EM Workforce ProgressAs the grains of sand fall through the hourglass of emergency medicine this year, we find ourselves managing increasingly more complex and tragic situations. It is what we have trained to do. The overwhelming number of changes that we dealt with this past year have highlighted and sped up the work being done on a national level with the Future EM workforce initiative. We must define our future, and if we do not, someone else will, and the outcome will likely not be favorable. The good news is that TCEP is here to help carry and facilitate this task. Over the upcoming months, the TCEP Workforce Committee will circulate ongoing communication to its members regarding the ‘ins and outs’ of the EM Physician Workforce of the Future - what it means nationally, what it means locally here in Texas, what is the current state of affairs in Texas, what changes and considerations need to be taken into account. If you have interest in contributing to the TCEP Workforce Committee, we invite you to contact us. We welcome you to participate in your future. Thank you, This report from August 5th gives an update on ongoing ACEP efforts related to workforce projections and is provided by TCEP’s workforce committee.Here is an overview of actions: 1. Define EM Residency Standards for the Future • ACEP met in early June with the Association of Academic Chairs of Emergency Medicine, Emergency Medicine Residents’ Association, Council of Emergency Medicine Residency Directors, American College of Osteopathic Emergency Physicians, Society for Academic Emergency Medicine (SAEM), and SAEM Residents and Medical Students to begin reviewing and developing recommended program requirement changes to the Accreditation Council for Graduate Medical Education (ACGME) for the 2022 review cycle. 2. Ensure Business Interests Do Not Supersede Education and Patient Care There are pressures to start residency programs from for-profit hospitals, nonprofit hospitals, and academic health systems. There are also some state laws that reward expansion of graduate medical education. • ACEP leaders will reach out to hospitals, physician groups, and other stakeholders to set up meetings to ensure they understand the history and growth of graduate medical education, the research from the Workforce Task Force about the potential future impact on the EM workforce, and the role the groups and health systems play. • Discussions also include legal, legislative, and regulatory options that tie Centers for Medicare and Medicaid Services (CMS) funding of graduate medical education to specialties and geographic areas of need, and how ACEP might be able to encourage needed changes. Findings will be reported. • An objective has been added to the Academic Affairs Committee to conduct research with residency programs with respect to employment models, funding sources, staffing models, physician assistant (PA)/nurse practitioner (NP) training programs, and policies for prioritizing critical care to EM residents. 3. Protect Unique Role of the Emergency Physician and Fight Independent Practice ACEP believes that emergency physicians provide the highest quality care of patients with undifferentiated illnesses. We fight for physician-led teams and robust guardrails to maintain the scope of practice for NP/PAs. • ACEP recently became a member of the American Medical Association (AMA) Scope of Practice Partnership (SOPP) and continues to attend regular meetings to leverage the house of medicine on ways to ensure physician-led teams nationwide, and to utilize and promote shared resources among chapters. • In early June, a proposal in Louisiana that would have allowed NPs to have independent practice was withdrawn with the help of the Louisiana ACEP chapter and its members. National ACEP is working to support other chapters facing similar threats of scope creep and other states, including Texas and Colorado, with an eye towards similar victories in those state legislatures. • Alarmed by the implications of independent practice for PAs, ACEP vehemently opposed the decision by the American Academy of Physician Assistants to change their professional title to physician “associate.” ACEP issued a statement denouncing the name change and advocated that the AMA address this through its SOPP efforts, including its truth in advertising campaign. • ACEP President Dr. Rosenberg established a task force to research and potentially establish an ED accreditation program that would define nationally recognized standards to provide the highest quality patient care. Joseph Adrian Tyndall, MD, FACEP, was named the chair of this task force, which will meet regularly and, by ACEP21 in Boston, will offer a proposed direction about pursing an accreditation program. 4. Support Emergency Physician in All Communities, Especially Rural • ACEP leaders have met with CMS staff to problem-solve rural hospital closings and will continue to explore ways to ensure access to quality emergency care, led by emergency physicians, no matter a patient’s ZIP code. • The Rural Emergency Medicine Task Force report closely aligns with efforts to influence change in the EM workforce of the future. ACEP leaders are working with the Rural EM Task Force members and the Rural EM Section members to ensure our next steps are coordinated. • ACEP is compiling and will promote a list of current opportunities within the federal government, Indian Health Services, Veterans Affairs, and other locations that have incentives for hiring emergency physicians to practice in rural and underserved areas. • To get better data-driven research, ACEP is helping to conduct a resident census about job availability and challenges year over year. This survey should be distributed within a few weeks and could become an annual effort to provide a sense of the hiring landscape over the long-term. 5. Increase Demand and Meet Evolving Needs of Our Communities We recognize emergency physicians’ skill sets are not defined by a physical location. Emergency medicine will continue to evolve to meet the changing health care landscape and delivery models as we emphasize our value, expertise, and necessity. • ACEP leaders continue to explore adding fellowships to expand emergency medicine’s brand. Successful models are being considered for replication. Potential areas for growth include geriatrics, hospice and palliative care, home health monitoring and post-acute care, disaster medicine, administrative medicine/executive leadership, and more. Recommendations are forthcoming. • ACEP is continuing to gather member profiles to highlight those who have successfully expanded their roles with a goal to crowd source and research ways to bring non-traditional EM practice areas (observation, acute psychiatric, EMS, telehealth) under the EM umbrella as viable career pathways. Related information: |