Is an EM physician a replaceable entity?

[Taurus]

I think this could be a real problem in the future. I don't see midlevels opening up EDs on their own or taking over contracts but I do see them replacing physicians in terms of hours worked. I think the most likely senario is one where more and more EDs use midlevels supervised by physicians. There will then be fewer physicians needed in the ED. I can easily imagine EDs that have traditionally had double or triple physician coverage dropping to single coverage with multiple midlevels.

If we go to socialized healthcare several of the roadblocks to this will be removed. Med mal will likely be greatly reduced as a barrier. Patient satisfaction won't matter (eg. post office and DMV). Cost will become the absolute paramount issue and midlevels may be seen as the way to reduce those costs.

Remember that the driving force behind American healthcare that that people want the absolute best care they can get without ever paying anything out of pocket.

I agree with this. When a midlevel can do 80% of your job, you have a problem. That's the key problem with being primary care internists, peds, and FP and anesthesia. The distance between the physician and the level below should be large and vast. Like how it is in surgery, rads, etc.

It makes economical sense to turn ED physicians into more supervisors of multiple midlevels than being hands-on. PA's aren't so bad. It's the DNP's who are advocating to work autonomously in any clinical setting, including the ED.

This doctoral degree enables advanced-practice nurses to gain the knowledge and skills necessary to practice independently in every clinical setting.​

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[EM2BE]

I agree with this. When a midlevel can do 80% of your job, you have a problem. That's the key problem with being primary care internists, peds, and FP and anesthesia. The distance between the physician and the level below should be large and vast. Like how it is in surgery, rads, etc.

It makes economical sense to turn ED physicians into more supervisors of multiple midlevels than being hands-on. PA's aren't so bad. It's the DNP's who are advocating to work autonomously in any clinical setting, including the ED.

This doctoral degree enables advanced-practice nurses to gain the knowledge and skills necessary to practice independently in every clinical setting.​

wow...that article is scary

In other words, as a patient, you get the medical knowledge of a physician, with the added skills of a nursing professional.

How exactly do they have the knowledge of physician? They have some...and they didn't say all, maybe that's how they got away with that statement.

 

[Egon]

The whole specialty of EM started because ERs were staffed inappropriately and patients had a lot of bad outcomes.

EM will never be replaced by PAs or NPs. It's the one specialty that you have to have an MD on staff in the hospital. Really sick patients come in at any time, and it would be took risky for a hospital to staff with just NP/PAs. They'll always be an important art of the team.

I've worked with PAs or NPs that stuck with EM long enough to get really good at it. However, most I know only did EM for a couple years and then went on to work in derm or a FP. (We had 2 superstar PAs in residency...they actually left and went to med school.)