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Emergency physician advocacy —An ACEP responsibility
with stratified systems of coronary care, with legal sanct i o n s - a l l were embodied in the document which evolved. The proceedings of the conference are to be published this October, 5 fittingly around the time of Halloween. They should do much to shed light on matters too long cloaked in darkness. The counsel of witches and wizards may be necessary to those who believe in such things. But the renaissance in resuscitation is offering creditable answers to our questions without them.
The Editor References 1. Refinementsin criteria for the determination of death: an appraisal, Task Force on Death and Dying of the Institute of Society, Ethics and the Life Sciences. JAMA 2:21, 46-53, 1972. 2. Vital Statistics of the United States, U.S. Department of Health, Education, and Welfare, Vol. II, Part B, Table 7-116, 1966. 3. McNeilly RH, Pemberton J: Duration of last attack in 998 fatal cases of coronary artery disease and its relation to possible cardiac resuscitation. Br Med J 3:139-42, 1968. 4. A!yarez H II1, Wills RE, Cobb LA: Sudden cardiac death: physiOlogic observations and therapeutic implication. Am J Cardiol 31:116, 1973. 5. Proceedingsof the national conference on cardiopulmonary resuscitation and emergency cardiac care, May 16-18, 1973, Washington, D.C. Co-sponsored by American Heart Association and National Academy of Sciences-National Research Council. In press.
Emergency Physician Advocacy --An ACEP Responsibility
The
priorities, functions, accomplishments and programs of the American College of Emergency Physicians are multifold. The most visible aspects of ACEP activity have been the educational programs, the stimulation of effective emergency medical service legislation, the functioning residency programs, and the advances toward specialty recognition and board certification. However, emergency physicians generally find themselves confronting more mundane matters, practical day-to-day problems, concerns seemingly far removed from these lofty College pursuits. A moment's consideration should bring many of these situations to mind. One of them may be contract negotiation difficulties, another fee schedule disputes with the medical staff or the administrator. It may be arduous to achieve departmental status, to obtain executive committee voting privileges, to bring emergency physician representation and authority into line with increasing responsibility. Perhaps there are backup problems with the medical staff. Or maybe, professional referral procedures are based on politics rather than the needs of the patients.
Page 344
The list of problems seems endless. The administrator or the director of nurses, with no direct knowledge, ex. perience, or understanding of the complexities of the emergency department operation, may suddenly decide that the department is over-staffed. There may be the burden of the recurring theme that any nurse is an "emergency nurse." The attitude that "a body" will suffice may frustrate attempts to develop a competent emergen. cy department team. An emergency physician may not be chairing the emergency committee of the medical staff, or he may have no vote on its deliberations. The daily vicissitudes of emergency medicine, faced alone, can appear formidable and oppressive. Anticipating future conflicts and avoiding them, developing countering strategies, resolving present difficulties may seem, at times, Utopian. The College was formed with the goal of developing solutions to the problems of emergency medical care. Not the least of these are the recurring, down-to-earth problems of its emergency physician members. While not as visible as some of the others, a major ACEP activity Is the provision of responsible answers to these common challenges, the provision of assistance in maintaining or, achieving mutually satisfactory relations with the hospital governing board, the administrator, and the medical staff. The Hospital Committee of ACEP has formulated and produced a functioning program of physician advocacy. It provides emergency physicians with information and consultation in the areas of emergency department policy and procedure, contract models, contract problems, departmental status, and socio-economic policy. Other areas of physician advocacy will be entered as the needs of members indicate. ACEP cannot act as or provide legal counsel. It is always advisable for physicians to retain their own counsel. However, ACEP will provide information, statistics and facts that define nationwide trends, activities, methods and procedures that involve or influence emergency medical practice. The mystique of "what goes on elsewhere" is often a most effective tool in persuading the administrator and medical staff members to accept the changes that are necessary to improve the quality of care within their hospital emergency department. The problems of members are the problems of the Hospital Committee. They may be submitted by letter, addressed to the Chairman, Hospital Committee, ACEP. Pressing problems may be submitted by telephone. Prompt response and assistance will be provided by the Committee members. ACEP members ask what-they get for their dues. The answer is simple. They get what they ask for. Physician advocacy is available for the asking.
