WMR:
Responding to a listserv topic about the role of nonABEM physicians addressing the needs for more physicians in rural and other underserved settings. One proposed solution is to use the workforce of primary care physicians who did on-the-job training to become competent with their ER skills. AAPS and the BCEM pathway has helped some of these physicians to achieve merit based recognition.
What a radical idea. Certification based on merit? Harvard and other academic leaders could train and certify the hybrid EM-FM physician sought by Dr. Saggars and hundreds of other communities. But, it would require restructuring of training cartels, and it would diminish the ability to maintain an economic monopoly on services.
Thousands of subspecialist professors would have to retrain, see patients and take night call. Deans would need to be financially accountable to the health care of the public. Hospital profits would slide and academic medical centers would need to cut their budgets. America cannot afford to spend less then 2.3 Trillion dollars a year. It would be un-American(grin).
However a hybrid generalist would be greatly appreciated by everyone who is seeking a physician who could provide quality health care unrestricted by age, gender, and organ system. That is approximately 80% of the planet. M. Deutchman at Colorado is proposing a fourth year fellowship blending OB and ER. This is a creative and practical plan. Way to go! Remind me to tell my story about the Deans responding to the rural health coalition's request for an rural affirmative action program.
Newsflash--Corporate drugstores are hiring nurses to provide health care at their quikcare centers for an average cost of $110 compared to $570 for similar care in the ER. Apparently they are making a profit at 1/4 the cost. Congratulations to all of our academic colleagues for their role in marginalizing the medical profession. Mehrotra A, et al.Ann Int Med Sept 2009; 151: 321-28
www.psot.com
Index--Emergency/Family Medicine,rural solutions via new training pathways
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