Emergency PA/NP Utilization Task Force

Update January 15, 2020

The PA/NP Task Force continues its work to refine a draft of its report. The group will meet again in February to consider suggested edits from various groups represented on the task force.

Two main tenets of the task force have emerged and will remain unwavering throughout any draft iterations –

• Nurse Practitioners and Physician Assistants should not work unsupervised in an emergency care setting.
   
• Physicians should not be required to sign a chart without seeing the patient.

A timeline for the Task Force to deliver a final report has not been determined.

Goals, Purpose, and Objectives

In the summer of 2018, Dr. Paul Kivela, ACEP’s president at that time, expressed interest in exploring the future of emergency medicine (EM) practice. There were many concerns, including the economics of practice, future workforce needs, the role of physician assistants (PAs) and nurse practitioners (NPs), the consolidation of the employment market, to name just a few. To determine the most important first steps in this discussion, Dr. Kivela appointed a Board-level workgroup to discuss the issues and suggest the first steps.

Dr. Kivela appointed Christopher Kang, MD, FACEP to serve as chair. Others appointed to the workgroup were James Augustine, MD, FACEP; Nida Degesys, MD; Alison Haddock, MD, FACEP; Kevin Klauer, DO, EJD, FACEP; and Debra Perina, MD, FACEP. Dr. Sandra Schneider served as staff liaison.

The group recommended a task force composed of stakeholders in the provision of care of emergency patients, including AACEM, AAEM, AAENP, ACOEP, AMA, EMRA, NAEMSP, RAMS, RSA, SAEM, and SEMPA.

The workgroup suggested that the primary objective be: recommend the scope of practice for PAs and NPs in the ED, considering such factors as membership growth, education, training and experience, patient acuity, employment models, and the utilization of adjuncts such as telemedicine and other forms of oversight.

Timeline of Projects

Task force appointed - September 2018
In-person task force meetings - ACEP18 and LAC19
Report to the ACEP Board of Directors - October 2019 meeting (first draft)
Endorsement request to representative organizations - January 2020
Feedback from representative organizations reviewed - Beginning February 2020

Task Force Members

ACEP Representatives:

Dan Freess, MD, FACEP – Chair

Savoy Brummer, MD, FACEP

Kathleen Cowling, DO, FACEP

Susan Derry, MD

Zach Jarou, MD

Gabor Kelen, MD, FACEP

Linda Lawrence, MD, FACEP

Leslie Mukau, MD, FACEP

John Rogers, MD, FACEP

Nathan Schlicher, MD, JD, MBA

Phillip Shayne, MD, FACEP

Suzi Siegel, MD, FACEP

Sullivan Smith, MD, FACEP

Tom Sugarman, MD, FACEP

John Sy, DO, FACEP

Representatives from Other Organizations:

AACEM – Andrew Nugent, MD, FACEP

AAEM – Robert Frolichstein, MD

AAEM/RSA – Gabriel Stahl, MD

AAENP – Paula Fessler, RN, MS, NP; Elda Ramirez, RN, MSN, FNP

ABEM – Deepi Goyal, MD, FACEP

ACOEP – Joseph Beirne, DO, FACEP, FACOEP-D

CORD – Danielle Hart, MD

EMRA – Jason Lesnick, MD

ENA – Michael Gooch, DNP

SAEM – Mark Courtney, MD, MSCI, FACEP

SAEM/RAMS – Chad Mayer, MD, PhD

SEMPA – Fred Wu, MHS, PA-C; Dayna Jaynstein, MSPAS, PA-C

Board Liaison

Christopher Kang, MD, FACEP

Staff Liaison

Sandra Schneider, MD, FACEP