Section Spotlight Series

ACEP Section Spotlight Logo  

This monthly series featured three of ACEP’s thirty-three sections so you can learn what they’re all about, what they are accomplishing and how their members connect.

Check out your section, or discover a new section to join and share your interests!  

April 2015 Section Spotlights

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David Stuhlmiller, MD, FACEP Air Medical Transport Section Logo  

An Interview with David Stuhlmiller, MD, FACEP, Chair of the ACEP Air Medical Transport Section
Three vehicles collide on the interstate; multiple patients need access to timely emergency medical care. Ambulances arrive, but it will take 45 minutes to reach the trauma center and the most seriously injured patient may not survive. Soon a medical helicopter arrives; the medical crew intubates the patient, gives blood during transport and arrives at the trauma center 18 minutes later.

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Dr Howard Mell EMS-Prehospital Care Section Logo  

An Interview with Howard Mell, MD, MPH, FACEP, Chair of the ACEP EMS-Prehospital Care Section
It’s an exciting time to be involved in EMS, according to Dr. Howard Mell, chair of the ACEP EMS-Prehospital Care Section. “There have been more changes in the past two years within EMS than in the previous 10 years,” he says. Dr. Mell attributes those changes to the rise of academic research in EMS and the fact that EMS is now an official emergency medicine subspecialty.

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Dr Matthew Sutter Tactical Emergency Medicine Section  

An Interview with Matthew Sutter, MD, FACEP, Chair of the ACEP Tactical Emergency Medicine Section
Tactical EM Section members work together to identify and address the unique challenges emergency physicians face in caring for and participating with tactical teams in both training and potentially hostile environments. “Our section is recognized as a group of national experts and is often consulted for guidance on education and policy matters”, says Dr. Matthew Sutter, Section Chair.

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March 2015 Section Spotlights

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Dr Sullivan Smith Careers in Emergency Medicine Section Logo  

An Interview with Sullivan Smith, MD, FACEP, Chair of the ACEP Careers in Emergency Medicine Section
You’ve dedicated your career to emergency medicine and have a long track record in your ED. You know why they call it the "pit" and you know how difficult night and weekend shifts can be. You also know the joys of having a successful professional life and how fulfilling emergency medicine is. And you understand the importance of being recognized for your contributions to the field.

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Dr Donald Lum Emergency Medicine Workforce Section Logo  

An Interview with Donald Lum, MD, FACEP, Chair of the ACEP Emergency Medicine Workforce Section
The ACEP Emergency Medicine Workforce Section has existed for 20 years, during which time the need to understand the realities of the rapidly changing EM workforce and its implications for emergency care have only deepened, says Dr. Lum. The EM workforce is best viewed from two perspectives—the “little picture” and the “big picture,” according to Dr. Lum.

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Dr Dan Freess ACEP Young Physicians Section  

An Interview with Dan Freess, MD, FACEP, Chair of the ACEP Young Physicians Section
Any new career requires adjustment and time to acquire knowledge. But imagine that, even during that time, patients are depending on you to cure their illnesses and even save their lives. You would likely take advantage of any resource that would enable you to “fast-forward” that adjustment period. That’s precisely why the ACEP Young Physicians Section (YPS) exists.

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February 2015 Section Spotlights

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Dr Grant Tarling Cruise Section Logo  

An Interview with Grant Tarling, MD, MPH, Immediate Past Chair of the ACEP Cruise Ship Medicine Section
The ACEP Cruise Ship Medicine Section enables physicians with a special interest or expertise in providing medical care within the cruise industry to initiate, discuss, and develop ideas to improve patient care aboard cruise ships.

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Dr Janet Lin International Emergency Medicine Section Logo  

An Interview with Janet Lin, MD, Chair of the ACEP Section on International Emergency Medicine
As globalization continues, so does the need to support, promote and develop the specialty of EM. If you enjoy learning about other cultures and want to share your EM expertise throughout the world, consider the ACEP Section on International Emergency Medicine.

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Dr Bruce Derrick ACEP Undersea and Hyperbaric Medicine Section  

An Interview with Bruce Derrick, MD, Chair-Elect of the ACEP Undersea & Hyperbaric Medicine Section
The ACEP Undersea & Hyperbaric Section (UHMS) members learn and grow from hearing about the unique, challenging and rewarding work involved in caring for divers, pilots, astronauts, miners, and medical and surgical patients.

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January 2015 Section Spotlights

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coletti_hsfa42 ACEP Dual Training Section Logo  

An Interview with Dr. Christian Coletti, MD, FACEP, Chair of the ACEP Dual Training Section
The ACEP Dual Training Section serves as a resource to dually trained emergency physicians in areas such as education, research, practice management, networking and collaboration.

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Christopher Baugh ACEP Observation Medicine Section Logo  

An Interview with Christopher Baugh, MD, MBA, FACEP, Chair of the ACEP Observation Medicine Section
It’s been proven that observation units make sense, both operationally and financially, resulting in a growing number of observation units nationwide. As a result, there’s plenty to talk about in ACEP’s Observation Medicine Section.

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Moira Davenport ACEP Freestanding Emergency Centers Section Logo  

An Interview with Moira Davenport, MD, Chair of the ACEP Sports Medicine Section
The ACEP Sports Medicine Section is a multifaceted group whose members have a wide range of interests. To learn more, ACEP interviewed Dr. Moira Davenport, section chair.

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November 2014 Section Spotlights

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Dr Rosenbloom ACEP Democratic Group Practice Section Logo  

An Interview with Robert Rosenbloom, MD, FACEP, Immediate Past Chair of the Democratic Group Practice Section
What is the easiest way to describe a democratic group practice? It’s equitable pay and scheduling with an opportunity to make decisions by offering equal voting to all members. It gives the group’s physicians a say in their self-determination and future.

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Dr Rosenbloom ACEP Emergency Medicine Practice Management and Health Policy Section Logo  

An Interview with Nicholas Vasquez, MD, FACEP, Chair of the Emergency Medicine Practice Management and Health Policy Section
"The EMPMHP Section focuses on the various issues that affect emergency department management. Because EDs are open 24/7 to all comers, anything that affects people’s access to care, understanding of health or their daily lives can impact ED management" says Dr. Nicholas Vasquez.

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Dr Ybarra ACEP Freestanding Emergency Centers Section Logo  

An Interview with R. Joe Ybarra, MD, Chair of the ACEP Freestanding Emergency Centers Section
"This section is a forum for interested members to discuss all freestanding emergency center issues, and that includes both independently licensed freestanding emergency centers and satellite hospital outpatient departments," says Dr. R. Joe Ybarra."

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October 2014 Section Spotlights

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Dr Darrell Carter ACEP Rural Emergency Medicine Section Logo  

An Interview with Darrell Carter, MD, FACEP, Chair of the Rural Emergency Medicine Section
Small towns often mean small hospitals. That translates to smaller emergency departments with fewer emergency physicians, specialists and staff members. It can also mean a lack of in-house diagnostic equipment. Together, these factors create a unique set of problems, according to Dr. Carter.

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Dr Neal Sikka ACEP Emergency Telemedicine Section Logo  

An Interview withNeal Sikka, MD, FACEP, Chair of the Emergency Telemedicine Section
Telehealth/telemedicine encompasses several different models of care, providing real-time clinical care via video technology to remote monitoring of diagnostic tests and images that can result in a decision to treat locally or transfer the patient to a hospital with more advanced capabilities.

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Dr Sarah McCullough ACEP Wellness Section Logo  

An Interview with Sarah McCullough, MD, FACEP, Chair of the Wellness Section
Emergency physicians generally choose their career paths because they have a passion for people, their overall health and their general well-being. But as any emergency physician knows, it’s a career that requires a lot of time and energy—both mentally and physically.

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September 2014 Section Spotlights

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Dr James F Holmes Jr ACEP Emergency Medicine Research Section Logo  

An Interview withJames F. Holmes, Jr., MD, MPH, FACEP, Chair of the Emergency Medicine Research Section
As an emergency physician, you may be interested in research but have little idea of where to begin. Or perhaps you’re further along in your research but have reached a turning point where you need advice or some other kind of assistance. Odds are you’ll find exactly what you need as a member of the ACEP EM Research Section.

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Dr Shawn Varney ACEP Toxicology Section Logo  

An Interview withShawn Varney, MD, FACEP, Chair of the Toxicology Section
“Let’s run a tox screen” are words that most emergency physicians likely say all too often, particularly with the prescription opioid misuse and abuse so rampant in the United States today. Those symptoms, including small pupils and slowed breathing, are signs that all emergency physicians are aware of.

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Dr Michael Caudell ACEP Wilderness Medicine Section  

An Interview with Michael Caudell, MD, FACEP, FAWM, Chair of the Wilderness Medicine Section
The term “wilderness medicine” brings to mind practicing emergency medicine on a victim high in a mountain range. But that’s just the tip of the iceberg. Dr. Caudell recalls a panic-stricken neighbor asking him to examine his son’s possibly broken arm. The boy’s arm is indeed broken, and the hospital is a half hour away.

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August 2014 Section Spotlights

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Dr Evie Marcolini ACEP Critical Care Medicine Section Logo  

An Interview withEvie Marcolini, MD, FACEP, Chair of the Critical Care Medicine Section
Evie Marcolini was pursuing her desire to become an emergency physician when she developed an equally strong passion for critical care medicine during her residency. Then she realized that the two specialties aren’t mutually exclusive. “Half of the patients in the ICU start their hospital visit in the ED,” says Dr. Marcolini.

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Dr Joseph Sabato, Jr ACEP Disaster Medicine Section Logo  

An Interview with Joseph Sabato, Jr., MD, FACEP, Chair of the Disaster Medicine Section
The ACEP Disaster Medicine Section is a multi-faceted group whose members strive to better prepare themselves for all types of disasters. Mass casualty events such as the Boston Marathon, Japan’s nuclear events, the challenges of influenza and bioterrorism always top the list of discussion topics.

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Dr Jay Baruch ACEP Medical Humanities Section  

An Interview with Jay Baruch, MD, Chair of the Medical Humanities Section
The term “medical humanities” brings to mind different things for different people. It’s not an easily defined term, even for the chair of the ACEP Medical Humanities Section. But Dr. Baruch feels the importance of the creative writing that he does outside the emergency department every time he’s on shift.

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July 2014 Section Spotlights

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Dr Kevin Baumlin ACEP Infomatics Section Logo  

An Interview with Kevin Baumlin, MD, Chair of the Emergency Medicine Informatics Section
The Merriam-Webster Dictionary defines “informatics” as the collection, classification, storage, retrieval and dissemination of recorded knowledge. You probably became an emergency physician because you wanted to heal people; little did you know you’d have to become an IT expert just to keep up!

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Dr Ralph Riviello ACEP Forensic Medicine Section Logo  

An Interview with Ralph Riviello, MD, MS, FACEP, Chair of the Forensic Medicine Section
When members of the ACEP Forensic Medicine Section get together or meet via conference call, their topics can range from child abuse and sexual assault to motor vehicle collisions and gunshot wounds. They’re dire topics for sure, but they’re also an emergency physician’s daily reality.

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Dr Chris Beach ACEP Quality Improvement and Patient Safety Section  

An Interview with Chris Beach, MD, FACEP, Chair of the Quality Improvement & Patient Safety Section
Emergency physicians must hand off patients to their peers thousands of times in their careers. It’s a critical juncture in patient care, when the exchange of significant information between two physicians can significantly impact a patient’s future. And it’s lacked standardization — until now.

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June 2014 Section Spotlights

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Dr Christopher Raio ACEP Emergency Ultrasound Section Logo  

An Interview with Christopher Raio, MD, FACEP, Chair of the Emergency Ultrasound Section
Look at the ACEP Emergency Ultrasound (EUS) Section, and you’ll find more than 1,200 members who believe that ultrasound is critical to the work they do on a daily basis — and they’re determined to spread that word to their physician colleagues and beyond.

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Dr Chris Carpenter ACEP Geriatric Emergency Medicine Section  

An Interview with Chris Carpenter, MD, FACEP, Chair of the Geriatric Emergency Medicine Section
Treating geriatric patients is probably already a part of your everyday emergency practice. We realize that treating the elderly can present significant challenges and it’s our obligation as emergency physicians to continually improve the care we deliver.

