Thursday, July 24, 2014

We Asked and You Responded - And Then Some

View from the Podium

When we asked via Twitter and email for your input on the 2015 AAEM Scientific Assembly in Austin, Texas (scheduled for February 28–March 4), nearly 40 people responded and gave us more than 75 possible topics and speakers. Now it’s up to the Scientific Assembly Subcommittee to make the hard decisions: what tracks, what topics, what speakers?

Although I was in charge putting together the Scientific Assembly from 2001 through 2006, as AAEM surged to the forefront of education in emergency medicine, a lot has changed since then. New young educators from the third generation of emergency physicians have burst onto the education stage, demonstrating new ways of teaching and learning. The Free Open Access Medical Education (FOAMed) movement has quickly assumed a major role in the day-to-day — and sometimes hour-to-hour — education of emergency practitioners. Shorter didactic session times have become the norm. Adult learning principles such as “Flipping the Classroom” are now common.

Wednesday, July 9, 2014

Tenet Wants Emergency Physicians to Subsidize the Rest of the Hospital

Mark Reiter, MD MBA FAAEM
AAEM President

AAEM President’s Message: Tenet Wants Emergency Physicians to Subsidize the Rest of the Hospital

Tenet Health, one of the largest hospital networks in the country with 49 hospitals, recently put the contracts out for bid at 11 of its hospitals in California, to replace their emergency medicine (11), anesthesiology (11), and hospitalist (5) groups. Currently, most of the hospitalist contracts and some of the anesthesiology contracts include a subsidy from Tenet, while most of the emergency medicine contracts generate enough revenue through collected professional fees to be entirely self-supporting and quite profitable. According to some of the local groups involved, Tenet made it clear to the large contract management groups (CMGs) it is soliciting that it is looking for a no-subsidy arrangement for all 27 contracts (three specialties at 11 hospitals). Essentially, Tenet wants the profits from the emergency medicine contracts to cover its losses on the hospitalist and anesthesiology contracts. As only the largest CMGs can even hope to staff 27 new contracts at once, it looks like many local emergency medicine, anesthesiology, and hospitalist groups will be tossed out. This situation parallels the hospital-CMG joint ventures I wrote about a few months ago, since it is another attempt by hospitals — like CMGs — to feast on the professional fees of emergency physicians.

In the past, the quality of the care provided by a medical group was of paramount important to the hospital. But for Tenet Health, a for-profit hospital network, it appears that minimizing expenses and maximizing profit trumps everything else. Tenet earned a profit of $387 million in the first quarter of 2014. Perhaps by destroying the medical practices at 11 hospitals, Tenet will be able to cut its hospitalist and anesthesiology subsidies by a few million dollars in future quarters and make its investors happy. Of course, many of these groups have served their hospitals and their communities well for decades and built strong, productive relationships with their medical and nursing staffs. I’ve been told that many hospital CEOs are very supportive of their local medical groups, but the decision to put the contracts out for bid was made at Tenet’s headquarters in Dallas. Tenet’s corporate executives are not so easily swayed by simply providing excellent care — not when there is a chance to squeeze out more profit for investors and corporate officers.

Thursday, June 19, 2014

New Podcast: Health Information Exchanges

Health Information Exchanges
In this Policy Prescriptions® edition of the podcast, Cedric Dark, MD MPH, Assistant Professor of Medicine at the Emergency Medicine Residency Program at Baylor College of Medicine, speaks with Dr. Ellana Stinson, a practicing emergency physician in Boston, MA, and Dr. Jason Shapiro, Associate Professor and Chief of the Division of Informatics in the Department of Emergency Medicine at Mount Sinai Hospital. The discussion points include: a review of the article "Does Health Information Exchange Reduce Redundant Imaging?: Evidence from the ED," EMR versus HIEs, regional sizes and accessibility of HIEs.

