Dada! Look at the Big Poop I Made!

Well I just love ACEP. ACEP is the American College of Emergency Physicians and they sit around and scratch their collective chins and wonder why those of us who work in non-academic institutions are so shitty. Here is an article which summarizes a 'report card' in which we get a 'D-'. I smell a set up for a bail out!

They even come up with some suggestions about how to fix our problems. Thank goodness.

My feelings about ACEP are detailed elsewhere but here's some refreshers. ACEP is the organization that has stood by and watched as EMTALA wrecked our health care system. They have never drawn a line in the sand, they have never pointed out that the inevitable consequences of EMTALA are the very problems detailed in the report.

It must be very heady to live in an ivory tower and speak in theoretical terms about the way things should be, here's the way things are...

1. Americans have come to expect their health care to be 'free' and EMTALA has made this possible.

2. Since you can 'always go to the ER', that's exactly what has happened, and ACEP has noticed that we are awash in uninsured patients who use us for primary care.

3. I have no idea what the Access to Emergency Services Act is, but unless it is a piece of legislation that puts at least a modicum of responsibility on patients to care for themselves and to find a way to either purchase medical insurance or contribute to the cost of their care it will be a disaster akin to EMTALA.

4. ACEP has made wonderful decisions in the past like getting television personalities to speak at their national convention and instituting the LLSA exam which requires us to pay them to take tests every year to make sure we are up to snuff on the latest bit of wisdom from the academy (like how the prevalence of rabies has changed in sub-Saharan Africa and how we can force our sub specialist colleagues to work for free).

5. ACEP, at every opportunity, has said 'how high' when the government has asked them to jump, and they lament that physicians are refusing now to give away their services and to weather malpractice climates in which the question is not whether one will be sued or not, but rather how many times.

6. ACEP has jealously guarded our specialty from other physicians who wish to become board certified but have not gone the traditional route. Let's be honest, a good family practitioner or internist can learn the critical skills needed to work in an ER in a year, and that's probably too much (if they train in a busy trauma center). And now, WOW! we don't have enough EM physicians. Three on this blog alone have quit full time ER work early in their careers due to the circumstances extant in the practice of Emergency Medicine that an organization such as ACEP could have averted had they even the germ cells of gonads in their collective body.

See you later ACEP. Thanks for nothing, and that pain in your ass... it's your head.