President's MessageOctober 2024
The last place I thought I’d find myself holding back tears during a presentation was in the Boston Convention Center surrounded largely by people I didn’t know, and a handful I had just met. It was October 2015, and I had recently begun my year as a TCEP leadership and advocacy fellow (TLAF) and was attending my first ACEP Council meeting. Knowing next-to-nothing about what would unfold in the jam-packed 2-day business meeting, I was completely taken off guard when the room of nearly four hundred people united in silence and stillness as the “In Memoriam” presentation began. Names and faces of physicians who had served their patients, colleagues, and our specialty who had died in the past year since the Council had last convened were shown in succession, followed by the reading and presentation of framed resolutions to their families and state chapters. I must pause here to say that I am unable to adequately describe the emotions that come with such a presentation and urge you to read the resolutions submitted for our own Texas Councilor Dr. Juan Fitz who died from COVID November 3, 2020, and most recently for TCEP member Dr. Veronica Greer who passed May 26, 2024. Reflecting on why I have continued to attend ACEP Council every year since, I realized that this brief presentation, while so emotionally challenging, encapsulates the essence of our Council. It’s the palpable sense of community, respect, and support for one another underlying a common cause that I find so rare. We get glimpses of it with our individual hospital ED teams, but the power of 400+ emergency physicians coming together for two days with the common goal of improving our ability to care for the patients we serve is unique. Year after year I am continually impressed at Council by the diversity of experience, the vast knowledge and the expertise united in one room, volunteering for emergency physicians, our patients, and our specialty. Disagreements and arguments abound during the two days of debating resolutions and selecting ACEP’s leadership, but the underlying respect for one another and common desire to lean-in and be part of the solution rather than accept circumstances placed upon us is paramount – it is also quite contagious. Current TLAF Stephanie Onyechi, MD, related to me after attending her first Council this year, “Sitting in the room where it all happens is an ‘unveiling’ which lets me be part of the solution process and not just a bystander. As residents we sometimes just accept certain policies and situations during our training, but now I can truly understand more of the processes and the reasons behind them.” This year I was impressed with how the knowledge and experience of some councilors was applied to the boarding crisis. We have known for years that ED boarding is a problem that affects the ED, but is not solely caused by the ED. So many external factors contribute to the current crisis that finding our agency and refusing to accept boarding has been difficult. ACEP’s ongoing advocacy on boarding led to a federal summit in October to investigate solutions, and this year another innovative solution was passed at Council. The resolution’s authors dug into the minutia of policy and procedures and presented a creative mechanism to help combat ED boarding. The resolution instructs ACEP to send a proposal to the Joint Commission to account for hospital overcrowding when assessing patient safety incidents in the hospital. Believe it or not, this is not actually current practice. When I hear “The Joint Commission is coming today” I think of ED staff cleaning up frantically, being told to discard half-full bottles of lidocaine, and generally preparing for a hostile “invasion” of the ED. These councilors, however, by not acquiescing to a system that erects barriers to us safely caring for our patients, saw the Joint Commission and their influence as a potential means to address a crisis. Early on I learned that Council is about even more than passing resolutions and electing officers. It’s about relationships, inspiration and recharging. For me, it’s about becoming a better emergency physician. A suggestion was made to me early on in my Council career to sit next to someone I didn’t know at meals rather than staying in a “safe zone” with acquaintances. With so many accomplished people around, I might just find a great new connection and broaden my horizons. Sure enough, this year I sat next to the alternate councilor for the Undersea & Hyperbaric Medicine Section who was a self-proclaimed “dive-bum” in a previous life, doing everything he could to spend time scuba diving. This, of course, led him to his current position as a flight surgeon now working with astronauts at NASA. Whoa, didn’t see that one coming. With these opportunities lurking around seemingly every corner at Council, it is almost impossible not to be inspired. The diversity of people that I have met over the past decade has changed my perspective on our specialty, as well as my understanding of the power we all possess to affect change. One year you meet someone at lunch or in a committee meeting, and then years later see that they are a state health official in charge of an entire state’s pandemic response (actually, two such members!). Heads of top academic programs, acclaimed EM podcast producers, former state representatives, former presidents of the Texas Medical Association and the American Medical Association, the list goes on. In this environment it can be difficult not to suffer from imposter syndrome. But strangely, what I’ve found is that the more experienced and accomplished a person is at Council, the more they are interested in what I am doing, and how they can help me succeed. I get the feeling that a sense of mentorship is not actually strange, but rather an essential part of being an emergency physician when I’m at Council. It becomes clear, when a past president of ACEP who has committed decades of their life to serving our members comes up to you, a new councilor, and asks how things are going and how they can help, that mentoring and a sense of service isn’t an anomaly but rather second nature to those who continue to show up year after year. It's hard to overstate how refreshing and motivating an environment is where people want to see others do great things and succeed without regard for their own standing. Maybe that’s just a function of being an ER doc who gravitated to a specialty that requires selflessness, humility and collaboration to achieve the common goal of treating patients in the ED. Maybe this trait is within all of us in EM, but I’ve found that ACEP Council brings out this quality and displays it in such a warm and endearing way. Through Council, I have truly learned first-hand how helping another’s achieve success in their life and career is far more rewarding than achieving it oneself. Increasingly, we as emergency physicians feel undervalued, commoditized, and forced to provide more care to more patients with ever-shrinking resources. This is a very stressful place, where it feels that things are just being done to us and we have no agency to speak up and push back with solutions. At ACEP Council, and similarly at ACEP’s annual Leadership and Advocacy Conference, the collaboration and feeling of oneness of purpose and agency is palpable. Yes, we come from different backgrounds, geographically, politically and culturally, but those in the room at Council voluntarily travel across the country year after year to be together and effect change while fostering a sense of respect and mentorship. I gravitated to EM for the diversity of practice and well-rounded knowledge base needed to be a strong emergency physician. Through my training and bedside experience, I have found that our calling as advocates for our patients underpins all we do. ACEP Council has helped me reach even further with advocacy to help our doctors, our patients and our specialty in a supportive, energizing and soul-restoring environment. Already looking forward to seeing everyone next year in Salt Lake City! Best Regards, Doug |
