Saturday, April 30, 2005

Missed the point?

I respect Symtym and enjoy reading his blog. However, I suspect that he missed the point in one of my recent posts.

I was answering a question from someone who had asked a question in a comment. I was asked how an FP could work in the ER. That was it. I wasn't trying to insult or demean board certification by ABEM/ABMS or to suggest that this doesn't mean anything.

I recognize that some BCEP's (board certified emergency physicians) may be defensive about their specialty and board certification. And with good reason. There are many out there who have made it clear that they don't think there is any justification for this specialty. I agree completely with this post by MM House, MD. I also agree with most of what Symtym wrote here.

Let me comment on what Symtym wrote:

"First" Thank you. I have read enough of your site to know that I respect your opinions.

"Second" I agree. However, when you wrote, "These are always put forward..." did you mean to suggest that I was putting this forward? If so, I think you missed my point. I agree with what you wrote and do not think this is the issue.

"Third" I agree. Again, did you mean to suggest that I was complaining about the ABMS/ABEM monopoly? I support the monopoly. I am proud of my board certifications and don't want them watered down by any "mail in" boards. I wrote "This is not considered true board certification by those who believe in the monopoly of the AMBS, but allows some to claim "board certified." I think if you told a hospital credentials committee you were board certified and it turned out your board was AAPS, they might view that negatively." I don't believe that AAPS is recognized as a legitimate board and shouldn't be. I think you missed my point.

"Fourth" I agree. What did you mean by the "feign of ignorance" comment? Did something I wrote suggest to you that I was unaware that the practice track had been closed? Did you think that I was feigning ignorance of this?

"Fifth" I agree. The first three sentences are exactly what I was saying in my post. I think, however, that you are using unnecessary hyperbole at the end of this point. There is much less of a difference between FP and EM than there is between GYN/Pediatrics and Neurosurgery.

"Sixth" The way I read this, you are saying that you read my post as suggesting that I consider my board certification in FP to be valid, while at the same time saying that EM boards are not valid. Perhaps you missed my point. I think both are valid. There are a huge number of docs out there that are practicing "family medicine" who did not do residencies in FP nor are they board certified in FP. Many of them are residency trained and have been board certified in other specialties. Does this mean they are good or bad at FP? No, but without board certification, you have no measure. At least board certification is some measure. If I went to the ER and had no knowledge of the docs, I would feel more comfortable, in general, with the residency trained, board certified EM specialist.

I am making the exact same points as you! Don't be so defensive. I think you missed my point. I have a great deal of respect for the EM training programs and recognize the need for some limits on board eligibility and board certification.