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News and Announcements
AEP President's Recruitment Letter
Publish Date : 4-15-2009   Author : Jim Hayes, MD

 “President’s Letter—Spring 2009”

 Jim Hayes MD, FAAFP, BCEM


As your new President, I thought I would share aspects of my background and motivation for becoming an active member of the Association of Emergency Physicians (AEP).  I think you will see how it is relevant to the ongoing struggle non-emergency medicine residency trained physicians are having, especially in light of Dr. Carlos Camargo’s recent Harvard research data on the Emergency Medicine Workforce.  I think you may see yourself in my story.


My background includes an internship in Internal Medicine and a residency in Family Medicine.  I did extensive moonlighting during residency in rural Emergency Departments and was a member of the American College of Emergency Physicians (ACEP) when I worked full-time in Emergency Medicine.  I later went into full-time private family practice in St. Augustine, Florida.  When I applied for privileges, I was initially judged by my title, not my abilities.  However, because I had documented my procedures and had letters from the sub-specialists that had supervised me during residency, I was granted all the privileges I requested.  These included Obstetrics, D&C’s, surgery assisting, Critical Care, stress testing, etc.  I became a member of the Medical Executive Committee placing me in a position of judging new staff applicants on their abilities, not just their title and training.  After ten years, I decided to go into Emergency Medicine full-time. Having family obligations at the time, I could not justify the time or money to attend an Emergency Medicine residency. I was very surprised that there was no option to shorten an Emergency Medicine residency based on my proven practice and experience.  So, I set out to prove myself in Emergency Medicine with the overall goal of teaching Emergency Medicine (and possibly Family Medicine) residents in the future.  I began with low volume, low acuity rural departments and continued to take jobs with increasing acuity and volume.  These higher volume, higher acuity departments asked “Are you ABEM certified?”  What do you mean, “Grandfathered in?” which led me to recall a day in 1988 when I received a letter from ACEP which I placed in my white coat pocket to read later that day.  After placing ETT’s and Swan-Ganz catheters in two of my patients who were in cardiogenic shock, (prethrombolytics and no available interventional cardiology), as well as running 3 drips on them without consultation, I casually read, “We would like to invite you to become board certified in Emergency Medicine by taking an American Board of Emergency Medicine (ABEM) examination.”  I threw that letter away not thinking I would ever leave my full-service private practice.  Just think, I could have been a ‘revered, sought after’ Emergency Medicine Residency Professor, board certified in both Family Medicine and Emergency Medicine.  


After several years of practicing full-time emergency medicine, I began searching for an organization of Emergency Physicians that represented folks like me.  I came across AEP and eagerly researched the organization.  Their mission of representing “in the trenches” Emergency Physicians really attracted me.  I contacted them and spoke with Dr. Jeff Bates, the Vice President at the time.  We became friends due to our common interests and passion for our profession.  He recommended I look into becoming Board Certified in Emergency Medicine (BCEM), through the American Association of Physician Specialists (AAPS).  While working full-time in Emergency Medicine, I studied extensively for 18 months; attended ACEP sponsored written and oral board review courses; attended a grueling two day one-on-one “boot camp” oral board review course in Chicago; and extensively researched and wrote up ten of my emergency patients.  I must say that that was a lot of work and expense but well worth the certification.  Being BCEM/AAPS has opened doors for me to work in some of those high volume, high acuity Emergency Departments.  Shands Jacksonville Florida Emergency Medicine Residency Program invited me to apply to join their faculty.  After they reviewed my curriculum vitae, I received an email stating the Residency Review Committee would only consider ABEM certified candidates. 


The irony of this whole story is that the hospital in my home town, St. Augustine, FL, where I used to eagerly help the Emergency Physicians out with complicated admissions, and where I was on the Medical Executive Committee, will not even interview me to work in their Emergency Department because I am a not an ABEM Certified Emergency Physician.  Of course, the hospitals use staffing companies, so they would say that “they” are not denying anyone employment which would violate The Code of Federal Regulations, Chapter IV, Section 483.12,a,7 which states that ‘Medicare receiving facilities are prohibited from discriminating against physicians on the basis of board certification, board eligibility or membership in any group or club…’  There is definitely something wrong with this picture, especially in Florida where twice the Florida Board of Medicine ruled equivalency of AAPS/BCEM and ABEM certifications.  As an organization, we will continue to fight for all “in the trenches” Emergency Medicine Physicians.


I am extremely proud to be the newly elected president of AEP.











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