September 18, 2025
Emergency medicine is not defined by four walls, but rather the skills and scope of the practice of emergency medicine. The Michigan College of Emergency Physicians supports emergency physicians everywhere who are operating within the scope of their ability and their practice. Providing procedural and moderate sedation is something that is not only a core competency of emergency medicine training but also a skill set that emergency physicians are credentialled for by their own hospitals. The CMS guidelines also state that “… emergency medicine–trained physicians have very specific skill sets to manage airways and ventilation that is necessary to provide patient rescue. Therefore, these practitioners are uniquely qualified to provide all levels of analgesia/sedation and anesthesia (moderate to deep to general). Emergency physicians have a well-established track record of safe sedation and are important research and thought leaders in this multidisciplinary field.
For many decades, emergency physicians have provided their expertise within their emergency departments, on the sidelines of major sporting events, alongside our emergency medical clinicians on the streets, and within our own hospitals, outside of the four walls of the emergency department Today, many emergency physicians utilize their unique skills to provide safe and effective care in all sorts of clinical practices. Patients should know that when they are receiving care from a board-certified emergency physician, they are in skilled hands that will provide safe care.
Michael Gratson, MD, MHSA, FACEP
President
Centers for Medicare & Medicaid Services
CMS Manual System: Pub 100-07 State Operations Provider Certification
Appendix A. 42 CFR. Section 482.52. Revised hospital anesthesia services interpretive guidelines (January 14, 2011)