Emergency medicine and family practice leaders agree that it is unsafe to have an ED without a physician. Indiana and Virginia legislatures recently passed on-site physician requirements.
As an Emergency Medicine PA who has worked in Critical Access for the past 15 years, I agree that best practice is to have an EM boarded doc in all EDs. Now the trick for all the EM docs is to take a lower wage that will allow that facility to remain open when margins are already very tight. Oh yeah, and go work in a facility without all the bells and whistles that the doc is used to. And as far as Family Med, I'm not so sure about that. I know there are some excellent ones, but there are also plenty that wouldn't be able to manage a modest day in a busy CAH.
By forcing CAHs and REHs to employ MD/DO full time, I wager that will force hospitals to close because they won't be able to support that added financial strain (I don't expect docs to take a significantly lower wage to work in a more austere environment because they have med school debt). That will cause the cascade of worsening health in that rural area as the hospital closes, losing employment in an already lower socioeconomic area. Subsequently health outcomes will decrease as the local populace who already have trouble getting to a local ED are forced to try and find transport to the larger ED that's over an hour away. Having a doc staffed 24/7 is a nice thought, but I don't think its feasible.
This is an incredibly disingenuous article. I am a board certified PA with 12 years experience working exclusively in rural and austere environments. Would it be nice to have a board certified EM doc in every ED in America? Heck yeah it would! Is it a pipe dream that is impossible to achieve? Absolutely! Rural hospitals run on a shoestring budget as it stands right now. Many are closing their doors on a daily basis. Limiting the fragile access many rural patients have to healthcare in general. Rural hospitals could never afford to staff their EDs with only docs. Why would they? When you can pay me a fraction of the cost to do the same work? Yes, I said ”the same work”. The standard of care doesn’t magically decrease because the care is provided by a PA versus a MD. To insinuate the care I provide to my ED patients is substandard or below what a physician would provide makes me angry. Yes, I didn’t go to medical school and I did not endure years in residency honing my skill set. However, I have been doing this a while now. I do believe strongly in collaboration and reach out to my physician colleagues when I need their help. Still, I believe I (and many of my PA/NP brethren) provide high quality, cost effective care to patients on a daily basis. Shame on the doctors in this article who think otherwise.
As an Emergency Medicine PA who has worked in Critical Access for the past 15 years, I agree that best practice is to have an EM boarded doc in all EDs. Now the trick for all the EM docs is to take a lower wage that will allow that facility to remain open when margins are already very tight. Oh yeah, and go work in a facility without all the bells and whistles that the doc is used to. And as far as Family Med, I'm not so sure about that. I know there are some excellent ones, but there are also plenty that wouldn't be able to manage a modest day in a busy CAH.
By forcing CAHs and REHs to employ MD/DO full time, I wager that will force hospitals to close because they won't be able to support that added financial strain (I don't expect docs to take a significantly lower wage to work in a more austere environment because they have med school debt). That will cause the cascade of worsening health in that rural area as the hospital closes, losing employment in an already lower socioeconomic area. Subsequently health outcomes will decrease as the local populace who already have trouble getting to a local ED are forced to try and find transport to the larger ED that's over an hour away. Having a doc staffed 24/7 is a nice thought, but I don't think its feasible.
This is an incredibly disingenuous article. I am a board certified PA with 12 years experience working exclusively in rural and austere environments. Would it be nice to have a board certified EM doc in every ED in America? Heck yeah it would! Is it a pipe dream that is impossible to achieve? Absolutely! Rural hospitals run on a shoestring budget as it stands right now. Many are closing their doors on a daily basis. Limiting the fragile access many rural patients have to healthcare in general. Rural hospitals could never afford to staff their EDs with only docs. Why would they? When you can pay me a fraction of the cost to do the same work? Yes, I said ”the same work”. The standard of care doesn’t magically decrease because the care is provided by a PA versus a MD. To insinuate the care I provide to my ED patients is substandard or below what a physician would provide makes me angry. Yes, I didn’t go to medical school and I did not endure years in residency honing my skill set. However, I have been doing this a while now. I do believe strongly in collaboration and reach out to my physician colleagues when I need their help. Still, I believe I (and many of my PA/NP brethren) provide high quality, cost effective care to patients on a daily basis. Shame on the doctors in this article who think otherwise.