Read Dr. Stinson's article on the Policy Prescriptions blog: "To scan or not to scan: Can health information exchanges help deter emergency departments from ordering unnecessary imaging tests?"

Leave your comments below!

Wednesday, June 4, 2014

Ultrasound Should be Integrated into Undergraduate Medical Education Curriculum

Photo Owned by Ashika Jain, MD
AAEM Clinical Practice Committee Statement
Ultrasound Should be Integrated into Undergraduate Medical Education Curriculum (5/30/2014)

 Visit the Clinical Practice Statement page on the AAEM website.

Chair: Steven Rosenbaum, MD FAAEM

Authors: Lisa D Mills, MD FAAEM
                Zachary Soucy, DO FAAEM

Reviewers: Ashley Bean, MD FAAEM
                   Jack Perkins, MD FAAEM

Reviewed and approved by the AAEM Board of Directors (5/30/2014).

Policy Statement:
It is the position of the American Academy of Emergency Medicine that ultrasound should be integrated into the core curriculum of undergraduate medical education.

Medical diagnostic ultrasound has been used by various specialties since the 1950s. Contemporary point of care ultrasound (POCUS) was first researched and utilized by emergency physicians in the mid 1980s. Emergency physicians have formally defined and pioneered POCUS over the past two decades. Research in a broad array of applications indicate improved patient care via procedural safety and success (11,13,17), improved diagnostic accuracy (20,21,22), decreased procedural pain (8), decrease time to critical interventions (11, 22), and decreased time to discharge (3). The practice of POCUS continues to grow. In the most recent decade there is an expanding role for POCUS across many specialties in medicine. As hospital wide ultrasound application has increased many healthcare institutions struggle to meet the growing educational needs of faculty and residents to obtain standardize ultrasound training. In addition, multiple specialties have POCUS fellowships and specialized POCUS training during other fellowships.

Tuesday, May 27, 2014

View From the Podium - Call for Educational Proposals!
View from the Podium
21st Annual Scientific Assembly

Joseph Lex, Jr., MD FAAEM MAAEM

It’s time to think about the next Scientific Assembly — scheduled for Austin, Texas, from 28 February 28 through March 4, 2015. The success of the 20th gathering in New York back in February will be tough to surpass. That’s why I need your help.

It is my great honor to once again be in charge of putting together the AAEM Scientific Assembly. I did it for five years from 2001 to 2006, before handing the reins over to Kevin Rodgers. But I lobbied for the job one more time, and I need to show that the trust put in me by Education Committee Chair Mike Epter and President Mark Reiter is warranted.

Friday, May 16, 2014

New Podcast! Due Process Rights: The Case of a Physician Who Fought Back and Won

Due Process Rights: The Case of a Physician Who Fought Back and Won
Larry Weiss, MD JD FAAEM, Professor of Emergency Medicine at the University of Maryland School of Medicine and past-president of AAEM, interviews Jeffery Lurner, APC, about due process rights in the case of Dr. Chudnovsky v. Chapman Medical Center. They will discuss the highlights of the case, the due process issues called into question, and medical staff bylaws in relation to contract provisions. Mr. Lurner can be contacted for questions at

Leave your comments below!

Wednesday, May 14, 2014

New Position Statement: AAEM Opposes ED Wait Time Guarantees

The American Academy of Emergency Medicine (AAEM) announces a new position statement approved by the board of directors in May 2014.
Emergency Department Wait Time Guarantees
The American Academy of Emergency Medicine (AAEM) opposes emergency department wait time guarantees. Wait time guarantees potentially compromise patient care by forcing emergency physicians to reduce their attention on truly emergent patients to ensure that less-emergent patients are seen within the wait time guarantee interval. As wait time guarantees do not take into account patient acuity or surges in patient volume, they may put the most critical patients in the emergency department at risk. Although EDs strive to increase efficiency to minimize patient delays, wait time guarantees should be discouraged.

To view this AAEM position statement and all archived position statements, visit