An ER Doc’s Top Ten List

The post below was circulated to me anonymously. Yes, it’s a rant but I think it is extremely pertinent to the discussion and would like to share it with you all. I agree with many of the points made, (except for the FMGs):

Tom Scaletta, MD FAAEM: …”For instance, it could be required that physicians are board certified (or prepared) in emergency medicine.”

MY TOP TEN LIST:
1) What about the fact that only about half the ER docs are EM-RT (in spite of HUGE increases in our EM residency slots and programs) ?

2) What about the fact that ‘MORE THAN HALF’ the ERs in the country are covered with non-EM-RT docs ? (because we don’t train for, and we cannot interest the new grads in working in the trenches, and we don’t have ANY solutions to discuss) ?

3) What about the fact that 1/3 of the resident in the country are FMGs already ?

4) Where do we get these residents to fill all those forth coming (not really) NEW GME slots ?
(does medicare fund this…someone should just tell them we need more money…I think they will just write us a check, because health care has been so thrifty and cost effective

5) Where do we get the spots in medical school to teach them ? (AAMC says we need a 30-40% increase across the board, maybe more in states likeTexas and Florida)

6) What about the fact that already the Number 1 and Number 2 schools filling residency slots are Caribbean schools ? (St George’s Univ and Ross Univ…Number 3 Illinois…) (AAMC data)

7) Why don’t we just STEAL the medical students going into Internal medicine
and Family Practice ? ( it doesn’t matter that they have a crisis too and want more GME slots and are filling about half their classes with US grads ALREADY—hey we should look into getting more docs to leave their county and practice here–who cares about their country

8 ) Where do we get the college grads interested in Medical School ? (med school deans say there are less than 20% quality applicants out there to increase it to, not the 30-40% AAMC wants)

9) What about the fact that the med school deans say it will take 15 years before we see the first grad out of residency ?

and the MOST IMPORTANT OF ALL

10) The Lawyers, Insurance companies, Chiropractors, Nurse Practioners, Optometrist, Psychologist, Physical Therapist, Acupuncturist are just jumping for joy that we cannot “COME TOGETHER” (great slogan I heard somewhere). That we spend time and money fighting WITH EACH OTHER in Florida and other places, to make our product look better, to make more money, to increase the cost of healthcare.
Because the Nurse Practioners in Texas only have one issue this year….increased scope of
practice…..and the Optometrist have only one issue this year….increased scope of practice. and we should have 67 from the IOM report. But no, apparently THIS is a priority issue. I am sure our patients would just love to hear about how we smart doctors are looking out for ourselves, oops I mean “their safety”.
If this is such an important SAFETY issue, perhaps we should just close half of the already overwhelmed ERs in the country seeing 11% more patients in the last 2 years (while gearing up for the next Bioterrorism Event), because we don’t have a better “solution”. “

“We must all hang together, or assuredly we shall all hang separately.” -Ben Franklin