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Dr Mark Rosenberg ACEP Palliative Medicine Section Logo  

An Interview With Mark Rosenberg, DO, MBA, FACEP, Chair of the Palliative Medicine Section
"In the U.S., 70% of people die in unfamiliar surroundings, despite the fact that virtually 100% of people say they want to die at home or in familiar surroundings, according to Dr. Rosenberg, Chair of the Palliative Medicine Section. "About 90% of the dying come in through the ED", he says.

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May 2014 Section Spotlights

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Dr Kathleen Clem Women Emergency Physicians Section Logo  

An Interview with Dr. Kathleen Clem, Chair of the Women Emergency Physicians Section
First and foremost, let’s clarify a possible misconception about AAWEP: it’s not just for women! "If you’re a man whose motive is to help with the recruitment, retention and advancement of women in EM, then AAWEP is the place for you," says Dr. Kathleen Clem, Section Chair.

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Dr Sean Fox ACEP Pediatric Emergency Medicine Section Logo  

An Interview with Dr. Sean Fox, Chair of the Pediatric Emergency Medicine Section
Many EDs don’t have pediatric emergency physicians, and some hospitals don’t yet have dedicated pediatric EDs, according to Dr. Sean Fox, Section Chair. But you don’t have to specialize in pediatric EM to treat children - or to want to ensure that all kids get the best care possible.

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Dr Megan Ranney ACEP Trauma and Injury Prevention Section  

An Interview with Dr. Megan Ranney, Chair of the Trauma and Injury Prevention Section
Injuries represent 30 percent of emergency department visits nationwide, and that’s exactly why the ACEP Trauma and Injury Prevention Section (TIPS) was created. TIPS exists in parallel to ACEP’s Public Health and Injury Prevention Committee.

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An Interview with David Stuhlmiller, MD, FACEP, Chair of the ACEP Air Medical Transport Section

Three vehicles collide on the interstate; multiple patients need access to timely emergency medical care. Ambulances arrive, but it will take 45 minutes to reach the trauma center and the most seriously injured patient may not survive. Soon a medical helicopter arrives; the medical crew intubates the patient, gives blood during transport and arrives at the trauma center 18 minutes later.

This is just one example of why air medicine is such an integral part of our health care system. The ACEP Air Medical Transport Section works to ensure that air medical transport is used to benefit patients while providing the highest standard of care in a safe and effective manner. To learn more, ACEP interviewed Dr. David Stuhlmiller, section chair.

Q: Can you give us a brief background on your section and why it exists?

A: The Air Medical Transport section is a niche (air) within a niche (EMS) of emergency medicine. We’re a very small community of physicians with the same goal—to ensure that the most critically ill and injured persons in our society are safely treated and transported from either one hospital to another or from the scene of illness/injury to the hospital.

Treating a patient during air medical transport is different than caring for a patient in the emergency department or even a ground ambulance. Our section gathers experts in medical care in this unique environment.

Q: What kinds of topics does your section discuss on a regular basis?

A: We discuss how air medical transport benefits patients because of the clinical care delivered by the providers and together, we learn from each other and bring best practices back to our own air medical transport services. We talk about the risks of air medical transport, both transport safety and patient safety, and how to mitigate those risks.

We talk about the importance of quality of care to our patients. We also realize that more research is needed to show the benefit of and to shape the role of air medical transport as an integral part of the health care delivery system.

Q: What do you most want other ACEP members to know about your section?

A: The Air Medical Transport section is the best resource for emergency providers for all issues related to critical care transport. With regionalization of health care delivery, our section members are experts in out-of-hospital transport and may be integral in transfer decision-making regarding critical patients. If you haven’t thought about the clinical capabilities and quality of care of medical transport services available to you and your patient, we have.

Q: Why should ACEP members want to be part of your section?

A: Patients will continue to become ill or injured and need critical care transport, including air medical transport. If you enjoy interacting with dedicated, intelligent, specialized physicians interested in defining benefit, quality and best practices during out-of-hospital transport, join the Air Medical Transport section.

For more information and to join the ACEP Air Medical Transport Section, visit:  https://www.acep.org/airtransportsection/.

An Interview with Howard Mell, MD, MPH, FACEP, Chair of the ACEP EMS-Prehospital Care Section

It’s an exciting time to be involved in EMS, according to Dr. Howard Mell, chair of the ACEP EMS-Prehospital Care Section. “There have been more changes in the past two years within EMS than in the previous 10 years,” he says. Dr. Mell attributes those changes to the rise of academic research in EMS and the fact that EMS is now an official emergency medicine subspecialty. Read on to learn more.

Q: Can you tell us a little about your section and why it exists?

A: EMS is now a board-recognized subspecialty in emergency medicine, and the number of emergency physicians who are active within EMS across the country is quite large. Our section is represented accordingly within ACEP. We’re an active networking group that shares ideas and experiences, but also works with the EMS Committee to assist on projects and policy development as needed. In addition to serving the Board on EMS-related issues, we exist to promote research.

Q: What kinds of topics does your section discuss on a regular basis?

A: The primary topic over the last couple of years has been the completion of board certification because that’s relatively new. The first board exam was in 2013 and it had a 40 percent pass rate. The next exam is in October 2015 and so that’s taken up a lot of our time as a section. We’ve partnered with the National Association of EMS Physicians to create a board review course for those who plan to take the exam, and section members traditionally deliver lectures on EMS topics at ACEP’s Annual Scientific Assembly.

We also deal with the need for EMS research, and community paramedicine has definitely been a hot topic of discussion in that area—that is, using paramedics to essentially perform outpatient services. The paramedic visits the patient in their home, checks on their medications and makes sure they’re doing okay.

We also look at any new drugs or treatments that become available pertaining to our practice.

Q: What do you most want other ACEP members to know about your section?

A: We have an amazingly active listserv where a lot of common wisdom gets passed along among section members each week. Someone posts a question, such as “Our supply of lorazepam is out. Is anyone else experiencing this, and what workarounds have you found?”

Another issue that came up recently was a medical director experiencing issues with a union firefighter who he felt wasn’t performing adequately, but the union filed a grievance against the physician. So the physician asked if anyone else had experienced a similar issue. There are also many questions of protocol, among other topics.

Our listserv is open only to our section members, so it functions as a safe place where members don’t have to worry as much about what is said. It allows a bit more freedom to know that we’re speaking among peers as opposed to having to edit our comments for public consumption.

For more information and to join the ACEP EMS-Prehospital Care Section, visit:  https://www.acep.org/ems-prehospital.aspx.

An Interview with Matthew Sutter, MD, FACEP, Chair of the ACEP Tactical Emergency Medicine Section

The ACEP Tactical Emergency Medicine Section provides a forum for emergency physicians with an interest or expertise in tactical medical support to share information with the College and external organizations. Section members work together to identify and address the unique challenges emergency physicians face in caring for and participating with tactical teams in both training and potentially hostile environments. ACEP spoke with Dr. Matthew Sutter, section chair, to discover more.

Q: Can you give us a brief background on your section and why it exists?

A: The section was formed in 2003 with the aim of facilitating medical care and support for tactical operations by law enforcement and military agencies. The roots of this movement are deep, but are related to advances in medical care for military special operations.

Q: What kinds of topics does your section discuss on a regular basis?

A: There is ongoing discussion of the mechanics of providing medical care in the field, medical direction of field care, training and the logistics of tactical medical support.

Q: Does your section engage in any particular learning activities?

A: The ACEP Tactical Emergency Medicine Section has a learning session at our annual meeting at ACEP Scientific Assembly. Many of our section members are also active in other national law enforcement and medical organizations that provide conferences and ongoing training.

Q: If you had to narrow it down to only your top two or three things, what would you most want other ACEP members to know about your section?

A: I would want ACEP members to know that the section is recognized as a group of national experts and is often consulted for guidance on education and policy matters. Our section contains thought leaders in high-threat medical care and translation of military lessons learned to the civilian environment. I would also want members to understand that the section provides a forum for tactical physicians and tactical EMS medical directors to learn from each other. We’d welcome anyone with an interest in medical support of law enforcement or military. 

For more information, or to join the ACEP Tactical Emergency Medicine Section, visit https://www.acep.org/tacticalsection/.

An Interview with Sullivan Smith, MD, FACEP, Chair of the ACEP Careers in Emergency Medicine Section

You’ve dedicated your career to emergency medicine and have a long track record in your emergency department. You know why they call it the "pit" and you know how difficult night and weekend shifts can be.

You also know the joys of having a successful professional life and how fulfilling emergency medicine is. And you understand the importance of being recognized for your contributions to the field.

These experiences make you the perfect champion of emergency medicine. And they may mean that the ACEP Careers in Emergency Medicine Section is the perfect place for you. To learn more, ACEP interviewed Dr. Sullivan Smith, section chair.

Q: Can you give us a brief background on your section and why it exists?

A: The Careers Section includes members from all walks of careers, including academics, residents and community docs. The section exists to support members who are experiencing issues in their careers, as well as to recognize long-serving and distinguished emergency medicine physicians.


Q: What kinds of topics does your section discuss on a regular basis?

A: All kinds of current emergency medicine topics, including political advocacy, Legislative Advocacy Conference and Leadership Summit reports, career changes and challenges, and the changing health care environment and how it impacts emergency physicians. Physicians who are recognized for their service (see below) have the opportunity to share stories and lessons learned with the section.


Q: Does your section engage in any particular learning activities? 

A: We have two learning functions. Our mentorship program allows members to get help/advice from a list of mentor leaders in the College if they’re experiencing difficulties or issues of any kind related to their career or emergency medicine in general.

We also have a blog called "In All My Career." It includes stories, “gee whiz”-type observations, surprises and any unusual member job-related experiences. Sometimes the stories are heart-wrenching, sometimes uplifting and sometimes just incredible. Stories don’t have to be scientifically based nor do they have to quote literature.


Q: What would you most want other ACEP members to know about your section?

A: We recognize and support all ACEP members wherever they may be in their careers, including section members with the longest tenures in a single department and the longest careers. We have awards for career milestones such as 20, 25, 30 and even 40 or more years in emergency medicine.

We’re also developing awards for outstanding contributions to emergency medicine practice that will be presented this year at Scientific Assembly. The new awards are for exceptional things that our members do at local, state and national levels that might otherwise go unrecognized, such as a heroic act, political action, community service, volunteerism and advocacy.


Q: Why should ACEP members want to be part of your section?

A: Careers in EM is the section to join for all of the regular working docs who step up every day and work to make a difference in those patients they have yet to meet. In particular, members who have served for several years in emergency medicine should join.


For more information and to join the ACEP Careers in Emergency Medicine Section, visit: https://www.acep.org/careersinEMsection/.

An Interview with Donald Lum, MD, FACEP, Chair of the ACEP Emergency Medicine Workforce Section

The ACEP Emergency Medicine (EM) Workforce Section has existed for 20 years, during which time the need to understand the realities of the rapidly changing EM workforce and its implications for emergency care have only deepened, says Dr. Lum.

The EM workforce is best viewed from two perspectives—the “little picture” and the “big picture,” according to Dr. Lum. The little picture includes emergency departments/your daily work environment—which is rapidly changing in terms of technology, for example.

“The big picture includes the persistence of a hybrid workforce,” says Dr. Lum. “Both emergency medicine residency-trained and primary care residency-trained physicians are entering the EM workforce. Then we have the advent of advanced practice providers in large numbers, including physician assistants and nurse practitioners, and that ongoing trend will profoundly impact how emergency care providers practice in the future.”

The section is currently focused on five primary issues, including:

  • Creating an emergency medicine workforce census/profile: “One doesn’t exist on a national level,” says Dr. Lum. “We need to understand the workforce composition in terms of different providers, whether or not they employ advanced practice providers, and these new providers’ distribution (rural versus urban concentration). These statistical issues can help drive public policy and College-level initiatives and support.”
  • Understanding the changing roles of physicians, nurses and advanced practice providers in the future of emergency medicine and the emergency department.
  • Dissecting the emergency medicine job market and debunking myths about what today’s job market really looks like.
  • Addressing ongoing issues regarding educational resources for all emergency physicians.
  • Measuring the impact of innovative technologies such as bedside ultrasound and telemedicine on the workforce.

