EM Trained Physician Qualified to Function/Practice as a GP?

[16846]

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I know for a number of years that the ABEM & ABFP have argued over whether FP-Trained physicians are qualified to function/practice in the context of an ER setting. However, I am looking at this from the opposite perspective. Is an EM-Trained physician qualified to Function/Practice as a GP (in the same capacity as an FP-Trained physician)? I have been strongly considering a specialty in EM, but want the possibility of opening my own general/family practice in the future without having to do another residency. Any information is appreciated.

Mike

 

[chicamedica]

I'm interested in knowing this as well. . .

Does anybody know?

 

[docB]

I firmly believe that EM trained doctors are not qualified to be primary care docs. We are not trained in the incremental management of chronic diseases, preventive medicine and other acpects of primary care. Byond these factors we must have enough humility to admit that we are not trained to do their jobs if we argue that they are not trained to do ours. If you really want to do EM and have an office practice I suggest doing one of the EM/IM programs out there.

 

[deleted6669]

...or em/fp if you are a d.o.

 

[stoic]

If you're an FM/EM or IM/EM and one of your primary care patients presents at the hospital ER you're working at (assuming you have privilages there) can you admit them or does someone else do it for you? For instance, what if the patient needs to be seen in the ICU as soon as possible, but you have 10 hours left on in the ER?

 

[edinOH]

I think alot of the EM trained docs out there who end up seeking a little more predictability and lower acuity tend to go the urgent care route. Basically working in a doc-in-the-box walk in type setting. EM docs are obviously qualified for this as are the IM/FM types.

I for one doubt there are many EM trained docs out there who find themselves wishing that they were the ones adjusting insulin dosages or following up TSH levels, pANCAs and rheumatoid factors. If that stuff didn't float your boat when choosing a specialty, I doubt it will after you've been practicing for a few years.

 

[drpcb]

As a former GP, currently 3rd year EM resident, perhaps I can shed some light.

First of all, the distinction between GP and FP is crucial, particularly to the folks out there who do a 3 year FP residency:

GP: General practitioner. 1 year of training gets you a license in California, and you become a GP, should you wish to hang a shingle or go to work in primary care. Unless you are VERY rural, it is unlikely you will have any admitting privileges, be able to get any type of OB malpractice, or work in any ED.

FP: Family practitioner. 3 years of training. Often less able to get OB or hospitalist type of privileges in urban IM and OB-heavy hospitals. However, 3 years of broad training certainly provides a solid base to perform safe routine OB and hospitalist work in areas that are less specialist dense.

That being said, a boarded EM physician could likely work in a VERY rural place in a full FP capacity if the place was REALLY desperate (i.e. prison or Indian reservation.)

Would likely be able to practice safely in a very basic primary care setting in a GP capacity, as it would overlap a great deal with much EM.

The basics in lipid management, hemoglobin A1C, microalbuminuria, annual pap/breast/colonoscopy, testicular exams, depression and anxiety, hypothyroidism, are things that could be learned fairly quickly, particularly if the physician was
dedicating his/her time to primary care exclusively. Like emergency medicine, much of primary care is obtaining timely referrals, and following a course of action with the assistance of a specialist.

Hope this helps, and I hope I was able to avoid stepping on the toes of any FP's.

 

[drpcb]

One last little tidbit.

In an ED, there is a physician in charge of authorizing or hiring the EM physicians, and if they do not want to have a non EM physician working, they will not hire.

On the other hand, a licensed physician can start a private practice in primary care or brain surgery for that matter, regardless of his training, provided that he practices at the standard of care. Therefore logistically, the EP working as a GP is more likely to happen than the GP working as an EP.

 

[docB]

drpcb brings up some really good points and is absolutely correct. It is certainly possible for docs to practice outside of their specialty training. The issue up for debate here is that they can, but should they?