Are there any FM boarded docs on here that practice EM at a Trauma Center?

[monkeymedic]

The title basically says it all. I have been informed that after having built up some seniority in my group, the way they are interpreting the American College of Surgeon's Committee on Trauma (ACS-COT) guidelines, they can't have FP trained physicians practicing at at Level 2 Trauma Center. Waiting on some clarification still, but basically, because I only graduated in the past 5 years, I'm not eligible to be grandfathered in even though I keep a valid ATLS card. (We were previously under the impression that as long as I kept ATLS, I was good which is what my paperwork said when I was hired--I'm being told that is erroneous now). My options are basically to practice exclusively at one of the 3 small rural hospitals (<10k volume each compared to the 50k+ at the "Mothership") or to put in for a lateral transfer to a hospital that also seeks ~50k patients per year and is about the same distance from me (going the opposite way), but even though it is part of the same large hospital conglomerate, it's part of a different sub-group so I would lose my seniority status for scheduling, site preferences, holidays, etc.

Anecdotally, I have heard of other Trauma Centers that have non-ABEM boarded docs on staff--we can't be the only one right? Is admin at this hospital misinterpreting the ACS-COT guidelines somehow? Does anyone here either work at or know of a colleague that works at a Trauma Center without being ABEM boarded? If so, what ACS Trauma Level is the hospital?

I always knew we were going the way of the dinosaurs, just didn't expect to be extinct and forced out for another 5-10 years...

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[topraman]

This is unfortunate and typical. Would be good to raise with AAFP as this they have consistently fought scope standards that are specialty based rather than competency based. There could be legal review for unfair restriction of trade since there is no evidence to justify this restriction. It also overrides the autonomy of the local medical staff. Seems Trauma III is exempt but otherwise the ACS language is clear.

In Level I and II trauma centers, physicians must be board-certified or board-eligible in emergency medicine or pediatric emergency medicine.
– Physicians who completed primary training in a specialty other than emergency medicine or pediatric emergency medicine prior to 2016 may
participate in trauma care.

 

[Make Or Break]

I think going forward as more and more EM grads finish their training, FM and IM will get pushed out even at these rural locations. It just seems inevitable with the over saturation and how things are going.

 

[Kach]

The title basically says it all. I have been informed that after having built up some seniority in my group, the way they are interpreting the American College of Surgeon's Committee on Trauma (ACS-COT) guidelines, they can't have FP trained physicians practicing at at Level 2 Trauma Center. Waiting on some clarification still, but basically, because I only graduated in the past 5 years, I'm not eligible to be grandfathered in even though I keep a valid ATLS card. (We were previously under the impression that as long as I kept ATLS, I was good which is what my paperwork said when I was hired--I'm being told that is erroneous now). My options are basically to practice exclusively at one of the 3 small rural hospitals (<10k volume each compared to the 50k+ at the "Mothership") or to put in for a lateral transfer to a hospital that also seeks ~50k patients per year and is about the same distance from me (going the opposite way), but even though it is part of the same large hospital conglomerate, it's part of a different sub-group so I would lose my seniority status for scheduling, site preferences, holidays, etc.

Anecdotally, I have heard of other Trauma Centers that have non-ABEM boarded docs on staff--we can't be the only one right? Is admin at this hospital misinterpreting the ACS-COT guidelines somehow? Does anyone here either work at or know of a colleague that works at a Trauma Center without being ABEM boarded? If so, what ACS Trauma Level is the hospital?

I always knew we were going the way of the dinosaurs, just didn't expect to be extinct and forced out for another 5-10 years...

doom and gloom as usual. I practice at a trauma center. i'm FM

 

[Kach]

I think going forward as more and more EM grads finish their training, FM and IM will get pushed out even at these rural locations. It just seems inevitable with the over saturation and how things are going.

doom and gloom. as for your comment, maybe and maybe not.

 

[NYEMMED]

I think going forward as more and more EM grads finish their training, FM and IM will get pushed out even at these rural locations. It just seems inevitable with the over saturation and how things are going.

I think this is true. With the proliferation of EM residencies nationwide and the staffing cuts in EM there will be a glut of EM physicians.

Even ACEP announced at current state there will be about 9,000 unemployed EM docs in 8-9 years. That’s going to push any non-ABEM/AOBEM docs out as well

 

[AlbinoHawk DO]

I think this is true. With the proliferation of EM residencies nationwide and the staffing cuts in EM there will be a glut of EM physicians.

Even ACEP announced at current state there will be about 9,000 unemployed EM docs in 8-9 years. That’s going to push any non-ABEM/AOBEM docs out as well

Depends. Many people already have connections and established relationships, so they won't lose their jobs. It's the new generation of FM wanting to do EM that will likely face difficulties in finding work

 

[monkeymedic]

I think going forward as more and more EM grads finish their training, FM and IM will get pushed out even at these rural locations. It just seems inevitable with the over saturation and how things are going.

I think that even though ACEP's report shows an oversupply of 9k by 2030, it failed to take into account (due to the study being done beforehand) the fact that a TON of EM docs retired early, semi-retired, or decided to go part time during the pandemic and those effects are still being felt. As long as the younger generation prefer living and working in the cities, they would rather accept a lower rate and work in the city than come out to BFE where I work. I'm pretty young myself, and like living in a city with easy access to bars/restaurants/entertainment but find the drive worth it for the extra ~$100 an hour. Many of those around my age would disagree and would much prefer to be somewhere they can walk out of work and walk down the street to get a drink with friends. I think it will still be a while before the pay discrepancy reaches the point where the cost/benefit pushes the younger grads toward looking further away from the city.

doom and gloom as usual. I practice at a trauma center. i'm FM

When did you graduate? I don't really think the doom and gloom is unwarranted for those of us that graduated after 2016 as it isn't theoretical at this point--it's actually happening. If you graduated after 2016 and are at a L1 or L2 TC, I'd be curious as to what the workaround you guys have is to see if I can get it to work here too.

Depends. Many people already have connections and established relationships, so they won't lose their jobs. It's the new generation of FM wanting to do EM that will likely face difficulties in finding work

I agree that other than situations where some external force is requiring ABEM like in the current situation I am dealing with at my trauma center, I would guess that most people who have been around for years and who are clinically adequate would be kept onboard as they are a known quantity and admin would need a good reason to bring an unknown variable in other than just "EM boarded." That being said, if the oversupply issue hits and newer BC/BE docs are willing to work for less than we are getting paid, the whole job security thing changes as now they are getting someone board certified at a lower cost.