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Emergency Medicine Workforce

Updates from the Chair - May 2014

Donald L Lum, MD, FACEP
Chair, Emergency Medicine Workforce Section

As a reader of my prior messages and updates, you know that I highly value collaboration and engagement. I am also a busy emergency physician who continues to practice full-time in my local community hospital ED. That makes it challenging to find the necessary time to both collaborate and engage with others, including section members, outside the workplace and home.

In January, this section applied for a section grant for a pilot project towards the creation of a national ED registry and workforce survey. This grant application followed on the heels of last year’s 2013 Emergency Medicine Section Annual Program 
“Physicians, Nurses, and Physician Assistants: Present and Future Roles in a Changing Emergency Medicine Workforce?” (we are working on making this program more widely available to section members later this spring). While the Task Force member reviewers agreed that a national ED registry would be an important resource for policy decisions and ACEP members, they noted that “the registry concept has been considered and rejected several times in the past few years as being too expensive to complete. Also of concern is the lack of reliable data for ED directors. Because ED Directors self-report their current title and position, the ACEP database of ED directors may not be robust enough to make this project work. Consequently, our proposal was not selected to submit a final application. However, I do not view this setback as serious as it helps the section to focus on the scale on which one might begin to build an ED registry and identify useful work force data: the state. A ground up rather than top-down approach.

In particular, it has come to my attention that the Washington ACEP State Chapter has been conducting its state-wide Emergency Medicine Leadership Summit which targets Emergency department medical directors and other ED stakeholders. It is inclusive and engages ACEP members and non-members alike. It aims to update emergency department leaders on statewide issues pertinent to the practice and management of an emergency department. An important by-product of this long-standing and successful endeavor is that a robust and current email database of the state’s ED medical directors has been established and maintained.  The section would do well to explore using this model as a strategy to build state-level specific ED registries and emergency medicine workforce data as well as identify eligible members.

I was also struck by an inter-generational connection that came to light last October between EMRA and Legacy physicians in ACEP.  EMRA began its Legacy Initiative which culminated in a documentary “24|7|365: The Evolution of Emergency Medicine” and an accompanying panel discussion at ACEP 13. It highlights the origins of the specialty and the pioneers and the early ED environments and conditions. The experiences in the 1980’s reminds me of my early days in the local hospital in Northfield, MN before we had dedicated in-house emergency physicians.  The nurses called you ad hoc in the middle of the day or night to come to the ED to care for one of your patients! I think this documentary offers an opportunity for different generations of emergency physicians to understand each other with more appreciation and empathy.

Indeed, I am very aware of the next generation of emergency physicians as life comes full circle - my daughter, a 4th year Case Western Reserve University medical student, will be starting the University of Utah emergency medicine residency in Salt Lake City in June, 2014. I am eager to learn in depth through her eyes what she is learning and mastering in her training and what we may learn from each other’s career perspectives.

Finally, I just completed a year of periodic locum tenens ED work assignments in eastern Maine.  It was a real pleasure to practice emergency medicine at Calais Regional Hospital during 2013. At the same time this experience has made me more mindful and keenly aware of the challenges of providing high quality emergency care at a critical access hospital which is a significant distance from the nearest tertiary care referral center. This experience reinforces my advocacy work at ACEP for greater resources and support of rural emergency medicine.

I look forward to dialogue with individual section members in the coming months prior to ACEP 14 and beyond to discover what is important to you, what engages you, what challenges you.

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