The Vermont Chapter of the American College of Emergency Physicians (ACEP) is voicing strong opposition to a recommendation by the state’s Green Mountain Care Board (GMCB), to convert four hospitals into standalone emergency departments staffed by nonphysicians.
“Emergency medicine is a complex and demanding specialty that requires comprehensive training and expertise,” said Niki Thran, MD, FACEP, president of Vermont ACEP. “Every Vermonter deserves access to a fully qualified emergency physician when they arrive at an emergency department.”
The chapter’s letter to the GMCB outlines concerns about care quality and patient safety, emphasizing that nurse practitioners and physician assistants are indispensable members of the care team. However, they simply do not have the training or education of an emergency physician.
“…this is a plea to ensure we have the right staffing in the right settings to guarantee the best possible outcome for our patients. To put it plainly, a non-physician staffing model in Vermont’s EDs would be a dangerous decision.”
Matthew S. Siket, M.D., MHCI, FACEP
President-Elect, Vermont ACEP
The letter explains that unsupervised nonphysician care can lead to:
Increased costs: NPs delivering care without supervision increased lengths of stay by 11% and raised 30-day preventable hospitalizations by 20% compared with EM physicians.
Increased resource utilization: Multiple studies have demonstrated higher diagnostic test utilization, longer length of stay, and reduced clinical efficiency in non-EM physician led staffing models.
Lower patient satisfaction: 95% of U.S. voters said it is important to them for a physician to be involved in their diagnosis and treatment and 62% said patients are most likely to be harmed from scope of practice changes.
Increased medico-legal risk: Over 85% of malpractice claims against NPs are due to errors in diagnosis, treatment, and medication.
Increased inappropriate prescribing: Non-physicians are more likely to prescribe antibiotics when non-needed and overprescribe opioids than physicians.
“There should be no ambiguity about the importance of a physician-led care team in emergency settings,” the letter said.
ACEP strongly supports state and national efforts to prioritize physician leadership. There is no substitute for a licensed, trained, and board certified emergency physician.
Related:
Fighting for Physician-Led Care