While the majority of ACEP sections are more narrowly focused, the emergency medicine workforce is an incredibly broad issue that affects every emergency physician. “One of our previous chairs joked that you can make anything into an emergency medicine workforce issue, and it’s true,” says Dr. Lum. “But when you break it down, there are three primary reasons why ACEP members would want to be part of our section.”

  • The EM Workforce Section is a resource for the College to understand the rapidly changing emergency medicine workforce.
  • The section collaborates with other ACEP Sections, other parts of ACEP and beyond on issues that impact emergency care, both now and in the future.
  • The section advocates for over-arching policies within ACEP.

Diversity is incredibly important to gain an in-depth understanding of an issue like emergency medicine workforce, and the more section members who can contribute, the better, says Dr. Lum. “Our aim is to be representative of the entire workforce, and that goes beyond even the College,” he says. “Certainly we want our section to become increasingly more diverse over time, just as the workforce itself. There’s more than enough room for projects both large and small.”

For more information and to join the ACEP Emergency Medicine Workforce Section, visit:  https://www.acep.org/emworkforce/.

An Interview with Dan Freess, MD, FACEP, Chair of the ACEP Young Physicians Section

Any new career requires adjustment and time to acquire knowledge. But imagine that, even during that time, patients are depending on you to cure their illnesses and even save their lives. You would likely take advantage of any resource that would enable you to “fast-forward” that adjustment period. That’s precisely why the ACEP Young Physicians Section (YPS) exists.

YPS provides a forum for new emergency physicians to build a knowledge base, share information and serve as a resource for ACEP’s Board of Directors. “The concept is helping physicians transition from residency to becoming young physicians and specifically, young attendings,” says Dr. Freess. “We do a lot of board preparation, early leadership development, and general overviews of things that aren’t necessarily taught in residency, from advocacy to billing and coding.”

YPS received an ACEP section grant to support the revision of ACEP 101, a guide created to help ACEP members better understand the function and structure of the College—ultimately increasing young physicians’ College participation. “It’s an orientation manual in terms of how to get involved and understand the College’s leadership structure,” says Dr. Freess. “It’s more or less a guide to all of the things our section is involved with and promotes.”

Section members stay in the loop through In Transition, a monthly e-newsletter containing information specific to early career development and personal life issues for young physicians. YPS also develops and co-sponsors with the Emergency Medicine Residents’ Association (EMRA) an educational track at ACEP’s Legislative Advocacy Conference and Leadership Summit. “The event is held for half a day on Sunday before the conference, and we go over a lot of the things that will be talked about and do a general introduction to both leadership development and advocacy just for young physicians,” says Dr. Freess. “Many older emergency physicians also attend because it tends to be a well-received event.”

Unlike most ACEP sections that are focused on a specific topic, this section is more broad-based, covering a wide range of ideas and issues important to today’s young physicians. “On a yearly basis, we go by what section participants tell us they want to discuss,” says Dr. Freess. “A couple of years ago two physicians were passionate about gun violence, so we put together some resolutions on that. Previously we focused on board preparation and education. We’ve written two Council resolutions regarding liability litigation stress, which were successfully passed. The topics are always interesting and evolving.”

For more information and to join the ACEP Young Physicians Section, visit:  https://www.acep.org/youngphysicianssection/.

An Interview with
Grant Tarling, MD, MPH, Immediate Past Chair of the ACEP Cruise Ship Medicine Section


The ACEP Cruise Ship Medicine Section enables physicians with a special interest or expertise in providing medical care within the cruise industry to initiate, discuss, and develop ideas to improve patient care aboard cruise ships.

To accomplish this goal, the section developed and continually updates the ACEP Health Care Guidelines for Cruise Ship Medical Facilities, the only quality guidelines of their kind in the world. They’ve been endorsed by all member lines of the Cruise Lines International Association (CLIA), which represents more than 90 percent of cruise ships worldwide.

“Guidelines for shoreside medical facilities are often disease-specific, while ours are broader and cover many areas such as infrastructure, staffing, clinical practice, pharmacy, laboratory and contingency plans—all of which encompass the wider scope of health care at sea,” says Dr. Tarling. “These are very far-reaching guidelines.”

With 20 million people or more cruising annually and up to 8,000 passengers and crew per ship, ACEP’s guidelines are more vital than ever. They’re usually the most popular topic of discussion at section meetings because they cover so many different medical situations in a multitude of environmental settings.

On a ship, physicians may be practicing ophthalmology one minute, orthopedics the next, and managing a heart attack patient in the intensive care unit. “We try to reengineer best practices from shoreside facilities and adapt them to fit into the relatively isolated cruise ship environment,” says Dr. Tarling. “We also discuss medical technologies that we can adapt to cruise ship medicine.”

Many ships now perform up to 50 different point-of-care tests in less than 15 minutes, including comprehensive blood and infectious disease testing. A few major cruise lines have recently also adopted electronic health records, including clinical decision support tools that help medical staff better manage the health of patients.

“Some cruise ship corporations employ up to 100,000 crew members from more than 100 countries, so it’s a significant seafaring population to care for,” says Dr. Tarling. “An emergency medicine skill set is important, but our valuable crew members are onboard for anywhere from a few weeks to 10 months, so we also manage their chronic diseases such as high blood pressure and diabetes. That’s why our guidelines address the entire spectrum of the clinical care that we provide.”

Regardless of what country you live in or your type of practice, you will feel at home with other ACEP Cruise Ship Medicine Section members. “We’re a diverse group of well-traveled physicians from all over the world—each with incredible experiences to share in dealing with the most complex and unusual health issues you can imagine occurring in remote settings,” says Dr. Tarling. “Our meetings and social events are wonderful opportunities to learn from each other.”

And every learning opportunity is important when you’re a cruise ship physician. “You definitely can’t just jump from any typical specialty onto a ship,” says Dr. Tarling. “The change in practice from land to ship is sometimes quite dramatic and you have to approach the clinical care within the wider context of an ever-changing geographical area.”

For more information and to join the ACEP Cruise Ship Medicine Section, visit:  https://www.acep.org/cruiseship/.

An Interview with
Janet Lin, MD, 
Chair of the ACEP Section on International Emergency Medicine
 
As globalization continues, so does the need to support, promote and develop the specialty of emergency medicine. If you enjoy learning about other cultures and want to share your emergency medicine expertise throughout the world, consider the ACEP Section on International Emergency Medicine. It’s a unique opportunity to unite with more than 1,800 emergency medicine colleagues to have a global impact by sharing your knowledge and experiences with others.

This section has a wide and varied membership. Some members are based in the United States, with many regularly working in other countries. As part of their ACEP membership, international members are automatically enrolled in the section. Membership also includes resident physicians exploring their options, as well as retired physicians who still want to provide some manner of medical service.

While some members are primarily interested in research, others are focused on service or education. “We try to be innovative and think outside the box, both because we want to meet everyone’s needs and because we’re such a dynamic group,” says Dr. Lin.

The growing section has a place for everyone, and includes the following committee leadership opportunities:
  • Ambassador Program
  • Ambassador Task Force
  • Communications Committee
  • Education Committee
  • Nominating Committee
  • Research and Grant Development Committee
The section also incorporates resident physician mentorship opportunities within each committee for development of the next generation of leaders.

The Ambassador Program is the “jewel of the section,” says Dr. Lin. Ambassadors keep ACEP apprised of the state of emergency medicine and any new emergency medicine-related programs in their respective countries. They also work closely with international counterparts who serve as liaisons. The program serves as a resource and point of contact for ACEP members who are interested in exploring international work or collaborating on the development of emergency care in any of the represented countries.

The section hosts an educational session at each Scientific Assembly, many of which have featured collaborations with other ACEP sections. The section also works with external organizations, such as the International Federation of Emergency Medicine and the African Federation of Emergency Medicine.

Because the section is so large, being the perfect resource for everyone is difficult. But Dr. Lin and her leadership team don’t let that stop them from trying. They recently issued a survey to section members to “get the pulse of the section,” says Dr. Lin. “What are our emergency physicians doing? What are they interested in getting out of the section, and what would they like to see more of? We really wanted to tap into members who may not have taken an active role in the past.” The team received a 30 percent response rate—and a host of new ideas.

Whatever your goals around international emergency medicine, you’re sure to find new ideas, inspiration, support and camaraderie within this section. “One of the biggest takeaways here is that our section isn’t intended for any one type of practitioner,” says Dr. Lin. “Our goal is to serve the interests of our section as a whole and further the development of quality emergency care throughout the world.”

For more information and to join the ACEP Section on International Emergency Medicine, visit:  https://www.acep.org/InternationalSection/.
An Interview with
Bruce Derrick, MD, Chair-Elect of the ACEP Undersea & Hyperbaric Medicine Section

The ACEP Undersea & Hyperbaric Medicine Section (UHMS) exposes emergency physicians to the clinical, didactic, research and academic opportunities that abound in undersea & hyperbaric medicine. Members learn and grow from hearing about the unique, challenging and rewarding work involved in caring for divers, pilots, astronauts, miners, and medical and surgical patients. ACEP talked with Dr. Bruce Derrick, section chair-elect, to learn more.

Q: Can you tell us about the composition of your section’s membership, and what types of things your members do?

A: In general, hyperbaric medicine physicians come from a wide range of specialties. While a physician can become board-certified in UHM (Undersea & Hyperbaric Medicine) through emergency medicine or preventative medicine, many practitioners are emergency physicians, in part because a variety of emergency conditions are treated with hyperbaric oxygen. 
It’s hard to define what the typical hyperbaric provider looks like because there really isn’t one type. This section connects a very diverse group of people with different ideas and subspecialty trainings—making for great discussion and lively conversation as we each add our own knowledge base and specialty training to the mix.

Q: What are your section’s biggest topics of discussion?

A: First and foremost, we discuss fellowship training, as it’s critical that we maintain a substantial body of well-trained and well-educated hyperbaric doctors. The number of board-certified hyperbaric medicine providers isn’t as numerous as we’d like, so we’re trying to encourage interested emergency physicians to seek formal, year-long training in one of the eight fellowship programs across the country. We also discuss ways to increase the general public’s awareness and understanding of hyperbaric medicine so that other providers and potential patients realize the potential benefit of hyperbaric oxygen therapy.

We talk about the various hyperbaric treatment protocols used across the country, and discuss difficult or interesting cases involving injured divers and other emergency patients. Another hot topic is the evolving health care environment, including forthcoming billing and reimbursement changes. In addition, we alert section members to the various learning opportunities that exist across the subspecialty, including a national online diving medicine e-conference. Monthly presentations by each of the fellowship programs provides an opportunity for fellows, faculty and practicing hyperbaricists from across the country to join in a “face to face” discussion of cases and clinical practice patterns.

Q: What would you most want other ACEP members to know about your section?

A: We’re a small group of incredibly dedicated emergency physicians with a wide variety of experience, and our section provides an amazing networking opportunity. You automatically have a group of people you can reach out to with similar academic and clinical interests, yet each person has their own area of expertise. Our members know that solving a problem may be as easy as picking up the phone or sending an email to a fellow member. We also have a great listserv that allows section members to chat back and forth amongst themselves, brainstorming ideas and solutions. Our section is a close group where everybody helps everybody and aims to further the field of undersea & hyperbaric medicine.

For more information, or to join the ACEP Undersea & Hyperbaric Medicine Section, visit:  https://www.acep.org/hyperbaricsection/.
An Interview with Christian Coletti, MD, FACEP,
Chair of the ACEP Dual Training Section

The ACEP Dual Training Section serves as a resource to dually trained emergency physicians in areas such as education, research, practice management, networking and collaboration.

To learn more, ACEP interviewed Dr. Christian Coletti, section chair.

Q: How has this section evolved since it began?

A: Initially, the section was called the Emergency Medicine/Internal Medicine Section. But about two years ago we realized that we needed to be more inclusive of colleagues with dual training in other areas such as emergency medicine and pediatrics, as well as some providers with non-traditional emergency dual training—meaning that they did their residency program separately but are still dual-boarded. So we renamed the section to be sure everyone was included.

Q: Can you tell us about some of the topics and/or challenges your section regularly addresses?

A: We often discuss new career opportunities and trends for Dual Training Section members, and that’s a new and evolving conversation every year—whether it’s observation medicine or having opportunities under one employer to work in both departments in which you’re trained. We discuss improvements in combined residency training programs, and how we could make more medical students and residents aware of these programs should they expand. We too often find that medical students don’t know about these programs until they’re already in training and thus, never even have the option to consider them as a career opportunity.

