ACEP ID:

May 28, 2021

What’s in a name? A lot, when it comes to your health.

Photo caption: Baselice & Associates conducted an internet survey of 801 adults on behalf of the AMA Scope of Practice Partnership between May 1–June 6, 2014. The overall margin of error is +/- 3.5 percent at the 95 percent confidence level.

Welcome back to ACEP Lately. Before I update you on the happenings at the College, I wanted to share some thoughts on the recent news that Physician Assistants (PAs) have voted to change their professional title to Physician Associates.

This news came a surprise to probably everyone – except the PAs who have been contemplating this kind of change for decades. Dr. Rosenberg and I recently had a conversation with Lamont Hunter MPH, PA-C, the president of the Society of Emergency Medicine Physician Assistants (SEMPA) and Michelle Parker, their executive director. As the national organization representing EMPAs who practice in emergency departments across the country, SEMPA has always been and continues to be proud of the team-based approach in emergency medicine. They shared with us the history surrounding the name change and I appreciate that there may be some good reasons why this name seeks to maintain, not distance, the collaborative relationship between the physician and the PA.

Nonetheless, words matter.

The statement ACEP released with EMRA on May 26 stated our opposition to this name change. We believe in physician-led teams, but that has to come with transparency to make sure that patients and the public can readily understand the education, training and experience of every professional who contributes to their care. Given the evidence that patients don’t always understand this, we feel the term "associate" creates more, not less, confusion, especially in the event of an emergency. We are concerned it does not appropriately convey to our patients or the public the role physician assistants serve while working under emergency physician-led care.

Of course, actions matter too.

Long before this name change, ACEP has worked to support transparency for patients, especially as it pertains to physician-led teams. We resolutely maintain there is no replacement for the knowledge, skill, and experience provided by emergency physicians. PAs and Nurse Practitioners (NPs) working on EP-led teams do not replace EPs and should not perform independent unsupervised care in the ED, regardless of state laws or hospital regulations. Our policies, going back nearly 20 years, clearly support this and provide standards that are available for our members to use in advocating locally or at the state level. Most notably are our policy statements on Emergency Physician Rights and Responsibilities and Guidelines Regarding the Role of Physician Assistants and Advanced Practice Registered Nurses in the Emergency Department. Together with the incredible resources and grassroots efforts of our state Chapters, we are fighting hard to ensure there are more wins than losses in scope of practice battles that would allow state legislatures, not physicians, to make important decisions about the care a patient receives. ACEP’s state and Federal government affairs staff are always available to assist you.

ACEP is also developing a public relations campaign to help the public understand the difference in education and experience between physicians and non-physician providers. Our new position on the AMA Scope of Practice Partnership gives us access to many data-driven resources, such as the finding that 91 percent of patients said that a physician’s years of education and training are vital to optimal patient care, especially in the event of an emergency. The overall tone of our campaign will not be negative or disparaging of other specialties and instead empower patients that they can and should ask to “see a doctor”—especially in a medical emergency. We will use this campaign to highlight the specialized training of emergency physicians and emphasize the incredible value that EM physicians provide to emergency medicine, the physician-led team and the broader health care system. 

In addition to using the AMA Scope of Practice Partnership data, ACEP will also conduct its own public opinion poll to gauge the layperson’s perspective on some of these relevant scope of practice and workforces issues specific to acute, unscheduled care, and we’ll use those data points to underpin our PR and advocacy messaging.

Ultimately, the perspective of the public is paramount to providing optimal patient care. I believe all ACEP members aspire to this, whether you work alone or lead a high-quality physician-led team. Words matter, and trust is built through respect and transparency. Actions matter, too, and ACEP’s voice is amplified best through your involvement and leadership. Working together, we can support what’s working right and push back on needless changes that harm our patients.

Now, let’s get into the updates:

ICYMI: We are moving forward on workforce issues, and we’ll continue to keep you updated. In early May, we released an infographic that outlines our next steps on the workforce issue: “ACEP Framework of Workplace Considerations.” Our leaders have been attending numerous town hall meetings to hear directly from ACEP members, with more coming up. Your feedback and input is welcome as we work together to develop solutions – join the conversation happening in the Workforce Forum or email the Workforce Task Force directly. 

NOW: As we close out Mental Health Month, we are grateful that the Dr. Lorna Breen Health Care Provider Protection Act passed unanimously out of the Senate HELP Committee by voice vote. S. 610, named in honor of emergency physician Dr. Breen, prioritizes the mental health of health care professionals. We developed and led a sign-on letter in support of this bill last month that was signed by 32 major provider and patient advocacy organizations including NAMI, AAMC, AMA, and the American Foundation for Suicide Prevention. Following the vote, Sen. Tim Kaine (D-VA) who has been the lead sponsor on the bill said he would like to “particularly thank the American College of Emergency Physicians” for our efforts.  The work continues: You can help generate more momentum for this bill by asking your legislators to sign on as co-sponsors.

Continuing on the topic of mental health, we expect the Dr. Lorna Breen Health Care Provider Protection Act just to be a key part of our lobbying efforts during the Leadership & Advocacy Conference in late July. We really look forward to seeing your faces at our first in-person event since the pandemic.

NEXT: Continuing on the topic of physician mental health – as we try to get back to something that better resembles our pre-COVID lives, many of us are realizing that the pandemic took a big toll on our wellbeing. It may be the first time you’ve been able to pause and reflect on this past year, and there is much to unpack. We encourage you to utilize ACEP’s Member Wellness & Assistance Program that provides free wellness coaching and crisis counseling. We’re also hosting a webinar in late June for those who want to discuss best practices for starting a peer support program at your institution. Lastly, the Wellness Hub is another helpful place to start.  

Sue’s Shoutouts

A huge thank you to our PEER editorial leaders Maria Moreira, MD, FACEP, Megan Fix, MD, FACEP, Tina Choudri, MD, FACEP, and John Bailitz, MD, FACEP, for their work on the new PEER. They were the driving forces behind the new product strategy that resulted in the recent development of PEERcert+, PEERprep for Physicians and PEERprep for Programs. They recruited an army of question writers, editors and reviewers, and continuing to grow and expand the product line to ensure it meets physician needs for board certification prep and lifelong learning.

 

Thanks for reading.

Sue Sedory, MA, CAE
ACEP Executive Director

 

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