An Emergency Medicine Physician’s Perspective
Every practitioner has a role on a care team but in an emergency room, it is especially important that an emergency medicine physician be the leader of your care team.
Emergency medicine physicians work primarily in hospital emergency departments and care for patients who are acutely ill or who have suffered traumatic injuries. In an emergency room setting, there are also non-physician practitioners who are an important part of the care team.
In this video, Thomas C. Dancoes, DO, an emergency medicine physician in Maine, shares details about the different roles of the practitioners, discusses how they collaborate to deliver the best care, and offers advice on how to learn who is leading your care team.
“The roles of the non-physician practitioners and the emergency medicine physicians are different. The differences are primarily due to our training and experience. An emergency medicine physician on average completes 11 to 12 years of education and training after high school. This includes 10 to 16,000 patient care hours as compared to a nurse practitioner or physician assistant who completes on average six years of education after high school, including approximately one to 2,000 patient care hours.”
Typically in the emergency department, non-physician practitioners care for lower acuity presentations. However, scope-of-practice expansion and legislative changes have now allowed for the possibility that a non-physician practitioner with little training and experience could be practicing independently. Why? One common argument and misconception for expanding scope of practice is that it will improve access to care.
“A review of the Graduate Nurse Education Demonstration Project showed that it is difficult to get non-physician practitioners to relocate to rural areas, showing that only 9% of graduating nurse practitioners went to rural areas. Many less populous areas continue to lack healthcare professionals of all types. However, regardless of where you choose to live, your healthcare team should be led by a physician.”
Dr. Dancoes states that scope-of-practice expansion could prove to be a dangerous situation for patients. Physicians not only have the knowledge and skills to provide lifesaving treatment and procedures for you and your family, but they also provide guidance and collaboration to the physician assistants and nurse practitioners.
“The advice that I have for my patients and families when receiving emergency care is to first realize that both physicians and non-physician practitioners play important roles on the team, however one does not replace the other. And I would make sure that you ask questions as to who it is that is providing your care and what level of training and experience that person has. It is important in the specialty of emergency medicine that you receive the highest level of care and that a physician is leading your healthcare team. “
Thomas C. Dancoes, DO, is a Maine-based emergency medicine physician. He trained in an urban center in Michigan and has been practicing for 13 years in his home state of Maine. He works in both community and rural settings. Dr. Dancoes has held leadership positions in his clinical practice as well as within Maine’s State Special Society and has been a counselor on the American College of Emergency Physicians Council for over a decade.