President’s Message – November 2019

Mark Baker, MD, FACEP
President, Hawaii Chapter ACEP

Aloha Hawaii ACEP Members! This President’s Message comes to you from the 2019 ACEP Council Meeting, where I represented our chapter as one of two Hawaii Councilors. Before describing the meeting, I want to thank Dr. Daniel Cheng, who stepped up to be our second Councilor. And I am hopeful that the nuances of Council operations don’t dissuade Danny from doing this again. I suspect it’s not as bad as the British Parliament!

The Council meeting occurs over two days, long days. Here’s a summary of activities and the most important information.

Day One: October 25, 2019:

  • ABEM Report: Beginning in 2020, physicians taking the board certification test can use Up-to-Date while taking the exam! I personally like that, very realistic. In the future, there will be an advanced ultrasound certification. For MOC: MyEMCert will be piloted in 2020; 8 modules need to be completed prior to certification expiring. It will include advances in emergency medicine.
  • Secretary/Treasurer Report: Cash flow is strong, CEDR and geriatric accreditation are strong, but membership revenue is not strong. 67% of revenue is from non-dues sources. Membership is growing – 39,345.
  • EMRA Report: EMRA was able to oppose and end the “standardized video interview” for resident applications. 90% of EM residents are EMRA members. They just released a new app: MobileEM.
  • EMF Report: Dr. Anderson showed the large variety of organizations that benefit from donations to EMF. There is a big push for Council members to donate.
  • NEMPAC Report: Dr. Jacoby reported on the National ACEP PAC. He described their method of determining who to support, how they support, and what bills ACEP is supporting. These topics came up later with a resolution.
  • Reference Committees: Resolutions are submitted to the Council ahead of time. Council members attend reference committee meetings where these resolutions are discussed. There is opportunity to comment and debate. After discussion, the reference committee meets and the resolutions are given one of three dispositions. They recommend that it be passed with or without modification, not passed, or referred to the Board of Directors for further consideration of the topic. The Hawaii Chapter submitted a resolution asking for ACEP to support videoconferencing for one person per chapter. No one spoke out against the resolution.
  • President’s Address: Dr. Vidor Friedman, outgoing president, described accomplishments of ACEP in this past year including work on sepsis, freestanding EDs, the role of APPs and many more.

Day Two: October 26, 2019:

  • Executive Director’s Report: this report was the last from Dean Wilkerson, who is retiring after about 20 years of working with and for ACEP. He gave a history of the many ACEP accomplishments during his tenure. I would comment that he has been an incredible force in the development and advancement of ACEP over these years. Congratulations are due to him and all those whom he worked with!
  • Reference Committee Reports: The reference committees present their recommendations. The Council members can ask for any resolutions to have further discussion. It can get tedious, picture more than 400 people trying to discuss a resolution. I have summarized the more interesting ones:
    • Reference Committee B: Noteworthy discussion was related to EMTALA (passed), supporting Universal Health Coverage (not passed), advocating removing naloxone from PDMP data (passed).
    • Reference Committee A: This committee included the resolution submitted by the Hawaii Chapter to provide a videoconferencing account to one member per chapter. It passed!
    • Other resolutions included some contentious ones. We debated removing the word “provider” from ACEP publications and instead using more precise descriptions (passed). A recommendation to support and provide implicit bias training engendered a lot of discussion: should ACEP encourage bias training for all providers, all health care workers, or just ED physicians? After several attempted changes, it passed. A resolution on NEMPAC showing more data did not pass. A resolution on physician salary and benefit transparency passed. Keep in mind that ACEP does not have the power to force transparency. The resolution on educating the public on the value of Emergency Medicine physicians went through a great deal of wordsmithing prior to being passed. A motion to encourage wearing white coats at the LAC (Leadership and Advocacy) conference failed. A resolution related to corporate involvement in medicine was debated. There was a great deal of discussion, amendments, suggestion to divide the resolves, an objection to divide that was overturned by the speaker, and finally both divided sections were passed. Basically, Council members want ACEP to investigate the impact of private equity firms on the practice of emergency medicine.
    • Reference Committee C: A medical neutrality resolution passed. A resolution asking ACEP to support vaccinations passed. ACEP will establish a rural EM advisory board. ACEP will support increasing capacity for patients with mental health issues. Again, keep in mind ACEP is not going to build capacity but will take a stance that we need more capacity for mental health patients.
  • President’s Address: Dr. William Jaquis is the incoming President. He discussed his focus on the workplace and wellness including improving technology in our workplace. He created the HIT committee. He is in favor of every emergency patient be cared for by a board-certified ED physician, while understanding there are limitations to this goal. ACEP will host an international EM summit in the spring of 2020. He expressed concern that emergency medicine physicians are near the top of the burnout ladder and ED doctors have high rates of depression. He has a request to all of us, “be kind.”
  • Elections: The Council votes for the President-Elect, Board of Directors, Speaker and Vice Speaker. This year the candidates all were exceptional and capable. These are the results:
    • President-Elect: Mark S. Rosenberg, DO, MBA, FACEP
    • Vice-Speaker: Kelly Gray-Eurom, MD, MMM, FACEP (Florida)
    • Board of Directors: Jeffrey Goodloe, MD, FACEP (Oklahoma); Gabor Kelen, MD, FACEP (AACEM); Gillian Schmitz, MD, FACEP (incumbent, Government Services); Ryan Stanton, MD, FACEP (Kentucky)

In summary, the Council meeting is the avenue for the pit doc to have input into the future of our College and the future of emergency medicine. We do that by submitting resolutions which promote conversation, decisions, and frequently actions. If you have any questions about the Council or our chapter, please contact me.

Mahalo, Mark Baker, MD, FACEP
President, Hawaii Chapter ACEP