Updated 3/05/08 On January 17th, the national ACEP Board of Directors approved the report from the On-Call Task Force chaired by Dr. Michael Carius. The Board agreed that in order to move forward on this issue, the first task is to support the chapters by providing background information that can be used to help educate members, as well as medical staff and local and state medical societies. The problem is clearly multifactorial, and varies from region to region. The articles included in the attached document provide information from the American College of Surgeons, the CDC’s reports on emergency department use , and the OIG’s advisory opinion regarding hospitals paying stipends to on-call specialists. I encourage you to disseminate this information to your chapter leadership, members, and your local and state medical societies. If you are aware of any creative solutions to address the on-call shortage problem in your state, please share them with Craig Price at ACEP. Currently there is no national mandate, like EMTALA, to require specialists to provide service. Although this might be a potential resolution in the future, it appears that the fastest action towards improving patients’ access to specialty care comes from work at the local/regional level. As emergency physicians, we automatically accept our responsibility to care for all patients that present to our departments. However, with dwindling reimbursement and threats of potential litigation, many specialties view emergency department call to be too great of a burden. This trend is disappointing and can obviously negatively impact patient safety, but as a reality in our current system, we need to continue to work together with our medical colleagues to achieve a workable solution. I encourage you to review the attached materials which will also be placed on ACEP’s web site. It contains an annotated bibliography with links to materials including reports, research articles, and a presentation about local efforts from The Advisory Board. Thank you for your help in this effort. - Kathleen Cowling, DO, FACEP |