From the Chair: Focused and Feasible Projects for the Future
Critical Care Medicine Section
March 2007, Vol 8, #1
David T. Huang, MD, MPH
My apologies if this reaches you well into 2007, but as I write this, it is exactly one hour into the new year, which I am having the pleasure of celebrating in the University of Pittsburgh Medical Center transplant intensive care unit – hey, what else are junior faculty good for!
At any rate, unlike past newsletters, I would like to discuss something besides the Critical Care "Board" certification issue. First, a new year merits a new topic, and second, because after a fairly busy 2006, there is no substantial new news to report since our last newsletter. As the American Board of Emergency Medicine (ABEM) President, Lynnette Doan-Wiggins, MD, JD, FACEP, told us in New Orleans, ABEM has started to have new conversations with the other American Board of Medical Specialties Boards. Our section has helped with these negotiations, and ABEM is "cautiously optimistic" at this point. We will see what happens next.
What I would like to discuss are projects, along with the essential concepts of Focus and Feasibility. This will read somewhat like many past Society of Academic Emergency Medicine editorials, but the concepts are universal, and apply to both research and political work. These concepts are worth repeating, particularly for the students/residents/junior faculty section members.
Bluntly speaking, nifty ideas are useless if they are not directed into focused, and feasible projects.
This applies even more so to organized medicine, including our section. It is important for section members to realize the strengths and limitations of their section.
Our key strengths are: (1) our organizational structure provides a degree of unity for Emergency Medicine (EM)/Critical Care Medicine (CCM) aficionados, with said unity being further strengthened by our close ties to our "sibling" sections in Society of Critical Care Medicine and Emergency Medicine Residents Association; (2) our status as one of the most rapidly growing sections within the American College of Emergency Physicians (ACEP) provides us a voice within ACEP, and; (3) the value that being part of the largest United States (US) EM organization provides.
Our major limitation, however, is something I certainly did not realize when I was a resident, and that is, simply that we have no operating budget of our own. ACEP has looked into innovative ways to address this issue, and ACEP section grants are a valuable source of funding for small projects.
In summary, it is important to recognize that our section’s main value is as an unfunded, "bully pulpit" and as a means to foster unity and collaboration within EM/CCM. Leveraged appropriately, we can be quite effective, even sans budget!
So how to be effective then? In the end, effective projects are all about Focus and Feasibility. To use a research example, idle musings about the utility of head computed tomographs in alcoholics with altered mental status will not amount to anything useful, unless specific aims are created (Focus) and an associated timeline, team, budget, abstract submission target, and plan (Feasibility) are also created! The exact same principles apply to organized medicine – in my admittedly limited experience, I’ve consistently observed that without a focused, feasible project, substantial results and progress are rarely achieved.
Over the last two years, this section’s main energies have been focused on two projects: 1) The board certification issue and publication of an associated White Paper, and 2) facilitating ACEP’s involvement with the Surviving Sepsis Campaign, with publication of an associated Annals of Emergency Medicine editorial.
While both projects continue to have ongoing work and refinement, most goals have been completed--or perhaps more accurately, at least the major initial steps have been completed!
Our section’s only current projects are:
(1) Updating the CCM Fellowship list, led by Dell Simmons, MD; and
(2) Updating the EM/CCM physician registry, led by Julie A. Mayglothling, MD.
To continue to grow and strengthen, our section needs new projects, and with the 2-year term limit of section chairs, new leaders! To that end, I am asking any section member who has been toying with a certain nagging/irritating/intriguing issue of any kind to consider if (1) it can be transformed into a focused, feasible project, (2) if the section could be of help, and (3) most importantly, if you are truly willing to commit to seeing the project from inception to completion, recognizing that projects ALWAYS take more time than you initially thought! The work is hard – but hey, so are residency and fellowship! The challenge is to apply the same level of detail and diligence to something more abstract and less immediate than a patient dying in front of you. It is a longer, and often more frustrating, road than daily patient care, but can ultimately result in true change for the better.
Please contact me care of criticalcare.section@acep.org if you would like to discuss these issues further. Happy New Year!
Or if this newsletter is delayed, Happy Chinese New Year (Feb 18, 2007)!
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