The following talking points were developed to support members in the creation of any materials crafted to address the overarching issue of Scope of Practice. Please feel free to utilize and further customize these points for use in social media posts, interviews with news media, industry speaking engagements or thought leadership activations.
1. The Value of Emergency Care
Access to emergency care is a patient priority.
- One in three people visit the emergency departmenteach year, for a total of more than 150 million visits.
Nine in ten adults say it is an “essential” or “high” priority for people to have 24/7 access to the ER, the highest of any utility or service that communities provide, according to an ACEP/Morning Consult poll - More than half of adults who sought immediate medical care chose to go to an emergency department because urgent care was unavailable, or they were referred by a medical provider.
- Another 40% went because their injury or ailment appeared too severe for urgent care, according to an ACEP/Morning Consult poll.
An emergency physician should be leading every emergency care team in the country. Emergency physicians are the most highly trained and qualified health care professionals able to make medical decisions in an emergency
2. Who are Emergency Physicians?
Despite a growing reliance on emergency medicine, many people do not get a chance to get to know the professionals who take care of them during some of life’s scariest moments.
Emergency physicians are the doctors in charge of the care teams on duty 24/7 in thousands of emergency departments across the country.
- No appointments are necessary, and no one will be turned away from an emergency department when they need medical attention—that’s the law. (EMTALA)
- Emergency physicians are medical professionals who are dedicated to saving lives and providing the highest quality of care to all their patients—regardless of their insurance status or ability to pay.
3. Patients prefer emergency physician-led care teams
When it matters most, patients want the most qualified health care professionals in the room. There is no substitute for a licensed, trained, and board-certified emergency physician.
- Patients overwhelmingly trust emergency physiciansto lead their care in the emergency department and prefer to see a physician when they're having an emergency, according to an ACEP/Morning Consult poll.
- Nearly 80% of adults trust a physician to deliver their medical care in an emergency, compared to a nurse practitioner (6%), physician assistant (5%) or registered nurse (8%), according to an ACEP/Morning Consult poll.
Patients deserve access to the most highly trained experts available.
- Shifts in the emergency department are exhilarating and unpredictable, but a licensed and board-certified emergency physician completes thousands of hours of training, and more than a decade of expert-level education, so that they are prepared in a moment’s notice for any challenge that comes their way.
- An emergency physician is required to complete 11 or more years of training and is the only member of a care team that completes a medical residency. In comparison:
- Registered nurse: 4 years of training
- Nurse practitioner: 5-8 years of training
- Physician assistant: 7 years of training
- Emergency physicians also have significantly more hands-on training with real patients than the other professionals on their team.
- A nurse practitioner is required to clock at least 500 clinical hours. For a physician that requirement is at least 12,000 hours.
Each member of the emergency care team is a highly trained professional who serves a vital and distinct role. But the level of training and education for an NP or PA is nowhere close to the requirements that physicians must meet.
- As the leader of a care team, emergency physicians work closely together with nurses, nurse practitioners, physician assistants and others. Each team member has unique skills and training that allows them to make important contributions to the team.
- Each member of the care team is an indispensable partner, but there are meaningful differences in the training that each member of the care team receives so that they can do their jobs.
People have difficulty identifying who leads their care while they are in the emergency department. While they prefer to be treated by an emergency physician, they are often not clear about the roles of each team member or who is leading their care.
- Patients will use a variety of unreliable criteria to make assumptions about whether they are being treated by a physician. According to the ACEP/Morning Consult poll, 20% of younger adults (ages 18-34) would use the color of a health care provider’s scrubs to determine if they are a physician. However, different facilities have different rules about scrub colors, which makes that an unreliable indicator of a person’s role.
- One quarter of adults (ages 35-44) make assumptions about job roles based on how colleagues interact with each other, which may not account for leadership styles, personality traits or individual biases.
There should be less ambiguity about the distinctions between different members of a care team, especially in an emergency.
- The laws that determine who can practice medicine without supervision vary across the country, so it is understandable that a patient can get confused about who manages their care.
- Hospitals are increasingly having non-physicians—like physician assistants and nurse practitioners—perform complex medical procedures.
- Allowing non-physicians to perform surgeries, administer diagnostic tests, prescribe medicines, or give medical advice that they are not trained for can have consequences.
There is evidence that granting too much independence to non-physicians can lead to overprescribing and overutilization of diagnostic imaging, or other services.
Nurse practitioners prescribed more opioids than physicians, according to one analysis. In states that allow independent prescribing, nurse practitioners were 20 times more likely to overprescribe opioids than those in prescription-restricted states.
Non-physicians ordered more imaging over a 12-year period, according to another study. Scans increased more than 400% by non-physicians, primarily nurse practitioners and physician assistants.
