a board certified specialist.

Commonly Touted Myths-

Myth: ABEM (or AOBEM) - certified physicians provide a higher quality of care than non-ABEM/non-AOBEM-certified emergency physicians. Reality: There are no valid studies that demonstrate a difference in outcomes between those with ABEM/AOBEM certification (including those with emergency medicine residency training) and those denied access to these exams, but who are practicing high-quality emergency medicine. Myth: ABEM/AOBEM-certified physicians reduce the risk of malpractice claims against hospitals. Reality: There is no evidence to support this notion either. Generally, practice experience plays a more important role in ensuring quality patient care than any limited specialty certification test. (For example, the ABEM exam is required once every 10 years, and BCEM is required once every 8 years in ordered to retain certification. That is why many groups/organizations are moving towards the idea of “Continuous Certification”, including methods of Practice Assessment.) Myth: There is a shortage of ABEM-certified physicians, thus justifying their higher salaries (compared to non-ABEM-certified physicians). Reality: The shortage of ABEM-certified physicians is artificial, created by the closure of the practice track (quite prematurely). This shortage has increased the real and perceived value of these physicians and may be in violation of the Sherman Antitrust Act (see Daniel et al. v. ABEM et al. Civil Action No. 90-1086A, U.S. District Court for Western District of New York). In addition, funding for EM residencies has decreased, resulting in less EM-residency trained physicians graduating annually. EM-residencies are not given the same funding for a physician who has had a previous residency (as they do for obtaining residents fresh out of medical school), making it very difficult for a practicing physician to obtain a spot in an EM residency. There are several EM fellowships available in the US (primarily for family physicians), but these are quite limited. Add to this that anecdotally, many physicians in practice will testify that many of the best EP’s in practice in their hospital ED’s are not those that are EM-residency trained or board certified in EM. Myth: Physicians who are not EM-residency trained or ABEM/AOBEM-certified are “moonlighters”. Reality: Surveys of non-ABEM/AOBEM certified EP’s have shown an average of 10 years of full-time ED experience. (Many of these EP’s are not certified by ABEM because they have not been allowed to sit for the exam.) Other Interesting Information-

The ABEM “practice track” (which no longer exists) required 7,000 hours and 60 months of emergency medicine practice (including 24 continuous months of EM practice) and 50 CME hour each year in practice. The BCEM exam requires (amongst other criteria) completion of an Emergency Medicine Residency -or- completion of a residency in a primary care specialty, practice of Emergency Medicine on a full-time basis for five (5) years (=60 months), and accumulation of a minimum of 7,000 hours in the practice of Emergency Medicine. [For an excellent comparison of the criteria for the three emergency medicine board exams available, see the ABPSGA web site at http://www.abpsga.org/certification/boc_comparison.html. AEP Fellowship Criteria include practice and/or teaching of Emergency Medicine for a minimum of 60 months total; and accumulated 7,000 hours total in the practice and/or teaching of Emergency Medicine; and accumulated 2,800 hours consecutively within any 24-month period of time; confining one’s practice to Emergency or Urgent Care Medicine; accumulation of 150 hours of CME credit within the previous three years of practice that is acceptable to the Fellowship Committee; and a demonstration of commitment to Emergency Medicine by active involvement in various ways. [For full AEP Fellowship Criteria, please contact the AEP Office, or see the Members-Only section.] Θ

  • Recent edits have removed some of the controversy regarding BCEM certification. Some of the convtroversy seems highly relevent (such as North Carolina rejecting BCEM as allowing the designation "Board Certified.") Interestingly enough, the above diatribe is a copy and past from the AEP.org webstie. ABEM no longer recognizes the practice track as they felt that it was not equivalent to residency training in Emergency Medicine. Since I personally have substantial bias, I have to wonder about other's thoughts.Bdolcourt 16:31, 9 September 2006 (UTC)
I just came to this article to try and find out a bit more about emergency medicine and was kind of surprised by the content. Now I see why! This whole section is more of an essay than an encyclopedia article at the moment. I'd suggest almost all the details around these qualifications ought to come out of the article. It's an article on emergency medicine in general - not on the controversies that the US has over qualification, or the detailed requirements of each certification process. The bit that is most relevant to this article in my opinion is:
Many types of physicians may practice in an Emerency Department; however, only those who have successfully passed the board certification process are considered "Emergency Medicine Specialists". Currently the ABEM and AOBEM require a number of years of residency training after medical school, followed by comprehensive written and oral examinations. The BCEM requires (in addition to passing written and oral examinations) completion of an ACGME approved residency in an approved specialty such as Family Medicine or Internal Medicine, 5 years of the practice of emergency medicine, 10 Peer reviewed case reports, current ATLS/PALS/ACLS certification and 3 letters of recommendation from peers.
A sudden surge of interest in the specialty in the late 1990s was due to the popularity of the American TV series ER. Showcasing the function of a Chicago Emergency Department (loosely based on Cook County Hospital) and its many characters, the show introduced a large number of people to the specialty.
Obviously rewritten, with sources, a sentence about the fact that recognition of certification is on a State by State basis (at least that's what I think is implied by the North Carolina reference above), and - if US physicians generally agree this is a significant controversy - a mention that there is controversy. The rest should go into other articles - possible one on each type of certification, or Emergency Medicine as practiced the USA - linked to from this article. Just an idea from a reader. --SiobhanHansa 17:45, 9 September 2006 (UTC)

How come there's nothing in the article specifically about emergency nursing? —The preceding unsigned comment was added by 68.238.181.203 (talk) 17:41, August 23, 2007 (UTC)

External links[edit]

The External links section is turning into an inappropriate web directory. Can we identify the most important ones and dump the rest? WhatamIdoing (talk) 03:28, 13 February 2009 (UTC)


Recent changes[edit]

All sources must be cited, and while you may think summarizing is good remember that the only time that is needed is if the article is difficult to read or it is in the intro. Also, the recent changes have a poor word choice. Aaron mcd (talk) 06:31, 14 August 2009 (UTC)

Member Organizations[edit]

The bullet-point list of organizations and certifying bodies has good info, but is too long and busy. Additionally, each of the organizations is a distinct entity that could have its own article. I'm condensing the list and breaking out the articles or merging info into the appropriate existing articles, if any. - Draeco (talk) 20:49, 26 August 2009 (UTC)

I created a draft article on one of the member organizations: Society for Academic Emergency Medicine. Please provide feedback if possible. Thank you. Seablue86 (talk) 22:01, 22 December 2011 (UTC)

Work[edit]

This section needs to be modified for a more international point of view. Work situations in the UK, Ireland, Canada and the EU are very different from the United States, this is not currently represented here. —Preceding unsigned comment added by 132.205.125.154 (talk) 18:46, 6 May 2011 (UTC)

Occupation Image[edit]

If we are pointing the image of an emergency doc towards a building, we are failing. Let us point an image towards an actual person doing the job. Better illustration in this. I have improved the image. 400 Lux (talk) 03:39, 12 April 2014 (UTC)