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Democratic Group Practice Section Newsletter - June 2014

October 2013 ACEP Democratic Group Practice Section Meeting Recap

Thanks to everyone who attended the 2013 Democratic Group Practice Section Meeting. There were many new faces. It is important to the viability of the section that we maintain our membership and invite our partners to join us. Happenings included:

Representation at the EMRA job fair providing resources and key questions to ask during job interviews.

Speaker Rick Grunau, MDSenior Advisor (former CEO) of Emergency Medical Associates provided us with a breakdown of what an Accountable Care Organization is and how it is relevant to democratic groups. After all we are “the other primary care” and make the ever so important “decision to admit.”

Discussions regarding the section website:
o Plans to make it public
o Resources on why to join democratic groups
o Perhaps posting a PowerPoint on the different types of EM groups
o Posting reasons to join the section

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The Case for Advanced Practice Provider (APP) Ownership in Democratic Groups

As I write this article, I am sitting in an airport, waiting for my flight that has been delayed several times tonight. I am flying to work at a site that has had some staffing challenges. Why am I doing this? It certainly isn’t because I enjoy being away from my wife and kids. It’s not because I enjoy the endless flight delays and security checkpoints or due to a deep seated love of driving rental cars. I am doing it because this helps MY Company. I am a shareholder, an owner, and this is the right thing to do! I am involved, vested and committed to the success of my company. No, I am not a Physician. I am employed by a company that offers ownership to APPs as well as physicians.

Not all democratic groups afford this opportunity and I wonder why. Do your APPs have a voice in your group? Are they a part of the team, or just non-owner employees? What will encourage them to stay if they do not have a voice in helping decide the direction of your company? In some cases the only company voice for APP’s concerns is a sympathetic Physician. How does this build esprit de corps? Why did your APPs join your group? Why are they still there? Why are they leaving? Are they growing personally and professionally? When you are on shift, you are managing your contract. You have a vested interest in making sure that things flow well. You are an owner and responsible for your business. You are a part of a team. Why would APP’s not want the same benefits? If you were an employee and had no real voice at the management level, how would you feel? Would you stay?

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Make a Difference: Write that Council Resolution

Many College members introduce new ideas and current issues to ACEP through Council resolutions. This may sound daunting to our newer members, but the good news is that only takes two ACEP members to submit a resolution for Council consideration. In just a few months the ACEP Council will meet and consider numerous resolutions.

ACEP's Council, the major governing body for the College, considers resolutions annually in conjunction with their annual meeting. During this meeting, the Council considers many resolutions, ranging from College regulations to major policy initiatives thus directing fund allocation. This year there are 367 councillors representing chapters, sections, AACEM, CORD, EMRA, and SAEM. 

The Council meeting is your opportunity to make an impact and influence the agenda for the coming years. If you have a hot topic that you believe the College should address, now is the time to start writing that resolution.

This year the deadline is July 28, 2014.

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Why Democratic Emergency Medicine

I distinctly recall the day that I matched in an emergency medicine residency. I felt my career path was pre-determined-- I would be an emergency physician, able to take my skills to any corner of the country. Little did I know that the journey was just beginning, as I had not yet chosen a practice style within emergency medicine. I soon found out that three main group practice structures exist within emergency medicine: 

  1. Employee (contract group or hospital)
  2. Independent Contractor
  3. Democratic Group

After weighing the pros and cons of each of these practice structures, I found that the Democratic Group model would serve me best.

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From Your Board Liaison


It is with great satisfaction that I serve as your Board Liaison this year. My first professional position upon graduation from residency was one where I became an equal shareholder in a single hospital group. In my current position where I advise residents on some of their career choices, I find it difficult to adequately explain what a unique experience this was. While challenging in many ways , there is nothing professionally, that has replaced the commitment and collegiality one feels for your partners when dealing with the challenges of being responsible for keeping the lights on and sharing the risk.

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Section Meeting at ACEP14: Save the Date!

Hold the following date and time on your calendars for our Democratic Group Practice Section Meeting:

Tuesday, October 28, 2014
11:00 AM - 1:00 PM

Registration for ACEP14 is open!  Visit to register and access the schedule-at-a-glance and other important information on hotels and events. 

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