Journal of the American College of Emergency Physicians
Karl G. Mangold, MD
Sept/Oct 1973
The Editor References 1. Refinementsin criteria for the determination of death: an appraisal, Task Force on Death and Dying of the Institute of Society, Ethics and the Life Sciences. JAMA 2:21, 46-53, 1972. 2. Vital Statistics of the United States, U.S. Department of Health, Education, and Welfare, Vol. II, Part B, Table 7-116, 1966. 3. McNeilly RH, Pemberton J: Duration of last attack in 998 fatal cases of coronary artery disease and its relation to possible cardiac resuscitation. Br Med J 3:139-42, 1968. 4. A!yarez H II1, Wills RE, Cobb LA: Sudden cardiac death: physiOlogic observations and therapeutic implication. Am J Cardiol 31:116, 1973. 5. Proceedingsof the national conference on cardiopulmonary resuscitation and emergency cardiac care, May 16-18, 1973, Washington, D.C. Co-sponsored by American Heart Association and National Academy of Sciences-National Research Council. In press.
Emergency Physician Advocacy --An ACEP Responsibility
The
priorities, functions, accomplishments and programs of the American College of Emergency Physicians are multifold. The most visible aspects of ACEP activity have been the educational programs, the stimulation of effective emergency medical service legislation, the functioning residency programs, and the advances toward specialty recognition and board certification. However, emergency physicians generally find themselves confronting more mundane matters, practical day-to-day problems, concerns seemingly far removed from these lofty College pursuits. A moment's consideration should bring many of these situations to mind. One of them may be contract negotiation difficulties, another fee schedule disputes with the medical staff or the administrator. It may be arduous to achieve departmental status, to obtain executive committee voting privileges, to bring emergency physician representation and authority into line with increasing responsibility. Perhaps there are backup problems with the medical staff. Or maybe, professional referral procedures are based on politics rather than the needs of the patients.
Page 344
The list of problems seems endless. The administrator or the director of nurses, with no direct knowledge, ex. perience, or understanding of the complexities of the emergency department operation, may suddenly decide that the department is over-staffed. There may be the burden of the recurring theme that any nurse is an "emergency nurse." The attitude that "a body" will suffice may frustrate attempts to develop a competent emergen. cy department team. An emergency physician may not be chairing the emergency committee of the medical staff, or he may have no vote on its deliberations. The daily vicissitudes of emergency medicine, faced alone, can appear formidable and oppressive. Anticipating future conflicts and avoiding them, developing countering strategies, resolving present difficulties may seem, at times, Utopian. The College was formed with the goal of developing solutions to the problems of emergency medical care. Not the least of these are the recurring, down-to-earth problems of its emergency physician members. While not as visible as some of the others, a major ACEP activity Is the provision of responsible answers to these common challenges, the provision of assistance in maintaining or, achieving mutually satisfactory relations with the hospital governing board, the administrator, and the medical staff. The Hospital Committee of ACEP has formulated and produced a functioning program of physician advocacy. It provides emergency physicians with information and consultation in the areas of emergency department policy and procedure, contract models, contract problems, departmental status, and socio-economic policy. Other areas of physician advocacy will be entered as the needs of members indicate. ACEP cannot act as or provide legal counsel. It is always advisable for physicians to retain their own counsel. However, ACEP will provide information, statistics and facts that define nationwide trends, activities, methods and procedures that involve or influence emergency medical practice. The mystique of "what goes on elsewhere" is often a most effective tool in persuading the administrator and medical staff members to accept the changes that are necessary to improve the quality of care within their hospital emergency department. The problems of members are the problems of the Hospital Committee. They may be submitted by letter, addressed to the Chairman, Hospital Committee, ACEP. Pressing problems may be submitted by telephone. Prompt response and assistance will be provided by the Committee members. ACEP members ask what-they get for their dues. The answer is simple. They get what they ask for. Physician advocacy is available for the asking.
Journal of the American College of Emergency Physicians
Karl G. Mangold, MD
Sept/Oct 1973