We also advocate hospital recognition and credentialing, particularly for EM-trained physicians. They may be dual-boarded in emergency medicine and pediatrics, yet certain pediatric hospitals aren’t fully recognizing some of their certifications and professional skills. We also talk about section grants and other ideas to help move both the section and the College forward.

Q: Do you find that dual-trained emergency physicians tend to venture into hospital administration, given their expert knowledge in more than one specialty?

A: Yes. Dual Training Section members often gravitate toward either administrative or academic positions within their institutions, and part of the reason is because they’re intimately involved in most aspects of the way hospitals operate. Because of that, we sometimes find unique challenges or issues that other emergency medicine colleagues may not run into in their everyday practice. So we try to further our understanding of what’s occurring throughout the country—both to help each other locally but also to assist nationally with issues that are important to the practice of emergency medicine.

Q: What do you most want ACEP members to know about your section?

A: We’re very proud of our members, and the knowledge they provide toward continuity of care can be very valuable when trying to address population health, administrative or reform issues throughout a hospital. We also need to do whatever we can to increase awareness to all ACEP members who may not understand that dual-training programs exist throughout the country. Our section is growing, and it’s exciting to see our research activities growing at the same time.

For more information and to join the ACEP Dual Training Section, visit:  https://www.acep.org/dualtraining/.
An Interview with Christopher Baugh, MD, MBA, FACEP, Chair of the ACEP Observation Medicine Section
 
It’s been proven that observation units make sense, both operationally and financially, resulting in a growing number of observation units nationwide.

As a result, there’s plenty to talk about in ACEP’s Observation Medicine Section. Members tasked with starting observation units have many questions that are regularly discussed on the section’s listserv, including:
  • Where do I begin when starting an observation unit?
  • What are the basic metrics for the size and staffing of an observation unit?
  • How does observation billing work?
  • How should we document to ensure that we’re billing correctly?
The Centers for Medicare and Medicaid Services’ (CMS) “Two Midnight Rule” has also been a big discussion topic recently. “CMS basically said that if you’re expected to be in the hospital for less than two midnights, then you should be an observation patient,” says Dr. Baugh. “This really made everyone think of observation in a different way, and it’s resulting in an expansion of observation services.”

The section also discusses condition-specific evidence-based protocols, often used to treat observation patients because they result in cost-savings efficiencies. But the opposite is also true of hospitals without observation units that place these types of patients on their inpatient units while they’re undergoing testing.

“They’re unlikely to be using protocols and don’t cohort their observation patients together, so they lose many of the efficiencies that a dedicated observation unit offers,” says Dr. Baugh. “The end result is an inpatient cost structure but the payment structure is outpatient, resulting in a big mismatch.”

Research is also a big discussion topic for the section, and there is a lot of interest in furthering the body of knowledge around observation—particularly for conditions not previously thought to be good candidates for observation units. “Certain conditions can be appropriate for observation if you approach them in a certain way or use a specific protocol, and we’re looking at conducting studies across multiple institutions and collaborating with others around novel ideas in observation,” says Dr. Baugh.

That includes participating in an annual observation conference through the Michigan College of Emergency Physicians led by Carol Clark, MD, MBA, FACEP, an ACEP Observation Medicine Section member. The conference brings together the nation’s thought leaders in observation medicine. This year’s conference is slated for September 2015 - the agenda, dates and location will be announced shortly. Dr. Baugh also plans to establish an online discussion board with rotating themes led by different content experts from the section. The content will be archived so that new section members can access it at any time.

“Observation medicine is an incredibly dynamic area right now,” says Dr. Baugh. “There are a lot of opportunities for folks with an interest to lead both locally and nationally in terms of establishing best practices that will help deliver better patient care and improve the standing of their department within the hospital—both politically and financially. There are also a multitude of national opportunities in administration and research. It’s definitely an exciting time to be a part of observation medicine.”

For more information and to join the ACEP Observation Medicine Section, visit:  https://www.acep.org/observationsection/.
An Interview with
Moira Davenport, MD,
Chair of the ACEP Sports Medicine Section
 

The ACEP Sports Medicine Section is a multifaceted group whose members have a wide range of interests. The section exists to:
  • Provide a forum to discuss sports medicine topics relevant to emergency physicians
  • Support collaboration in sports medicine research
  • Educate medical students, residents and fellows on current orthopedic and sports medicine topics
  • Promote subspecialty growth by providing mentorship resources and information on sports medicine careers
The section also sponsors a Sports Medicine Virtual Mentorship Program, funded by an ACEP Section Grant. The program supports mentoring relationships between experienced sports medicine/emergency medicine physicians and those interested in pursuing further training or careers in primary care sports medicine.

To learn more, ACEP interviewed Dr. Moira Davenport, section chair.

Q: What’s the biggest misconception about your section?

A: That you have to be a former athlete or have a huge interest in sports to learn from this section. Sports medicine is an American Medical Association-recognized subspecialty of emergency medicine, but not only does the section address the needs of those specialty-trained emergency physicians, but also the emergency medicine physician population in general. There is a tremendous amount of sports medicine in the regular practice of emergency medicine, including concussions, fractures and sprains, and performance-enhancing substances. Emergency physicians also see a lot of weekend warriors in the emergency department. So even if you’re not a huge sports person, many of the topics we discuss are relevant to daily emergency medicine practice.

Q: What are some of the primary topics of interest in your section right now?

A: Concussions, including how patients sustain them and how we manage them. Another really hot topic is the use of the long board for patients with suspected cervical and head trauma, and whether or not that’s something we should really be doing. We’ve also been discussing heat injury, such as teenagers becoming ill and even dying on the football field, as well as the effects of chronic exercise on the heart and cardiovascular system. We’re also working very hard to improve and incorporate more musculoskeletal ultrasound into emergency medicine.

Q: Tell us more about the musculoskeletal ultrasound if you would. What is its role in emergency medicine?

A: In Europe, ultrasound is the way that most emergency physicians diagnose rotator cuff tears and meniscal tears, whereas here, we rely on MRIs—which aren’t the easiest thing to accomplish during an emergency shift. That’s especially the case for something that’s not critical, like a shoulder injury. Most MRIs take at least 45 minutes. You can do a shoulder ultrasound in five minutes and get very viable images and a definitive diagnosis for your patient.

You can begin the treatment process earlier and as a result, patient satisfaction is much higher. That’s better than telling the patient they must follow through with an orthopedic surgeon to set up an MRI. Instead, you’re able to diagnose them, start their treatment plan, and improve both patient flow and outcome.

For more information and to join the ACEP Sports Medicine Section, visit:  https://www.acep.org/sportsmedicinesection/.

To learn more about the Sports Medicine Virtual Mentorship Program, visit: https://www.acep.org/sportsmedfellowship/.

An Interview with Robert Rosenbloom, MD, FACEP, Immediate Past Chair of the Democratic Group Practice Section
 
What is the easiest way to describe a democratic group practice? It’s equitable pay and scheduling with an opportunity to make decisions by offering equal voting to all members. It gives the group’s physicians a say in their self-determination and future.

While it’s not an easy style of practice from a manager’s standpoint, democratic group practices are associated with a high degree of physician commitment. “If you look at the big picture, emergency physicians who are most satisfied, comfortable and secure in their work are those who have voices within their organizations,” says Dr. Rosenbloom. 

The section includes both large and small democratic emergency medicine groups that oversee from one to nearly 100 emergency departments. “There is a clear focus on fairness and wholesomeness of the practice style within the section, and a significant amount of comfort among the members to work with and support each other—without worries of intergroup competition,” says Dr. Rosenbloom. 

The section is designed to educate emergency physicians on the various aspects of democratic group practice, including:
  • Obtaining and maintaining a contract
  • Understanding economic, hospital and health care policy
  • Furthering career opportunities
  • Maintaining career longevity and economic viability

Each of these issues is multifaceted with many important factors to consider, according to Dr. Rosenbloom. That’s why networking and sharing of ideas within the section is so critically important. The section provides members an internal list-serve to foster such communications.

When considering whether to join a democratic group practice, as well as the contract signing that goes along with it, emergency physicians should consider certain factors, including:

  • Is scheduling fair and equitable for all the physicians in the group (a backbone of democratic group practice)?
  • Are all practice members invited to governance meetings?
  • Are physicians compensated according to the business they bring into the practice?
  • Do all physicians work an equal percentage of night, weekend and holiday shifts? Does the practice pay a differential for such work?
  • Are the group’s financial documents open for review?
  • How are partnership decisions made? Will you have a vote? How long until you have a vote equal to the senior partners?
  • Does your potential contract provide a clear, delineated path to partnership? 

For residents, this ACEP section is an essential resource for finding a job in a supportive practice environment that’s comfortable and sustainable for the long haul. For physicians who are already part of a democratic group practice, networking opportunities abound in this section. 

“It’s a great place to improve upon the management you’ve already developed to support your democratic group practice style for the long run,” says Dr. Rosenbloom. “It’s also helpful to stay current with changes in the health care environment and how those changes will either threaten or support the democratic practice style.”

From a high-level perspective, a democratic group practice is often successful simply because its physicians look out for one another. “If I feel my peers have my back, it’s like any other situation in life,” says Dr. Rosenbloom. “I’m willing to stretch a lot more than I would if my peers weren’t looking out for me.”

For more information and to join the ACEP Democratic Group Practice Section, visit: https://www.acep.org/democraticsection/

 
An Interview with Nicholas Vasquez, MD, FACEP, Chair of the Emergency Medicine Practice Management and Health Policy Section
 
The ACEP Emergency Medicine Practice Management and Health Policy Section (EMPMHPS) provides a forum for members with a special interest in health policy and practice management issues to develop a knowledge base, share information, receive and give counsel, and serve as a resource to others interested in this area of emergency medicine. The EMPMHPS serves as a vehicle for creating and communicating ideas on how to provide high-quality, cost-effective care in a dynamic health care environment. To learn more, ACEP interviewed Dr. Nicholas Vasquez, who recently assumed the role of section chair.
 
Q: Can you give us a brief background on your section and why it exists?

A: The EMPMHPS focuses on the various issues that affect emergency department management. Because EDs are open 24/7 to all comers, anything that affects people’s access to care, understanding of health or their daily lives can impact ED management. It’s best to think of the ED as a crossroads for many things that exist in our society, and our section was established to foster discussion about those things we encounter in the ED that are not purely medical.  

Q: What kinds of topics does your section discuss on a regular basis?

A: We cover a wide range of topics including the sweeping epidemic of narcotic overdose deaths from prescription abuse; the heavy burden of boarding psychiatric patients in the ED; the lack of GME slots for emergency medicine residents which exacerbates the physician shortage; the effect on EDs in states that did or did not expand Medicaid and any other societal changes that impact the nation’s EDs. 

Q: Does your section engage in any particular learning activities?

A: While we do participate in several learning activities, they’re not your traditional CME, lectures or other typical educational material. We publish a section newsletter at least once annually to highlight specific important issues. We also hold an annual section meeting during Scientific Assembly that features either a panel discussion or a series of presenters focused on a specific issue.  

Q: What would you most want other ACEP members to know about your section?

A: I find it useful to think of our ED patients as a combined real-time, ongoing and continuous needs assessment for the community around us. Anything that affects that community and shows up in the ED is what our section handles. To put it another way, our section focuses on the community’s access to, quality of and cost of care. Changes in each of these will lead a patient to seek medical care from an ED when they perceive a need and don’t have the ability to obtain care elsewhere.  

Q: Why should ACEP members want to be part of your section?

A: To make a long story short, most members are already dealing with the issues our section covers but without the advantage of section membership behind them. Together we’re stronger—and the EMPMHPS is just one way we can team up.
 
For more information and to join the ACEP Emergency Medicine Practice Management and Health Policy Section, visit: https://www.acep.org/empracticemanagementsection/
 
An Interview with
R. Joe Ybarra, MD,
Chair of the ACEP Freestanding Emergency Centers Section
 

The ACEP Freestanding Emergency Centers Section is a newcomer to ACEP’s 33 sections of membership. But that doesn’t mean its members haven’t established a clear sense of direction for the future, including the types of issues they will frequently address. 

