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Why Primary Care Trained Physicians Working in Rural EDs Should Become Board Certified in Emergency Medicine

Rural areas have seen a shortage of qualified emergency medicine physicians for many years now. To fill the workplace gap, rural emergency departments have long relied on the services of primary care trained doctors. Compared with urban areas, medical specialization is less common in rural communities. Because primary care doctors are backed by years of extensive training, they can provide a wide spectrum of medical care in rural ERs, including most of the emergency care. In fact, for many primary care physicians, this greater clinical responsibility has led to professional growth.

The American Board of Physician Specialties® (ABPS), through the Board of Certification in Emergency Medicine (BCEM), offers primary care physicians with substantial experience working in emergency departments the opportunity to pursue board certification in emergency medicine.

Three primary care physicians who have worked in rural emergency departments can testify to the importance and benefits of becoming certified in emergency medicine through BCEM. Here are their stories:

Harry L. Wingate III, MDHarry L. Wingate III, MD, FACEP: In exchange for the state paying my medical school tuition, I agreed to practice primary care medicine in an underserved rural area. So, in 1990 after completing my residency in family medicine, I moved to Eatonton, GA.  While completing my primary care practice obligation, I also worked for seven years in rural EDs, accumulating over 10,000 hours of experience. Seeing the tremendous need for rural EM doctors, I decided, after successfully passing the rigorous oral and written BCEM exams in 1997, to transition to the full-time practice of rural EM. It is, by necessity, an engaging practice setting to say the least. As someone who is competitive and easily bored, I’ve found it perfect for my personality. What I like most about practicing medicine in a rural area is the appreciation and respect I’ve received from the community. As a rural physician, you are known and esteemed as a valuable community member.

Kevin Clarke, MDKevin Clarke, MD: After completing training in internal medicine at West Virginia University in 1989, I began working full time in EM. Given that it matched my skills and interest, EM was a better fit for me. I realized as time passed that hospitals were acquiring more ED physicians who were EM certified, but no EM residency program existed in West Virginia at that time. I also found that to continue long term in EM one needed board certification in the specialty. I went on to earn certification with the BCEM in 1997. Being BCEM certified, I can continue in EM for the rest of my career. EM certification has allowed me to participate in academic meetings and has given me a peer group that encourages self-continuing education and training in EM. I am also recognized by my peers as an equally trained colleague. Being EM board certified with primary care training, in my opinion, is optimal for rural emergency care. I can communicate with my inpatient specialty colleagues and hospitalists better because of my training exposure to inpatient care.

Alex Beuning, MDAlex Beuning, MD: I went into family medicine because I wanted to practice rural medicine. For my mentors, that meant all aspects of medicine in the small town they served, including covering the emergency department. I learned that while I enjoyed all aspects of medicine, I loved rural emergency medicine the most. I eventually became the ED medical director and began investing in my EM practice, eventually moving to a full-time EM practice after six years of full-spectrum care. Having earned BCEM certification through my proficiency in EM, I can connect with colleagues working in similar environments as me and can learn and grow from our interactions. I strongly encourage primary care trained physicians to complete an EM fellowship. If that is not possible, then I would encourage primary care doctors to commit to their development as EM physicians through the rigorous process of board certification with the BCEM.

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

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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