The monopolisation of emergency medicine in Europe

Professionalisation rather than monopolisation is the future of emergency medicine in Europe

“…Contrary to De Robertis’ assumption that only few anaesthesiological skills are relevant to only a few emergency patients, 1 most patients present to the ER because of pain. 7 Arguably, anaesthesiologists are highly experienced with different forms of pain.…”

“…In their recent Editorial, De Robertis et al 1 argue that some skills anaesthesiologists possess are highly relevant to a fraction of patients presenting to an emergency room (ER). From this observation, the authors conclude that emergency medicine should not be(come) a full specialty but rather be established as a supraspeciality, into which physicians can opt after their primary specialisation.…”

“…For example, the authors rightfully advocate multidisciplinary reception teams for the most severely injured or ill, 1 and the importance of teamwork in the diagnosis 2 and treatment of the critically ill 3 is indeed well established. However, it remains unclear as to how these reception teams are composed, by whom and for which patients.…”

“…A dedicated specialty with competencies clearly defined, taught and assessed fulfils these requirements much better than a supraspeciality degree added to a diversity of primary degrees. In addition, it is contradictory to call for a more precise definition of emergency medicine on the one hand 1 and, on the other, to advocate a supraspeciality degree adjunctive to a variety of primary degrees as different as ‘anaesthesiology, surgery, internal medicine and others’ 1 at the same time. De Robertis et al further advocate clearly assigned responsibilities for the pathway of emergency patients, and we could not agree more.…”

“…We would, however, argue that most patients have more than one active condition 4 and only a few skills that most specialty trainings convey are relevant to only a small fraction of these conditions. 1 Why not bundle the skills most commonly required by most emergency patients into a full specialty training and assign the responsibility for all emergency patient pathways accordingly? Such a responsibility obviously requires consultation with colleagues from other specialties for selected conditions.…”