“This is a forum for interested members to discuss all freestanding emergency center issues, and that includes both independently licensed freestanding emergency centers and satellite hospital outpatient departments,” says Dr. Ybarra. The section, which recently had its first meeting, is focused on two all-encompassing topics. 

The first is clinical issues, including stabilization of ST segment elevation myocardial infarction (STEMI), stroke, acute abdominal catastrophe and trauma patients. “With these patients we must make dispositions, stabilize them very quickly and get them to the right place,” says Dr. Ybarra. “Because we’re not a hospital, it’s quite a challenge to expedite and maintain quality for these patients, and that’s one of the topics we’ll cover regularly.”

The second topic is how best to achieve the “IHI Triple Aim,” a framework developed by the Institute for Healthcare Improvement in 2007. It refers to the simultaneous pursuit of improving the patient experience of care, improving the health of populations and reducing the per capita cost of health care. 

“In short, the ‘IHI Triple Aim’ includes quality, cost and accessibility, and we’ll discuss how freestanding emergency centers influence that,” says Dr. Ybarra. “For example, a recent ACEP report card gave the nation a D for access to emergency care, and we believe that freestanding emergency centers will help improve that access.”

The section will also act as a unified national resource for legislatures, physicians and medical communities making important freestanding emergency center-related decisions—one of which is whether to allow the existence of licensed freestanding emergency centers like those that exist in Texas and a few other states. “We need to be the voice for ACEP in these instances,” says Dr. Ybarra. 

Research will also be a major pillar for the section. Dr. Ybarra envisions collaborating with ACEP’s Research Section, among other research entities. “We would also like to work with ACEP state chapters because some of them haven’t yet fully embraced freestanding emergency centers, and we would like to assist the states that don’t already have individual state committees of freestanding emergency centers in developing those.”

Another primary goal of the section is to ensure that everyone has an accurate understanding of what these centers are and are not. “There are a lot of misperceptions, and we want to accurately represent that we are part of emergency medicine and the emergency medicine community,” says Dr. Ybarra. “For those physicians who work in a freestanding emergency room, we would love to hear your voice and ideas. Let’s collaborate on issues that are important to emergency medicine—especially those issues that espouse the values of ACEP.”

For more information and to join the ACEP Freestanding Emergency Centers Section, visit: https://www.acep.org/freestandingcenters/.                     

An Interview with Darrell Carter, MD, FACEP, Chair of the Rural Emergency Medicine Section
 
Small towns often mean small hospitals. That translates to smaller emergency departments with fewer emergency physicians, specialists and staff members. It can also mean a lack of in-house diagnostic equipment. Together, these factors create a unique set of problems, according to Dr. Carter, that make it more difficult to provide high-quality emergency care in a rural or remote setting. Difficult perhaps... but not impossible.

In fact, the ACEP Rural Emergency Medicine Section was created precisely to address the challenges that rural emergency providers face. 

Examples of these challenges include:
  • Many rural emergency care providers aren’t residency trained in emergency medicine, and may lack specific skills necessary for airway management and trauma care
  • Those providers who work in low-volume emergency departments rarely experience certain types of emergencies, and therefore, may find it difficult to keep their knowledge and skill levels where they need to be
  • Rural emergency care environments may lack specialty care such as cardiologists and neurologists, as well as certain in-house diagnostic equipment
  • The teams that rural emergency physicians work with may not be emergency-trained
  • Though physician extenders, such as physician assistants and nurse practitioners, have been taking increased roles in some emergency departments, they may not have adequate training to handle all emergencies that present to a rural facility

“Our primary focus is to improve rural emergency care and, recognizing rural emergency departments’ limited resources and potential lack of trained personnel, work to improve their knowledge and skills base,” says Dr. Carter.

The section hopes to achieve that goal with its Rural Emergency Medical Education (REME) Program, a strategic plan that it presented to the ACEP Board for approval in June 2014. The plan’s mission is to improve the efficiency, effectiveness and reliability of rural emergency care. Accessible, learning-oriented, high-quality emergency medicine skills, knowledge and teamwork are crucial to that mission.

The REME Program is composed largely of nine action-oriented goals the section wants to achieve. Examples include:

  • Develop a Journal of Rural Emergency Medicine (JREM) designed to distribute information and improve emergency medical education
  • Increase the quality and distribution of the Comprehensive Advanced Life Support (CALS) Progam’s education and encourage CALS to be accepted as an Advanced Life Support Course  of choice for rural and remote hospital emergency providers (particularly critical access hospitals)
  • Encourage the development and utilization of telemedicine to augment emergency care
  • Help rural hospitals and providers obtain cost-effective emergency medical education
  • Create the Textbook of Rural Emergency Care

“Our activities have been focused on bringing the strategic plan to life, and now, we’re moving forward with action,” says Dr. Carter. As a result of the section’s proposal, incoming ACEP President Dr. Michael J. Gerardi has appointed a Rural EM Task Force to explore educational needs of rural providers and how they may be addressed.

The section welcomes any ACEP members who would like to work toward the cause of improving rural emergency medicine. “We have a lot of work to do, and it will take years to accomplish the tasks that we have on our plate,” says Dr. Carter. “But the important thing is that we’re really getting to the heart of improving rural emergency medicine through quality education.”

For more information and to join the ACEP Rural Emergency Medicine Section, visit: https://www.acep.org/ruralsection/.

 
An Interview with
Neal Sikka, MD, FACEP, Chair of the Emergency Telemedicine Section
 
Telehealth/telemedicine encompasses several different models of care, providing real-time clinical care via video technology to remote monitoring of diagnostic tests and images that can result in a decision to treat locally or transfer the patient to a hospital with more advanced capabilities.  

Now that improved access to high-speed technology and a greater cultural acceptance of online virtual care are revitalizing the field, Dr. Sikka and several colleagues felt the time was right to revitalize an ACEP telehealth section originally founded in 1998 and reconstituted in 2011. 

“There have been a lot of changes in health care over the last few years, including changing reimbursement models, decreasing technology costs and the Affordable Care Act—all of which have driven increased adoption of telemedicine services,” says Dr. Sikka. “This section provides a forum to share ideas and solutions for issues in the telemedicine space, as well as learn from each other’s experiences. Often times, one person figures out how to do something at their institution and can share that solution with section members so that we don’t all have to experience that same struggle.”

A variety of topics are regularly discussed among the group, including:
  • Operationalizing, staffing and implementing the best technologies for a telehealth service
  • Successfully creating reimbursement models 
  • Navigating the complex world of compliance, risk management and malpractice
  • The types of conditions that are appropriate for care via telemedicine technology
  • Patient confidentiality
  • Cross-state licensure and credentialing

Learning from each other is critical, particularly in such a rapidly evolving field. In his current practice, Dr. Sikka runs a maritime telehealth program focused on ships at sea. He’s also in the process of helping his multispecialty group launch a telemedicine service.

“The reimbursement models and consent procedures for these two service lines are very different, so I’ve been reaching out to section colleagues who have launched similar programs,” Dr. Sikka said. “Even though I have a lot of experience in one area, I need help with these compliance issues because they’re nothing like what I’ve worked with before. This section has been an excellent resource for me with this new program.”

The section’s “Telehealth in Emergency Medicine: A Primer,” is another great resource for members, offering great content such as modern applications in emergency medicine, mobile health and medical apps, security and risk, and challenges and opportunities. 

Designed to be a resource for both novices in the field as well as experienced telemedicine users, the section can benefit from everyone’s point of view—and their actions. 

“We want ACEP members to know that there are many emergency physicians either providing, creating or guiding telehealth services, so we’re very active players in this area with a lot of group knowledge,” says Dr. Sikka. “If we can share that knowledge, more members can take advantage of it and learn how to implement telehealth in their practices. Then we can lobby for coverage, payment and licensure policies that benefit the provision of emergency care services through telehealth—and that helps everyone.”

For more information and to join the ACEP Emergency Telemedicine Section, visit: https://www.acep.org/telemedicine/.

An Interview with
Sarah McCullough, MD, FACEP, Chair of the
Wellness Section
 

Emergency physicians generally choose their career paths because they have a passion for people, their overall health and their general well-being. But as any emergency physician knows, it’s a career that requires a lot of time and energy—both mentally and physically. 

In giving to others and ensuring a consistent level of quality care, it’s easy as an emergency physician to overlook your own care and wellness. But how can you be your best for your patients if you’re not taking good care of yourself?

Enter the ACEP Wellness Section, with a primary mission to help emergency physicians achieve balance so that they can enjoy their work and experience fulfillment in all aspects of their lives. The section educates members on important issues that impact physician well-being, such as burnout, compassion fatigue and resiliency. 

“This is somewhat of a unique section because it’s very much about the physician and for the physician,” says Dr. McCullough. 

Section members regularly discuss staying well in the challenging emergency department environment, preventing burnout and applying positive psychology, among other topics. The section also holds educational sessions at its annual meeting, and a regular newsletter keeps members up to date on the latest wellness-related news and ideas. The October newsletter was just released- view it here.  

The section has sponsored many opportunities at ACEP’s Scientific Assembly, including a quiet room for meditation and yoga, a Parents with Infants Lounge, and a space for Narcotics Anonymous and Alcoholics Anonymous to meet. The section also maintains online resources for its members covering multiple areas of physician wellness, from circadian rhythms and shift work to dealing with litigation stress. In addition to the information available to section members via the Wellness Section Microsite, there are many wellness-related resources available to all ACEP members on www.acep.org, including wellness text and lectures. Section newsletters are also available to the entire ACEP membership on the section website and via EM Today, ACEP’s daily e-newsletter. 

The Wellness Section used an ACEP section grant to support research with a study of emergency physician longevity and resiliency. “Instead of asking the usual question of why some emergency physicians burn out, we’re asking why some are resilient and still working when they’re 70?” says Dr. McCullough. 

“The main thing we want our colleagues to know is that we’re here for them, and we want them to come to us before they reach the point of burnout,” says Dr. McCullough. “Emergency physicians have one of the highest levels of burnout and emotional exhaustion so they need to be mindful of their wellness, and we provide so many resources to enable them to accomplish that. The ideas that they learn here are things they can take back to their hospitals and share with their colleagues—things that will make them happier with their jobs, enable them to work longer and provide improved patient care.”

For more information and to join the ACEP Wellness Section, visit: https://www.acep.org/wellnesssection/.                      

An Interview with
James F. Holmes, Jr., MD, MPH, FACEP,  Chair of the Emergency Medicine Research Section
 
As an emergency physician, you may be interested in research but have little idea of where to begin. Or perhaps you’re further along in your research but have reached a turning point where you need advice or some other kind of assistance.

Odds are you’ll find exactly what you need as a member of the ACEP Emergency Medicine Research Section, designed to provide a forum for communication and collaboration among researchers in emergency medicine and related fields to advance the specialty. The section expands connectivity between members and offers ways for those with research projects to elicit input and feedback from fellow members.

“We can assist our members by providing resources or insight on how to better conduct research, and we can put them in touch with individuals who have a like-minded interest in research,” says Dr. Holmes. “We’re really here to provide additional resources in whatever form they’re needed.”

The section issues a regular newsletter that keeps members informed of what’s happening in the world of emergency medicine research. “The person in charge of our newsletters, Wayne Bond Lau, MD, profiles successful researchers about their projects,” says Dr. Holmes. “He recently wrote an article on the new Office of Emergency Care Research (OECR) at the National Institutes of Health (NIH) and how that will help emergency physicians.”

The section also recognized the need for a short manual to assist and motivate trainees and novice investigators, and to offer a general introduction to emergency care research. The result is “Emergency Care Research–A Primer,” available in hard copy or as an e-book that addresses such topics as:

  • What constitutes emergency care research
  • Training in research
  • Grant-writing basics
  • The presentation of research results
  • Getting published
  • The top commandments of emergency care research
  • How to start a research career

Written by many successful emergency medicine researchers and edited by Vikhyat S. Bebarta, MD, FACEP, and Charles B. Cairns, MD, FACEP, the short book “helps emergency physicians get started and better understand the ins and outs of conducting research in emergency medicine,” says Dr. Holmes.

The section research topics are very much member-driven, according to Dr. Holmes. “It’s really about what the members are interested in and what’s important to them,” he says. “Whatever those topics are, we’re here to support them however we can.”

For more information and to join the ACEP Emergency Medicine Research Section, visit:  https://www.acep.org/emresearchsection/.

