Closing the Loop on Board Certification by Tom Scaletta, M.D.

Tom Scaletta, M.D.The American Association of Physician Specialists (AAPS) represents 15 specialties as a certification “backdoor” for those that do not qualify for the ABMS (allopathic) and AOA (osteopathic) pathways.  About 75% of their certification activity is in Emergency Medicine.  The Board of Certification in Emergency Medicine (BCEM) requires as a prerequisite 5 years emergency care experience after primary care or completing an add-on “EM Fellowship” offered by some Family Medicine programs (and unapproved by the ACGME or RRC-EM).

In 2002, the AAPS convinced the Florida Board of Medicine (FBM) into equating BCEM with ABEM (Rule 64B8-11.001), surely because the FBM emergency medicine representatives were AAPS members and the opinion of mainstream professional organizations was not sought.  Afterward, AAEM and ACEP successfully prevented passage of SB2584, a Florida Act that would disallow hospitals from mandating ABEM or AOBEM, which is the norm.  Since then, AAEM has been monitoring the activity of state boards around the country.  This effort proved fruitful in thwarting a similar AAPS coup in North Carolina.

In 2006, a New York lawsuit was filed by the AAPS alleging illegal exclusion from a popular physician profile website of those certified by their companion board. The federal suit argued that the New York Department of Health and State Education Department imposed economic losses on AAPS physicians and tarnished their reputation.

The lawsuit occurred during my tenure as AAEM President.  We engaged AAEM’s New York state chapter and agreed both to sign an affidavit for the Attorney General and appear in court to defend the integrity of legitimate board certification. Finally, on September 17, 2009, a New York federal judge granted Summary Judgment against the AAPS.  Just when I figured that justice prevailed and this loop on board certification was closed, an appeal was filed on October 19, 2009.  So, what do I think about that?  I'm reminded about one of my favorite lines in Ghostbusters, a movie that came out 25 years ago in 1984, five years after EM became a recognized specialty and the year I began my EM residency at Northwestern.

Dr. Raymond Stantz (Dan Akroyd): Gozer the Gozerian? Good evening. As a duly-designated representative of the City, County and State of New York, I order you to cease any and all supernatural activity and return forthwith to your place of origin or to the next convenient parallel dimension.

Dr. Peter Venkman (Bill Murray): That oughtta do it. Thanks very much, Ray.

Last page of the Summary Judgment (click here to download the full order):

Tom Scaletta, M.D. Talks To Rick Bukata, M.D. About Integrating Business With Medicine

Deming and Baldrige, Nerd and Cowboy by Tom Scaletta, M.D.

In the 1950s, a decade before the specialty of emergency medicine was conceived, the U.S. was basking in post-WWII economic prosperity while, on the other side of the globe, Japan was methodically rebuilding its financial state. Japanese leaders recruited Dr. W. Edwards Deming, an American quality control guru to accelerate their efforts....by Tom Scaletta, M.D.

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EM Best Practice: Standardized Patient Callbacks Performed by a Dedicated Staff by Tom Scaletta, M.D.

Try your hand at this multiple choice question: An ideal survey of a patient’s emergency department visit: (a) Is unobtrusively completed within days of the visit (b) Promptly identifies patients getting worse or with questions (c) Reduces lawsuits, claims, premiums and payouts (d) Accurately determines caregiver trends and facility issues (e) Improves patient satisfaction Of course, the best response is “all of the above.” By Tom Scaletta, M.D.

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