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New Delivery Model for Rural Care Proposed

Rural CareEmergency physicians in Michigan have proposed a new way of delivering healthcare to rural areas that the American Board of Physician Specialties® (ABPS ) finds particularly noteworthy. The new model foresees a partnership between emergency and primary care clinicians to reverse the trend of declining health for people in underserved parts of the country.

The proposal published online in the Annals of Emergency Medicine argues that the traditional healthcare model of serving rural population has proven ineffective, with rural residents facing higher mortality rates than urban residents for emergency medical conditions. Social, environmental, and economic factors all play significant roles. Besides being more socially and geographically isolated, rural residents are older, poorer, more affected by alcoholism and drug abuse, and engage in more high risk behaviors than their urban counterparts. Add to that the increasing hospital closures and doctor shortages in rural areas and the problem of delivering adequate medical care to rural Americans becomes acute.

To address these challenges, the proposal calls for improved coordination of care between emergency and primary care doctors. According to the plan, because many rural emergency departments already provide primary care, rural hospitals can serve as a hub for emergency care, primary care, preventive care, and social services that improve residents’ health. The model would supplement, not replace, the existing outpatient rural safety net, the paper’s authors say. Their plan envisions an emergency medicine-primary care model similar to that of Carolinas HealthCare System Anson in Wadesboro, NC, where a final hospital design has no physical walls between the emergency and primary care areas.

Board Certification in Emergency Medicine From the ABPS

The ABPS recognizes the challenges of delivering healthcare, specifically emergency medicine, to rural areas. Through the Board of Certification in Emergency Medicine (BCEM), the ABPS makes it possible for primary care trained physicians with substantial and identifiable emergency medicine training to become board certified in EM. Right now, almost half of the emergency department physicians in the country are not trained or board certified in EM. While many of them are certified in family medicine or another primary care specialty, they have been practicing in hospital emergency departments for several years. Emergency departments, including those in rural communities, can stand out by seeking to hire doctors who are certified through the BCEM. Having a BCEM Diplomate on staff would serve as a testament to a hospital’s commitment to providing comprehensive emergency medical care. When you consider that any BCEM applicant must complete a minimum of five years and 7,000 hours of emergency department casework, it’s easy to see how board certification allows a physician to demonstrate the kind of emergency medicine mastery that would inspire a hospital’s confidence and patients’ trust.

Eligibility Requirements of the BCEM

To qualify for initial certification through the BCEM, candidates must first meet the overarching requirements set by the ABPS, which include:

  • Graduating from an accredited U.S. or Canadian allopathic or osteopathic medical school.
  • Possessing a valid and unrestricted medical license in the United States, its territories, or Canada.

Additionally, the BCEM sets specific eligibility criteria for primary care physicians, which are:

  • Completion of an ACGME, AOA, RCPSC, or CFPC residency in family practice, internal medicine, pediatric medicine, or general surgery, coupled with a minimum of five years of full-time emergency medicine experience.

OR

  • Completion of an ACGME, AOA, RCPSC, or CFPC residency in one of the listed primary care specialties, followed by a 12- or 24-month emergency medicine fellowship approved by the BCEM.

You can find a list of fellowships approved by the BCEM here.

BCEM Board Certification Exam

Candidates seeking BCEM certification via any of the available pathways must take both a written and an oral exam. The written exam, administered at various designated testing centers throughout the United States, Canada, and Puerto Rico, is computer-based and comprises 325 multiple-choice questions. Candidates must pass this written portion before they are eligible to take the oral exam, which is conducted virtually.

Once awarded, the BCEM certification remains valid for eight years, expiring on December 31 of the eighth year.

To learn more about the eligibility requirements for certification in Emergency Medicine through the BCEM, click here. The BCEM is a Member Board of the ABPS.

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Patient Care Is Our Priority

Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine
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