An Interview with
Shawn Varney, MD, FACEP, Chair of the Toxicology Section
 
“Let’s run a tox screen” are words that most emergency physicians likely say all too often, particularly with the prescription opioid misuse and abuse so rampant in the United States today. Those symptoms, including small pupils and slowed breathing, are signs that all emergency physicians are aware of.

As common as it is, opioid misuse and abuse is just one type of toxicology emergency. “Our overall objective is to improve the prevention and treatment of all forms of toxicological, or tox, emergencies,” says Dr. Varney, speaking of the ACEP Toxicology Section. “We’re here to be an information source and a network that can serve ACEP and its emergency physicians who deal with these emergencies day in and day out.”

While toxicology does include drugs, poisonings, and overdoses, it also includes environmental and occupational aspects that have become increasingly important in recent years. Lead exposure is one example. “Over the past five to 10 years, there have been more kids with elevated lead levels who then experience developmental delays as a result,” says Dr. Varney. “So many tox issues happen throughout the world and we just try to keep our physicians abreast of what’s going on.”

The section’s hottest topic remains prescription opioid misuse and abuse. “According to the Centers for Disease Control and Prevention, we prescribe enough opioids to medicate every American in the U.S. for a month (taking a pain pill every six hours),” says Dr. Varney. “Used correctly, opioids are safe, appropriate and help people live meaningful lives. But some think that if a little is good, a lot is better.”

In October 2013, the ACEP Toxicology Section collaborated with NIDA/CDC and SEI to sponsor the ACEP13 pre-conference event. “The Effective Approaches to Treating Substance Abuse Patients in the Emergency Department, a Knowledge Exchange.” It’s hard to know as an emergency physician when you’re being deceived,” says Dr. Varney. “Is this patient really in pain? Did he really lose his medication or is he drug-seeking? Those are the kinds of issues we discussed at the symposium.”

ACEP looked to its Toxicology Section when the government asked for ACEP’s input on a biological warfare agent. In addition, the Accreditation Council for Graduate Medical Education (ACGME) asked for ACEP’s input when it was revising its medical toxicology fellowship requirements. “ACEP then asked our section to review the requirements and provide our insight as physicians who had been there,” says Dr. Varney.

The section will soon launch its Antidote Guide – Mobile Medical Application, which features approximately 40 antidotes with succinct administration guidelines to assist emergency physicians with split-second decisions.

The section, which offers an award-winning newsletter, is wonderful for those with an interest in toxicology who are looking for networking opportunities and the dissemination of knowledge. “It’s a great thing for emergency medicine residents and fellows, in particular, to find ways to influence and shape where toxicology and emergency medicine are headed, and this section is a great way to start,” says Dr. Varney.

For more information and to join the ACEP Toxicology Section, visit: https://www.acep.org/toxicologysection/.

An Interview with
Michael Caudell, MD, FACEP, FAWM, 
Chair of the Wilderness Medicine Section
 

The term “wilderness medicine” brings to mind practicing emergency medicine on a victim high in a mountain range. But that’s just the tip of the iceberg.

Dr. Caudell recalls a panic-stricken neighbor asking him to examine his son’s possibly broken arm. The boy’s arm is indeed broken, and the hospital is a half hour away.

“I didn’t have the materials to splint or cast him here at my home, but I came up with an improvised splint using a magazine and duct tape until he could be properly treated at the hospital,” says Dr. Caudell.

Dr. Caudell also recalls a recent incident in which a colleague’s son crashed his mountain bike on a trail far from a hospital. The emergency physician found himself with an out-of-range cell phone when he tried to call for help.

“Help couldn’t come to him so he relied on his wilderness medicine skills,” says Dr. Caudell. “You don’t have to be hiking in the remote Himalayas or trapped on a desert island to practice the principles of wilderness medicine.”

The ACEP Wilderness Medicine Section is working hard to change that type of thinking, particularly within academic administrations that don’t view wilderness medicine as an appropriate subspecialty. “A student elective component for wilderness medicine is a goal for us, but we have run across some administrators who see us more or less as ‘the camping guys,’” says Dr. Caudell. “That perception is very far removed from what we do, and that’s what we’ve got to change.”

The section’s Education Committee developed an informative packet (pending publication) offering an in-depth explanation of wilderness medicine. “It’s a great resource for those who run into administrative or academic hiccups to show what’s being done elsewhere in the country. This will help establish more student electives if we can validate what we do to those who are unsure,” says Dr. Caudell.

The section also formed a wilderness medicine fellowship committee of fellowship directors who will ensure a standardized didactic curriculum. “We want each fellowship to retain its unique experiential component while also having an agreed-upon core body of knowledge that graduating fellows will have mastered,” says Dr. Caudell. The group is currently working toward an exit exam for didactic knowledge.

The section’s networking opportunities are especially valuable for a subspecialty still finding its footing in the field of emergency medicine. “When I began in wilderness medicine years ago, I didn’t know what was happening in the next town, much less across the country, within my own specialty,” says Dr. Caudell. “So this section presents great opportunities to pass along your ideas and information and receive the same through networking with colleagues worldwide. You’ve got to have some way to find out about that next international austere environment trip. This is a great way to do it!”

For more information and to join the ACEP Wilderness Medicine Section, visit:  https://www.acep.org/wildernesssection/.                              

An Interview with
Evie Marcolini, MD, FACEP, Chair of the Critical Care Medicine Section

Evie Marcolini was pursuing her desire to become an emergency physician when she developed an equally strong passion for critical care medicine during her residency. Then she realized that the two specialties aren’t mutually exclusive.

“Half of the patients in the intensive care unit start their hospital visit in the emergency department,” says Dr. Marcolini. “Critical care medicine is a natural extension of emergency medicine because of the emergency physician’s ability to understand the needs of each patient—which span many specialties, including neurology, cardiology and pulmonary medicine.”

The ACEP Critical Care Medicine Section has fought for the opportunity to pursue critical care medicine board certification. “For more than 40 years, emergency physicians have been trying to sit at the critical care table, pursue fellowships and apply for board certification,” says Dr. Marcolini. “In the past two years that has finally come to fruition with fellowship opportunities in medicine, surgery, anesthesia and neurocritical care. In the meantime, we’ve been caring for critically ill patients both in the emergency department and the ICU, and doing it quite well.”

The section includes members who are active in both emergency medicine and critical care. “This section is a great place for people to share information, collect data, mentor medical students and residents, and generally support each other in the realm of emergency medicine/critical care,” says Dr. Marcolini. 

That support is useful, particularly with the challenges these physicians face. For example, some emergency physicians graduating residency with critical care fellowships begin their job search—only to encounter resistance or hesitation because not everyone is used to the concurrent specialty model. “We have to show prospective employers why this model can and does work,” says Dr. Marcolini.

Other issues include reimbursement, the lack of salary averages data for a combined emergency medicine/critical care job, and the variable job structures. “These are just some of the issues that we discuss in section business meetings,” says Dr. Marcolini.

Dr. Marcolini emphasizes that you don’t have to be trained in critical care or work in an ICU to be a section member. “We realize that even if you’ve never done a critical care fellowship, for example, that you’re still caring for critically ill patients in the ED, and we want your input,” she says. The section has divided meetings into business and education, with talks and panel discussions on topics pertinent to any emergency physician taking care of critically ill patients.   
A Note About innovatED at ACEP14  
The ACEP Critical Care Medicine Section is putting on critical care case demonstrations at the innovatED exhibit during October’s Scientific Assembly in Chicago. “This will provide attendees an opportunity to see the latest gear for critically ill patients while providing audience participants an opportunity to see their colleagues in action,” says Dr. Marcolini. “We hope that people will stop by to have a look at the latest emergency department tools and equipment.” 
 
For more information and to join the ACEP Critical Care Medicine Section, visit: https://www.acep.org/criticalcaresection/
 
An Interview with
Joseph Sabato, Jr., MD, FACEP, Chair of the Disaster Medicine Section

The ACEP Disaster Medicine Section is a multi-faceted group whose members strive to better prepare themselves for all types of disasters. Mass casualty events such as the Boston Marathon, Japan’s nuclear events, the challenges of influenza and bioterrorism always top the list of discussion topics. 

But that’s only part of their purpose. “We want to serve as a resource for the ACEP membership as a whole to develop the skills to effectively participate in disasters, and that means providing them with the leadership tools they need to be on the front line in the emergency department for disasters large and small,” says Dr. Sabato. 

To further that end, one of Dr. Sabato’s goals as section chair is to further develop disaster research. “There’s really a shortage of disaster research, and the only way to learn about disasters and plan for the future is to have some way to quantify what occurs,” he says. “We’re working to develop a disaster research agenda and facilitate that through the experiences of our section members.”

The section is divided into four subcommittees:
  • Research
  • Practice and Leadership
  • Education and Training
  • Innovation and Technology

One of the Education and Training Subcommittee’s objectives is to develop mentoring-type situations with the fathers of disaster medicine to allow newer section members to obtain guidance on specific situations and learn from the experts. 

The Innovation and Technology Subcommittee is focused on providing improved disaster medicine tools to assist all ACEP members, even those who aren’t ordinarily exposed to live disasters. 

A section listserv and newsletter provide regular avenues for section members to exchange information. And when a disaster does occur, such as the nuclear issues in Japan, involved section members share their experiences with their peers. “These are things that most emergency physicians will never experience, and our section members who were involved were able to provide some incredibly useful information to our section as a result of their work,” says Dr. Sabato. 

The exchange of new and useful ideas is crucial for the future of disaster medicine, and for the ACEP section itself, according to Dr. Sabato. “During my time as chair, I want this to be a very inclusive group—in that we want to encourage new members, new blood and new ideas,” he says. “Those things are necessary in order to move forward because if we stay in the same place that just means we’re going backwards. 

“We have an enthusiastic combination of experienced and young disaster medicine leaders and our goal is to help every ACEP member be both a leader and a practitioner in disaster response,” Dr. Sabato continues. “If ACEP members don’t have these skills, who would?”

A Note About innovatED at ACEP14  
The ACEP Disaster Medicine Section has planned live disaster medicine simulations at the innovatED exhibit during October’s Scientific Assembly in Chicago. “One of these is a blast situation, which emergency physicians don’t face that frequently,” says Dr. Sabato. “We want to expose attendees to those types of things so that they can get the experience without having to go through the actual event.”

For more information and to join the ACEP Disaster Medicine Section, visit: https://www.acep.org/disastermedicinesection/

 
An Interview with
Jay Baruch, MD, 
Chair of the Medical Humanities Section
 

The term “medical humanities” brings to mind different things for different people. It’s not an easily defined term, even for the chair of the ACEP Medical Humanities Section. But Dr. Baruch feels the importance of the creative writing that he does outside the emergency department every time he’s on shift.

“I believe the medical humanities are elemental to the act of caring for patients,” he says. “To fully respond to the sick and injured, we must not only attend to disease and physical damage, but also appreciate the impact and meanings of illness and impairment.”

This approach is particularly important today, when communities face increasingly complex health challenges further compounded by greater social, financial and psychological burdens. “Science and technology provide us with the means to diagnose and treat the sick and injured, but they don’t address the larger human questions that arise when patients face suffering and death—nor do they prepare us to examine our own values, frailties, and capacity for compassion and tolerance,” says Dr. Baruch. “The medical humanities provide tools for fostering critical thinking skills, encourage respect for differing opinions, and nurture passion and curiosity.”

Medical humanities include skills from writing and music to photography and stand-up comedy—and the ACEP Medical Humanities Section has them all. Section members regularly demonstrate their talents at the “Open Mic Night” event, held annually at Scientific Assembly. “Their talents are a core part of these physicians’ identities,” says Dr. Baruch. “And this event is a great community-building experience.”

The section’s newsletter, which includes essays, poems and photography submitted by members, also allows them to explore and better understand their roles as emergency physicians. “The very nature of emergency medicine doesn’t allow time for processing what an incredibly complex process this truly is,” says Dr. Baruch. “It’s not just science—you’re treating people, and it’s a profound, intense experience. Having a creative outlet allows us to absorb what we do without becoming so desensitized that we burn out.”

The section also recently started its own public Facebook page, https://www.facebook.com/ACEPMedicalHumanitiesSection?ref=hl, to allow members to share their works, thoughts, publication release dates and upcoming performance dates. Annual writing and visual arts awards are also part of the section’s recognition process for a job well done. 

