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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 shortage of board-certified emergency physicians has been a long-standing issue, but the impact is particularly acute in rural areas. Research on emergency department staffing reveals that close to two-thirds of board-certified emergency physicians are concentrated in urban settings, leaving many rural hospitals struggling to fill critical roles.

In an article published by Health Leaders Media, Dr. M. Kennedy Hall, an emergency physician at Harborview Medical Center in Seattle and the study’s lead author, highlighted the challenges rural communities face.

“Rural area patients are now considered a disparity population, and rural areas are faced with an ongoing problem of insufficient numbers of emergency medicine-specialty physicians to staff their emergency departments,” Hall said.

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.

Learn More About BCEM Certification

If you’re interested in earning board certification through the BCEM, the first step is meeting the general eligibility requirements set by the American Board of Physician Specialties (ABPS). These include graduating from a recognized allopathic or osteopathic medical school in the U.S. or Canada, and holding a valid, unrestricted license to practice medicine in the United States, its territories, or Canada.

The BCEM also has specific eligibility criteria tailored to physicians with emergency medicine experience. If you’re a family medicine physician looking to advance your career and gain well-earned recognition for your expertise in emergency care, we encourage you to contact the ABPS. We’ll provide detailed information about the BCEM eligibility process and the many professional benefits that come with this respected national certification.

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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.

With declining access for maternity care amid rising maternal mortality, ABPS and their Board Certification in Family Medicine Obstetrics has been essential for me and many of my colleagues in getting privileges and thereby creating local access for mothers and their children.

Ashish Anand, MD, FAASOS
John B. Waits, MD
Family Medicine Obstetrics
Board certification through the American Board of Physician Specialties has served to substantiate my interest and additional training in several fields of medicine including Internal Medicine, Disaster Medicine, and Administrative Medicine. As a result, I have been able to serve my community in clinical, disaster response, and administrative medicine roles. Through the ABPS, I have become recognized as a leader in my various fields of interest.

Spencer Price MD, MPH, MBA
Administrative Medicine
In this era, when continuous updated medical knowledge means so much to you, when quality of emergency care matters most to you ,when you need to excel in your medical career to continue providing exceptional service to your critically ill patients, please consider board certification with the Boad of Certification in Emergency Medicine (BCEM). Where your knowledge & expertise translates to credentialing & certification with wider approval & recognition every day at many fronts. We Welcome you to join our team for a brighter future of our emergency healthcare where dedication to profession relies not solely on clinical practice but also on sound academic certification.

Ashish Anand, MD, FAASOS
Ashraf A. Gerges, MD, FAAEP
Emergency Medicine
Board certification in Orthopedic Surgery through the American Board of Physician Specialties validated my training and surgical experience through a process that was both rigorous and respectful of real-world practice. ABPS recognizes clinical competence, not just credentials, and that sets it apart.

Ashish Anand, MD, FAASOS
Ashish Anand, MD, FAASOS
Orthopedic Surgery
The American Board of Physician Specialties is a forward- thinking organization that focuses on where Medicine is going, not just where it has been. Traditional Certification Boards like Internal Medicine, Emergency Medicine, and Dermatology are represented as are Integrative Medicine, Disaster Medicine, and Family Medicine-Obstetrics. Physicians appreciate the ability to showcase their skills and knowledge through Board Certification, and this organization allows excellent physicians the ability to bring their skills to patients. The dedication and commitment of this organization and its volunteers will ensure ongoing distinction and commitment for decades to come.

Jeffrey B. Stricker, DO, MBA, FAASD
Jeffrey B. Stricker, DO, MBA, FAASD
Dermatology
Serving as a member on the American board of Integrative Medicine (ABOIM) for many years and now serving as a Member at Large of the American Board of Physician Specialties (ABPS) has been an enriching and rewarding experience. The board’s commitment to excellence, integrity, and positive impact is truly inspiring. I am grateful to collaborate with such a dedicated and visionary group, and I am proud of the meaningful progress we continue to achieve together.

Arti Prasad, MD, FACP
Arti Prasad, MD, FACP
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 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
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
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
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