Emergency physicians from top organizations representing emergency medicine traveled to Washington, DC, this week to meet with Ben Harder, managing editor and director of health care analysis at US News & World Report and Dr. Nate Gross, co-founder of Doximity, an online social networking service for U.S. physicians that conducts surveys for US News.
The purpose of these meetings was to convey the concerns of nine emergency medicine organizations about the results of a Doximity survey, which was promoted by US News & World Report, identifying the nation’s top emergency medicine residency programs.
Prior to the meeting, emergency physicians from the nine organizations held a conference call and developed a joint letter to US News and Doximity challenging the sampling method and the implications of providing misleading information to medical students and the public.
Four physicians represented the group at these meetings:
- Hans R. House, MD, FACEP, ACEP board member
- Jeffrey N. Love, MD, MSC, president, Council of Emergency Medicine Residency Directors
- Jordan Celeste, MD, president, Emergency Medicine Residents’ Association
- Mark Mitchell, DO, FACOEP, president, American College of Osteopathic Emergency Physicians
During the meetings, the physicians conveyed that the results:
- Are misleading to medical students because they are not based on objective criteria.
- Are not useful to medical students because residency choices are made for many reasons, including geography, which are not factors in the Doximity survey.
- Are not an accurate portrayal of residency programs because they are based solely upon opinions expressed by physicians who have no first-hand knowledge of any residency training programs other than the ones they attended.
- Do not reflect the unique nature of emergency medicine.
- Send a dangerous public health message to patients having medical emergencies.
The physicians conveyed there is potential value in a secure data service for communicating HIPAA-compliant messages among emergency physicians. Also, a resource that provides detailed information on residency programs and their alumni could help medical students in making decisions about their applications to specialty training. However, the collective organizations that represent all of emergency medicine could not support the data as long as the rankings were included. Both US News and Doximity agreed there were significant limitations of the data and discussed the challenges of developing objective measures for emergency medicine, because it is a unique medical specialty. Both also agreed that these data would not be promoted to the general public.
The editor at US News described the new organiza
tion’s publications that rank hospitals and medical specialties as “consumer decision support,” which are intended to help members of the general public make decisions about where to seek care for complex medical problems. Emergency medicine has never been included in these rankings in the past, and there are no plans to begin doing so. The editor conveyed that US News recognizes that, in a medical emergency, the best place to get care is the nearest emergency department.
The physicians asked to provide a companion piece to the US News article about the results. The editor agreed to review and publish, if acceptable. The co-founder of Doximity offered to discuss these issues with leaders in his organization and suggested further discussion at ACEP 14 in Chicago.
The following organizations are participating in this effort:
- American College of Emergency Physicians
- American Academy of Emergency Medicine
- American Academy of Emergency Medicine Resident and Student Association
- American Board of Emergency Medicine
- American College of Osteopathic Emergency Physicians
- Association of Academic Chairs of Emergency Medicine
- Council of Emergency Medicine Residency Directors
- Emergency Medicine Residents’ Association
- Society for Academic Emergency Medicine