Dr. Baruch understands that not everyone believes as strongly in the necessity of medical humanities as he and his fellow section members. In fact, he considers it his biggest challenge as section chair.

“Our ties to the clinical side of emergency medicine practice aren’t as strong, and some feel, not as essential,” he says. “I see that as a major part of our role moving forward—demonstrating just how vital the medical humanities are to our work as emergency physicians.  I hope to cultivate a space where individuals can develop their own personal relationship to the term ‘medical humanities’ and figure out exactly what it means to them and their practice.”
 
For more information and to join the ACEP Medical Humanities Section, visit: https://www.acep.org/humanities/
 
 
 
An Interview with
Kevin Baumlin, MD, 
Chair of the Emergency Medicine Informatics Section

The Merriam-Webster Dictionary defines “informatics” as the collection, classification, storage, retrieval and dissemination of recorded knowledge. 

You probably became an emergency physician because you wanted to heal people; little did you know you’d have to become an information technology expert just to keep up!

Well, maybe not quite. But a certain amount of computer knowledge is necessary to properly document each patient’s experience and keep them as safe as possible. “We’re advocating for and are here to help all members better use technology, computers and systems, and we work very hard with the industry in order to make things better for physicians,” says Dr. Baumlin. “We’re also very focused on how we can improve the exchange of information so that we have the right information where and when we need it to best care for patients.”

The ACEP EM Informatics Section stays busy on a variety of topics, including:
  • Electronic health records/meaningful use
  • Health information exchange
  • Vendor community collaboration to secure improvements to vendor products
  • Plans to interact with governmental agencies to comment on draft policies
  • How to acquire and use data in the development of metrics  
  • Focusing on clinician user-centered design of health IT systems to ensure patient safety and reduce health IT-related medical errors and safety events

In addition to featuring a lecture series annually at Scientific Assembly, the section is collaborating to write a textbook/e-book to assist both emergency department directors and frontline emergency physicians. It will cover a wide range of emergency medicine informatics topics, such as:

  • How to implement/improve electronic health record
  • How to integrate clinical decision support
  • How to create safety committees to ensure that the tools in use are safe
  • Ensuring that a reliable mechanism is in place to report problems
  • Discovering health information exchange and what that really means
  • Data standards, including how data is captured/exchanged between different systems 

“This section is all about trying to ensure that we can work together as clinical colleagues with our information technology peers in order to better serve our patients,” says Dr. Baumlin. “It’s critical that we’re able to do that, because all practicing emergency physicians are or will be using electronic tools to obtain and share information and to perform their documentation. If you want to be part of making that better, then definitely join our section. We’d love to have you.”

For more information and to join the ACEP EM Informatics Section, visit: https://www.acep.org/informaticssection/

An Interview with
Ralph Riviello, MD, MS, FACEP, Chair of the Forensic Medicine Section

When members of the ACEP Forensic Medicine Section get together or meet via conference call, their topics can range from child abuse and sexual assault to motor vehicle collisions and gunshot wounds. They’re dire topics for sure, but they’re also an emergency physician’s daily reality. 

“We’re often the first physicians to see the victims of these crimes or events so we have the primary responsibility for the ABCs and recognizing and treating life-threatening injuries,” says Dr. Riviello. “But our other role is to consider the forensic importance of what the injuries look like and using proper terminology and documentation for those injuries. It’s also important not to lose important forensic evidence.

“A case may go to court and we don’t want mistakes and misinterpretations made by physicians to cause a case to be lost or not be prosecuted at all,” he continues. “What we do can also help victims get closure through the criminal justice system.”

Enter the ACEP Forensic Medicine Section, developed so that colleagues interested in forensic medicine can connect with other professionals and national professional forensic organizations for research, best practices and collaboration. In addition to the topics mentioned above, the section also frequently discusses testifying and expert witness work. 

The section has several exciting educational activities in the works. It’s currently developing an online, webinar-based forensic curriculum for all ACEP members. This 5-credit course, funded by a section grant, covers the gamut of emergency room forensic topics, including:
  • Intimate partner violence and elder abuse
  • Child physical abuse
  • Documentation, forensic photography and court testimony
  • Adult and pediatric sexual assault/evidence collection and preservation
  • Ballistics/pattern injuries/forensic aspects of trauma and motor vehicle collisions 

Through an ACEP section grant, the group also updated ACEP’s handbook “Management of the Sexually Assaulted, Sexually Abused Patient,” currently available on ACEP’s website at https://www.acep.org/sexualassaultebook.

Section members consistently share new thoughts and ideas when they meet annually at Scientific Assembly, through the Forensic Section listserv and via conference calls. A section newsletter also distributes valuable training tools and resources to keep members abreast of the latest industry standards and trends—and Dr. Riviello says that his section peers are ready and willing to share that knowledge with fellow ACEP members whenever it’s needed.

“There’s a great deal of talent and expertise on forensic emergency medicine within the group, and ACEP members should feel free to use us for advice and help of any kind,” he says. “And we’re always seeking new members with the same interests. There’s great professional development potential and a sense of camaraderie with peers who share many of the same views and values.”

Most importantly, Dr. Riviello reemphasizes the critical role that all emergency physicians play in forensics. “Almost every emergency physician cares for victims of violence in some way,” he says. “Considering the patient’s forensic needs while caring for them can make a huge difference to their life.”

For more information and to join the ACEP Forensic Medicine Section, visit: https://www.acep.org/forensicsection/

 
An Interview with
Chris Beach, MD, FACEP, Chair of the Quality Improvement & Patient Safety Section
 

Emergency physicians must hand off patients to their peers thousands of times in their careers. It’s a critical juncture in patient care, when the exchange of significant information between two physicians can significantly impact a patient’s future. And it’s lacked standardization — until now. 

“The Joint Commission, among other regulatory bodies, has been asking for standardized shift change handoff between emergency physicians for years,” says Dr. Beach. A 2010 white paper on the topic written by members of the ACEP Quality Improvement and Patient Safety (QIPS) Section led to Safer Sign Out, an initiative headed up by former QIPS Chair, Drew Fuller, MD, FACEP.

“Safer Sign Out means recording the essential items that you want the next physician to be aware of and what they need to follow up on,” says Dr. Beach. “The oncoming and off-going doctors also go to the bedside and make introductions to the patient and family and discuss the plan of care, and then coordinate the plan of care with the on-duty nurse. This is about putting theory into practice to create quality and safety for patients.”

The section also collaborates with the Emergency Medicine Practice Committee (EMPC) on one of the hottest topics in emergency medicine — the safe prescribing of opiates. Two QIPS members, one of whom is a toxicologist, are working with the EMPC to develop tools and handouts for emergency physicians on opiate prescribing and a better understanding of opiate use and abuse. QIPS also has an award-winning quarterly newsletter and an informative website that keep members up to speed on numerous topics.

QIPS enables emergency physicians interested in continuous quality improvement and patient safety to develop and share a knowledge base while also promoting efforts to improve patient care. “There are numerous educational opportunities and grant projects to choose from,” says Dr. Beach. “Less senior clinicians can also gain mentorship and develop quality and safety leadership skills.” 

The section’s work varies based on the current chair’s vision and goals, as well as the members’ goals and interests. Dr. Beach, for example, wanted to better collaborate with the United Kingdom College of Emergency Medicine on quality and safety work. 

“We’ve been exchanging emails and having conference calls on how to go about doing that,” says Dr. Beach. “The UK College of Emergency Medicine has shared their safety toolkit, which we’ve shared with our membership. They’ve also invited us to speak at their equivalent of ACEP’s Scientific Assembly in England in September, and we’ve extended the same invitation for them to speak at the QIPS meeting during ACEP’s Scientific Assembly in Chicago in October. It’s all about trying to build that relationship.” 

If you’re an emergency physician with a quality and/or safety idea and the drive to make it happen, then QIPS is for you, says Dr. Beach. “We can’t fix 50 things, but if you have the energy and desire to lead a project, we’re open to helping you do that,” he says. “This is a fun, energetic group that wants to contribute and bring to life the thoughts and ideas straight from emergency physicians in the pit. We want to improve care for patients — and your idea could help make that happen.”

For more information and to join the ACEP QIPS Section, visit: https://www.acep.org/qipssection/
 
An Interview with Christopher Raio, MD, FACEP, Chair of the Emergency Ultrasound Section

Look at the ACEP Emergency Ultrasound (EUS) Section, and you’ll find more than 1,200 members who believe that ultrasound is critical to the work they do on a daily basis — and they’re determined to spread that word to their physician colleagues and beyond. Ultrasound is used in the emergency department for a variety of reasons, including diagnosing life-threatening conditions, guiding invasive procedures and treating a number of emergent medical conditions. 

“Ultrasound improves success rates, reduces complications and makes procedures a lot safer for patients,” says Dr. Raio. “We can also use it to monitor the resuscitative process in critically ill patients. “

One of the largest sections of the College, the EUS Section primarily focuses on enabling all emergency physicians, regardless of their practice type or location, to use ultrasound technology in patient care. Topics regularly addressed include how to choose the right piece of ultrasound equipment for your particular environment, how to properly document your examinations in patients’ medical records and how to accurately bill to ensure reimbursement for the ultrasound work you perform. 

“The section is geared toward pushing the specialty forward and helping our members build successful emergency ultrasound programs,” says Dr. Raio. “Today’s hot topics include certification and subspecialty development through the Accreditation Council for Graduate Medical Education (ACGME) pathway; specifically, a group within our section is pushing to have clinical ultrasound recognized as a distinct subspecialty through the ACGME pathway.”

A wide range of important issues are addressed through the EUS Section’s sub-committees and special discussion groups, the latter of which are online forums that enable members to discuss and provide input on various topics. 

Sub-committees include:
  • Accreditation
  • Management Course 
  • Media/Government Relations
  • Reimbursement
  • Imaging Information Technology
  • Emergency Medical Services (EMS)
Special discussion groups include:
  • Community Practice
  • Critical Care
  • Industry Communications
  • Ultrasound in Global Health
  • Medical Student Education
  • Military/Tactical Ultrasound
  • Pediatric
  • Residency Education
  • Safety
  • Subspecialty Development
  • Webpage
Learning activities are a priority for the section, including “Sonoguide,” an effort led by Beatrice Hoffman, MD, PhD, RDMS as an online education, training and review tool that’s used by clinicians worldwide. With the help of section grants, Michael Stone, MD, RDMS, FACEP and Robert Blankenship, MD, FACEP developed an online emergency ultrasound examination used by trainees to address emergency ultrasound competency. 

The section also offers a yearly ultrasound management course (led by Troy Foster, MD, FACEP, RDMS and Vivek Tayal, MD, FACEP) at Scientific Assembly. “It addresses issues related to ultrasound program development and is very well-attended,” says Dr. Raio. “It always receives rave reviews.”

The EUS Section has so much to offer potential members, according to Dr. Raio. “There are more than 1,200 members, so at the very least, it’s an unbelievable networking opportunity,” he says. “There’s a tremendous amount of knowledge and expertise among the membership and a real sense of teamwork. When needs or issues arise that affect the section, it’s impressive to see our members come together and mobilize to address them.”

For more information and to join the ACEP Emergency Ultrasound Section, visit: https://www.acep.org/ultrasound/
 An Interview with
 Chris Carpenter, MD, FACEP, Chair of the Geriatric Emergency Medicine Section

Treating geriatric patients is probably already a part of your everyday emergency practice. We realize that treating the elderly can present significant challenges.  And you may think you know all you need to know about treating them.  However we can always learn more and it’s our obligation as emergency physicians to continually improve the care we deliver. 

“The body of research and literature on caring for the elderly in the emergency department is rapidly increasing,” says Dr. Carpenter. Geriatric patients many times spend longer in the emergency department, have more testing done and consume more resources — yet some may leave feeling dissatisfied with the care they received if we do not take the time to fully explain the reason for the testing and understand some of the psycho-social issues these patients are dealing with.

The ED geriatric population is the “canary in the coal mine,” one of the most vulnerable subset of our population”, according to Dr. Carpenter. Any deficiencies in our current emergency medicine network are going to first manifest themselves as problems with caring for older adults, and if we can improve that care and reduce those deficiencies, that will flow downstream to all patient populations.

