American Academy of Emergency Medicine

Crossing the Line II

Reading your editorial in the September/October issue, you discussed CMG travelling docs (special ops, the hit team, the strike team, etc.) and you discussed how they make it easier for a CMG to attack and take over emergency departments. Often those “special ops” guys and gals are the ones that make it easier for a CMG to steal a contract from a long-standing independent and democratic group or from another CMG. This is a fact.

There is something else, however, that you didn’t touch on: special ops physicians make it so much easier for a CMG or hospital administration to deny physicians due process.

I know because I used to be a special ops physician for a CMG long before the term “specil ops” was even invented. Early in my career, I worked for a medium sized CMG (that is now a large CMG). It was a frequent occurrence that I would get a call that a certain ED needed someone urgently and that they would pay me an extra amount to go cover a shift or group of shifts.

I usually would get to that hospital and realize that someone had been “taken off of the schedule.” As a young and slightly arrogant physician, I would be proud that I was called in to cover for the “less than adequate” physician.

Nowadays, I regret that I was ever used that way and I regret that I was part of the process. I now realize that almost all of the physicians that I replaced at the last minute were denied due process. I am ashamed of that.

Due process is important. It is important that we stand up for each other. If you are reading this letter and you are a special ops physician, think about it.

— Terence J. Alost, MD MBA FAAEM

Thank you for writing. You make an excellent and important point, one I had not considered. I hope our colleagues who now fill your former role will think long and hard about the ethics of what they are doing and how it effects our specialty.

 — The Editor

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