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Mid‐level providers and emergency care: Let's not lose the force
Author(s) -
Tintinalli Judith E
Publication year - 2014
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12263
Subject(s) - medicine , workforce , specialty , accreditation , nurse practitioners , emergency department , certification , medical emergency , physician assistants , emergency medicine , nursing , family medicine , health care , medical education , political science , law , economics , economic growth
The progressive rise of ED visits globally, and insufficient numbers of emergency physicians, has resulted in the use of mid‐level providers as adjuncts for the provision of emergency care, especially in the US and Canada. Military medics, midwives, aeromedical paramedics, EMT‐Ps, flight nurses, forensic nurses, sexual assault nurse examiner nurses ‐ are some examples of well‐established mid‐level provider professionals who achieve their clinical credentials through accredited training programmes and formal certification. In emergency medicine, however, mid‐level providers are trained for general care, and typically acquire emergency medicine skills through on‐the‐job experience. There are very few training programmes for NPs and PAs in emergency care. The manpower gap for physicians in general, and emergency physicians specifically, will not be eliminated in the reasonable future. Mid‐level providers – ENTs, paramedics, NPs, PAs – are an excellent addition to the emergency medicine workforce. However, the specialty of emergency medicine developed because specific and focused training was needed for physicians to practice safe and qualify emergency care. This same principle applies to mid‐level providers. Emergency Medicine needs to develop a vision and a plan to train emergency medicine specialist NPs and PAs, and explore other innovations to expand our emergency care workforce.