Geriatric patients may have an impact on patient flow. If we can more effectively care for geriatric patients and move them through the emergency department efficiently, it will not only improve the elderly patients’ experience but will benefit all of our patients via more reliable and faster access to emergency care.

The section has some exciting educational initiatives and activities underway that include:
 
  • "Geriatric Emergency Department Guidelines" — ACEP led the effort by convening a task force and inviting the Society for Academic Emergency Medicine, the American Geriatrics Society and the Emergency Nurses Association to participate. The 50-page document describes the attributes of an ideal geriatric-friendly emergency department, including staffing, training and quality indicators. The document has been widely disseminated and will be published in multiple industry publications, including the Annals of Emergency Medicine and Academic Emergency Medicine. It will also be presented at various conferences. 
  • Currently a work group of GEMS members that have expertise in leading/managing a Geriatric ED and the nurse manager of that Geriatric ED are working on prioritizing the various recommendations and elements. This work will help those wishing to implement the guidelines distinguish between critical and ‘nice to have’ elements.
  • Funding from the Hartford Foundation for Geriatric Emergency Department Boot Camps This grant will fund teams of two to three of the 14 authors of the “Geriatric Emergency Department Guidelines” to visit requesting facilities and help staff members operationalize the guidelines.
  • Establishing a geriatric emergency medicine research network — The recommended guidelines need further evaluation to assess whether they actually improve outcomes. One hospital’s research is not definitive or confidently extrapolated, thus the need to build a research network that communicates findings regularly.
  • Learning from the Academy of Geriatric Emergency Medicine (AGEM) Journal Club — A joint effort between the ACEP Geriatric EM Section and the Society for Academic Emergency Medicine (SAEM), the AGEM Journal Club is a high-quality, journal-worthy product. Each month, section members receive two to three articles rated highly enough by their section peers to alter the current standard of care for geriatric patients in the emergency department. The synopses prove useful to members in their daily clinical care, continuing medical education and communication with patients. 
    
While there is still much to learn when it comes to geriatric quality improvement, the Geriatric EM Section has many of the answers and is working hard to find the rest, says Dr. Carpenter. “The baby boomers are coming,” he says. “And we need to be ready.”

For more information and to join the ACEP Geriatric Emergency Medicine Section, visit https://www.acep.org/geriatricsection/
An Interview With
Mark Rosenberg, DO, MBA, FACEP, Chair of the Palliative Medicine Section
 

In the U.S., 70 percent of people die in unfamiliar surroundings, despite the fact that virtually 100 percent of people say they want to die at home or in familiar surroundings, according to Dr. Rosenberg. “About 90 percent of the dying come in through the emergency department, making it the front door for managing dying patients,” he says. “So those who work in the emergency department need to become familiar with the management of the dying patient, as well as those with serious and/or life-limiting illness.”

ACEP’s Palliative Medicine Section develops protocols, algorithms, toolboxes, strategies and a website for emergency physicians to help them better manage this challenging patient population. And the section is making significant progress, thanks in large part to the ACEP Board of Directors. 

“Because of their support, there has been a significant push to improve palliative medicine education to the membership, particularly with the Choosing Wisely® campaign, which has more timely referrals to palliative medicine and hospice as one of the key initiatives,” says Dr. Rosenberg. 

ACEP’s Educational Products Department is also working with the section to design a six-hour course for all emergency physicians, with an additional two-hour course for those who lead or would like to lead emergency medicine palliative care programs. The course’s overall goal is to teach emergency physicians in all practice settings how to handle the difficult issues in providing palliative care in the emergency department with compassion and confidence. All modules will be hosted on ACEP eCME. 

Issues to be covered include:
  • Goals of care
  • Time management
  • Pain management
  • Hospice and nursing home care
  • Family-witnessed resuscitation
  • Breaking bad news
  • Withdrawing and withholding care
  • High-yield medical management
  • Last hours of life
  • Protocols and other resources
Learning from such valuable resources is wonderful, but so is learning from each other. “This section, more than any other section I’ve been in, really has a sense of family and a sense of trailblazing together,” says Dr. Rosenberg. “We share stories of how we’re breaking ground at our hospitals, and there’s so much camaraderie. And it’s all-inclusive to anyone who wants to be a part of it.”

There is a positive energy within the group that members can feel — and one that encourages action. “This is an amazing group of people who are all excited about doing something that ACEP has never done before,” adds Dr. Rosenberg, “and that is to develop a section and a specialty that didn’t previously exist and one that will apply to almost everyone someday.”

For more information and to join the ACEP Palliative Medicine Section, please visit: https://www.acep.org/palliativesection/.
An Interview with Dr. Kathleen Clem, Chair 

First and foremost, let’s clarify a possible misconception about the ACEP American Association of Women Emergency Physicians (AAWEP): it’s not just for women! "It’s important for people to know that AAWEP is not anti-men in any way, shape or form," says Dr. Clem. If you’re a man whose motive is to help with the recruitment, retention and advancement of women in emergency medicine, then AAWEP is the place for you." 
 
AAWEP works hard to find solutions to the challenges women in emergency medicine face every day. "If we don’t address the issues related to women in medicine, we aren’t going to have all of the talent that we need at the table for emergency medicine to continue to grow and thrive," she says. "Both men and women who want to see the specialty of emergency medicine continue to grow understand the importance of doing whatever it takes to keep the female members of emergency medicine healthy and involved. That’s what we’re working toward as a group".
 
An emergency medicine career is challenging - particularly when your societal role as a woman often conflicts with your career goals and passions. There is no answer that’s right for everyone, because everyone’s specific issues are different.
 
"But what does help is to be able to put your issue(s) in front of a group and have someone else jump in and say, ’I faced a similar issue and here’s how I solved it,’" says Dr. Clem. The section talks about ways to further integrate your partner or spouse into daily routines, as well as the difficulties of being part of the "sandwich generation," helping to care for both children and aging adults. "It’s all about how we live, breathe and thrive in today’s society," says Dr. Clem.
 
In addition, the group discusses ways to promote the professional advancement and leadership skills of female emergency physicians, and members can request specific guidance on negotiation skills to secure their career progression in the context of societal role expectations at home. AAWEP also offers mentoring opportunities and mutual support for female emergency physicians.
 
Section members meet regularly for interaction and networking. Other activities include:
  • Publishing an interesting, educational and informative newsletter for AAWEP members every three months
  • Featuring top speakers on subjects of importance at both AAWEP meetings and ACEP national meetings
  • Presenting educational programs/workshops of particular importance to female emergency physicians on topics such as negotiation, navigating a career in emergency medicine and leadership skills
  • Developing best practice recommendations for the recruitment, hiring, retention and promotion of female emergency physicians
"While women have advanced in their careers without the networking, guidance and education that AAWEP provides, it’s much more difficult to go it alone," says Dr. Clem. "This section provides camaraderie and a whole host of resources to help you advance in your career. It’s also a year-round resource, and the section is large enough that you can count on someone within AAWEP to be able to respond to your unique challenge with some sound advice - right when you need it!"
 
For more information and to join the ACEP American Association of Women Emergency Physicians, visit https://www.acep.org/aawep.
 An Interview with Dr. Sean Fox, Chair  

Many emergency departments don’t have pediatric emergency physicians, and some hospitals don’t yet have dedicated pediatric emergency departments, according to Dr. Fox. But you don’t have to specialize in pediatric emergency medicine to treat children - or to want to ensure that all kids receive the best emergency care possible.

That’s the cause that unites the ACEP Pediatric Emergency Medicine (PEM) Section. "Our goal is to ensure that as emergency physicians, we’re equipped with the tools to care for kids as well as we possibly can," says Dr. Fox. "We want to allow emergency physicians, pediatric emergency physicians and pediatricians to work together to improve the care of children."

The section has five subcommittees that focus on specific objectives and provide regular updates at section meetings. The subcommittees include Research, Technology and Innovation, Disaster Preparedness, Emergency Medical Services for Children, and Education and Training.

The PEM Section produces an ACEP award-winning educational newsletter, and is also in the process of producing educational materials targeted toward families. "Our goal is for families to know what to expect when they go home from the hospital so that they already have the answers to the normal questions they might ask," says Dr. Fox.

The section recently started a new medical image competition entitled "EMages," which includes medical cases photographically represented with case vignettes. In addition, several grants have allowed the section to focus on research and educational endeavors suggested by members.

Some of these projects allow the PEM Section to collaborate with other ACEP sections, including the Emergency Ultrasound, Trauma and Injury Prevention, and International Emergency Medicine sections.

"From an emergency medicine perspective, these areas cross over so it’s helpful if we try not to duplicate work," says Dr. Fox. "And if we can get the other person’s perspective, we’ll get a more complete product on the other end of things."

Along the same lines, the section recently took a giant leap toward one of its original goals: enhancing the relationship between ACEP and the American Academy of Pediatrics (AAP). In a landmark agreement between ACEP and AAP, members of ACEP’s PEM Section can become affiliate members of AAP’s Section on Emergency Medicine (SOEM) at no cost - if certain qualifications are met.

You qualify for AAP SOEM affiliate membership if:
  • You ARE a member of ACEP
  • You ARE a member of ACEP’s PEM Section
  • You ARE NOT board-certified in pediatrics
  • You ARE NOT eligible for National AAP membership
A reciprocal arrangement is available to members of the AAP’s SOEM, giving qualified AAP members free subscribership membership in ACEP’s PEM Section.

The PEM Section will continue helping clinicians of all backgrounds maintain their comfort level while caring for kids by producing materials to make their jobs easier. "A lot of the products and projects we work on aren’t necessarily focused just on the pediatric-trained emergency physician," says Dr. Fox. "We try to be all-inclusive for everyone, so if you work in a small emergency department or a big one, or a middle-of-nowhere emergency department or one in the big city, our section can be beneficial to you."

For more information and to join the ACEP Pediatric Emergency Medicine Section, visit https://www.acep.org/pediatricsection.
An Interview With
Dr. Megan Ranney, Chair
 

Injuries represent 30 percent of emergency department visits nationwide, and that’s exactly why the ACEP Trauma and Injury Prevention Section (TIPS) was created. TIPS exists in parallel to ACEP’s Public Health and Injury Prevention Committee.

Injuries and trauma are expensive to both the health care system and to individual patients, and TIPS members are determined to make a difference.

History shows that injuries are unevenly distributed among the population. For example, people who were previously injured, don’t wear seat belts or drive while intoxicated have higher rates of future injury.

"Growing research and clinical evidence helps explain how emergency departments can help prevent future injuries and their after-effects," says Dr. Ranney. "But realistically, it’s difficult to implement emergency physician-led screening and intervention in busy emergency departments."

Enter TIPS, whose goal is to represent ACEP members’ interests with clinical and research expertise and trauma and injury prevention, and to create, study, and disseminate usable emergency medicine-based injury prevention strategies. To accomplish this, TIPS collaborates with a number of national groups and agencies, including the Centers for Disease Control and Prevention, the National Institutes of Health, and the Eastern Association for the Surgery of Trauma.

Previous section activities have focused on topics ranging from workplace violence, drunk driving, alcohol intervention in the emergency department, concussions and emergency department responses to mass shootings. This year’s topics are firearm injury prevention and prevention of opioid overdose. To address these, TIPS has three subcommittees:
  • "Guidelines" - Works with other organizations to develop emergency physician-appropriate trauma and injury prevention guidelines
  • "Firearm injury prevention" - Focuses on the ways that emergency physicians, as the first and only medical professionals to treat suicidal and violently injured patients, can help prevent future firearm injuries
  • "Education" - Develops educational programs, including Webinars and Scientific Assembly lectures
TIPS is hard at work this year to further its goals with regular learning activities including Webinars, publishing a regular section newsletter, and preparing to host educational activities at its Scientific Assembly section meetings. The section is also submitting two full applications for section grants for future activities.

"Our goal is to reduce injury-related emergency department visits in a way that is feasible for the average emergency physician," says Dr. Ranney. "As a section, we engage in high-level discussions with national agencies and organizations, as well as on-the-ground-discussions among clinicians, to make this feasible. Our annual focus is largely member-driven, so if you have a particular issue that you’re passionate about, please join us and work with us!"

For more information and to join the Trauma and Injury Prevention Section, visit https://www.acep.org/traumasection.
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