Physicians Seek Recognition for EMS as Subspecialty of Emergency Medicine

[Doczilla]

The reason behind this push is to get more physicians into EMS fellowships. It's a difficult argument to make to a resident just completing residency that they should do an EMS fellowship, when there is no recognized subspecialty exam, no pay differential, and no additional recognition. This push is really more about the physicians than EMS as a whole. There are other potential benefits, though, including a larger base for EMS research.

I tend to take the view that this further cements the relationship between doctors and EMS which shouldn't have to be there in the first place. This will make it even harder to become an independent profession with our own scope of practice if we have a group who has their own agenda for keeping it under their domain.

I'm going to ask that you clarify this statement. Are you proposing that EMS providers have their own prescribing privileges? And are you saying that EMS medical directors have a reason behind this agenda?

It is interesting; however, physicians in the United States are not as involved in EMS as many other countries. In countries such as South Africa and Australia, physicians work extensively in the pre-hospital environment and are quite involved with the pre-hospital providers. This is something that is unique in the United States. So, I see this as a potentially good move for physicians in the United States.

In many other countries, physicians do work in the prehospital environment, but a lot of that is a cultural thing that comes from EMS's origins in those countries. In the US, EMS was born from public safety and from funeral homes. It's hard to argue now to pay someone $150K+/year when they can get a paramedic for $40K (or less). If communities or hospitals decided to pay a physician a proper physician's wage for working prehospital, you'd have more of them doing it. This becomes harder to justify in this day and age of evidence-based medicine, when it is difficult to demonstrate the benefit of prehospital ALS, particularly showing the difference between outcomes with a paramedic providing the prehospital care or a physician (which I don't think there is any reproducible objective data to support). We may know it's a good idea, but we've got to be able to prove it to the bean counters.

'zilla

[Richard B the EMT]

I thought that "Emergency Medicine" was ALREADY considered a medical specialty amongst the MDs and DOs?

[JPINFV]

Emergency Medicine is an established specialty. What they are looking for is to make EMS (wouldn't "prehospital medicine" be a better name?) a subspecialty of Emergency Medicine. Kinda of like how cardiology is a subspecialty of internal medicine.

Edited March 16, 2009 by JPINFV

[Doczilla]

I thought that "Emergency Medicine" was ALREADY considered a medical specialty amongst the MDs and DOs?

It is. We have a national organization (ACEP, AAEM, SAEM) and our own specialty boards. (ABEM)

Emergency Medicine is an established specialty. What they are looking for is to make EMS (wouldn't "prehospital medicine" be a better name?) a subspecialty of EMS. Kinda of like how cardiology is a subspecialty of internal medicine.

Also correct.

'zilla