@Medicine' is what we trained in as a profession. Your formal title is
"Registered medical practitioner", not doctor. This is a courtesy title,
remember. It encompasses surgery as well. My main reason for pushing for
change is that it assists staff in redirecting people to other providers
of healthcare if their problem is not an emergency. I agree with Matthew
Cooke that we must ensure that there is good access to medical care
wherever people present, but redirecting the patient with a 6 month old
sprained still painful ankle is so much easier. And nobody else
worldwide sees the need.

-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty
Sent: 14 January 2003 03:33
To: [log in to unmask]
Subject: Re: Emergency Medicine


> 2. Do I want my department to be called an 'Emergency Department'? The

> question posed in the ballot is question 2. [Matt Dunn]

I haven't yet seen this ballot, but I sincerely hope the question posed
is not just "question 2" Matt, and if it is I will be very disappointed
with BAEM. This should not just be about what we call our departments,
but must also be about what we call ourselves, i.e. are we to be known
as emergency physicians, practising emergency medicine in emergency
departments?

> When the phone rings I call it "Casualty" which has a nice friendly
> ring
to it. [Charles Scott]

Yes, I defy anyone to find an A&E nurse in London who doesn't call an
A&E SHO "cas officer" or "cas doc" from time to time!

> To me Emergency Medicine is everything I do now - major trauma,
intubation, thrombolysis, minors, see n treat. [Steve Meek]

I agree, as long as it's an emergency, and it involves "medicine" in its
broadest sense, then surely it's emergency medicine!

> Importantly, we risk continuing confusion with
> our Acute Physician colleagues whose posts are sometimes actually
advertised
> by Trust HR departments as "Emergency Medicine" vacancies. [Jonathan
Marrow]

On the contrary, surely we risk greater confusion if we call ourselves
"emergency physicians" in the practise of "emergency medicine"? Perhaps
the debate should also consider what the acute physicians of the future
will call themselves, but we will have no control over that. However I
also suspect that this subject is now hot on BAEM's agenda for that very
reason i.e. the acute physicians might "highjack" the title of emergency
medicine, and the only way to stop them is to get there first!

> The big argument in favour of keeping the "Accident and" label is that

> it puts us first in most lists of medical specialities. Staying as we
> are also saves money on headed notepaper, signs, etc.

Another argument that rarely rears its ugly head in polite conversation
Jonathan is that there are some who hanker after some sort of surgical
"recognition". After all, A&E is every bit as much a surgical discipline
as it is a medical discipline, and its specialists have been drawn
fairly equally from either background. To the "surgeons" in our
specialty, dropping the word "accident", and especially adding the word
"physician", naturally feels like a big concession to them. And as
Andrew has alluded, there are actually A&E folk out there who style
themselves as "accident surgeons" and the like - I kid you not! Now I
don't condone such idiosyncratic terminology, and I've always felt that
"accident and emergency medicine" was fairly evenly placed to please
both camps. If however, as has happened in recent years, small groups of
us decide we would like to be called "emergency physicians", then this
just gives added justification to others who wish to be known as
"accident surgeons"! It is this random diversification over the last few
years that now demands attention from BAEM to bring some sort of order
to things; if we can't agree on our practise, let us at least agree on
our nominal terminology.

On a more pragmatic note there are also those who hanker after surgical
recognition as it is widely accepted that this is helpful in the
medicolegal arena. However, and speaking as someone who has a busy
medicolegal practice, I don't believe that lawyers concern themselves
with our title, although most are concerned that we possess a surgical
fellowship, which will of course remain. On that note, should we presume
that the title of "Mr" will also be retained for those who wish it?
Perhaps all that headed notepaper won't go to waste after all..!

At the end of the day, Patrick's arguments, while not particularly
persuasive, are nevertheless very attractive (basically we should change
to comply with the rest of the world). What I do dislike however is the
idiosyncratic piecemeal approach, and that goes for today's "emergency
physicians" almost as much as it goes for the "accident surgeons". After
all, we are all on the GMC specialist register as having trained in
"accident and emergency medicine", and until such time as this is
changed by government, then I believe it is wrong, and probably
unlawful, to use any other term.


Adrian Fogarty FRCS, FRCSEd(A&E), FFAEM
Consultant in Accident & Emergency Medicine