Archive for category From the President

ACEP Reacts to Death of AAEM President

Updated with joint statement from the EM community on Nov. 27, 2017

Nov. 21, 2017

ACEP extends our deepest condolences to the family and friends of AAEM President Kevin G. Rodgers, MD, FACEP, FAAEM.

“We were all shocked to hear of the tragic and untimely death of this strong leader. Working together, I appreciated Kevin’s collegiality and his exceptional ability to build bridges,” said ACEP President Dr. Paul Kivela. “His passing is a major loss for the entire emergency medicine community.”

At this time, our thoughts and prayers and with his family and all that knew him.

The following joint statement was released by the American Academy of Emergency Medicine (AAEM), the AAEM Resident and Student Association (AAEM/RSA), the American Board of Emergency Medicine (ABEM), the American College of Emergency Physicians (ACEP), the American College of Osteopathic Emergency Physicians (ACOEP), the Council of Emergency Medicine Residency Directors (CORD), and the Society for Academic Emergency Medicine (SAEM):


Decision Favors ACEP in Lawsuit Against Federal Government

This message was issued by ACEP President Dr. Rebecca Parker on August 31, 2017

The federal court system took a step in the right direction Thursday when it was announced that the Centers for Medicare & Medicaid Services (CMS) needs to further explain a regulation that impedes emergency physicians from receiving reasonable payment for out-of-network services.

ACEP filed suit against the federal government in May 2016 in response to the Government’s refusal to address concerns ACEP set forth regarding a CMS regulation for out-of-network emergency physician payment, which outlines the “greatest of three” options. As written, ACEP believes this rule, which originated from the ACA in 2010, opens the door for insurers to use black box methods to determine physician payment without providing any means to verify the data. In November 2016, ACEP then filed a Motion for Summary Judgment asking the Court to rule in its favor on this issue.

On Thursday, the U.S. District Court for the District of Columbia partially granted ACEP’s Motion and denied the Government’s counter motion. More importantly, it remanded the matter back to the federal agencies for further explanation of the ruling, saying that comments had previously been submitted during the regulation’s development expressing “concerns … for example, that the methods it used to set payments were not transparent and could be manipulated by insurers. Many of these commenters proposed using a transparent database to set payments instead. The Departments all but ignored these comments and proposals.”

Since 2010, ACEP has had numerous meetings with federal officials, sent formal comments, and drafted guidance to voice the concerns of our 37,000 members that the “greatest of three” rule cannot be enforced and has the potential to be manipulated by insurers without a transparent database of usual and customary charges

This decision does not invalidate the rule; however, it forces the Government to respond to ACEP’s concerns in a substantive manner.

ACEP will always continue the fight to protect the specialty of emergency medicine that Americans have come to depend on.

More details about the lawsuit –


Nation’s Emergency Physicians: Senate’s Alternative to Affordable Care Act Is a Huge Disappointment

This statement was issues from ACEP President Dr. Rebecca Parker on June 23, 2017:

The American College of Emergency Physicians (ACEP) today issued a statement deeply critical of the draft health care legislation introduced yesterday in the Senate, known as the Better Care Reconciliation Act, or BCRA. ACEP’s president, Dr. Rebecca Parker, said:

“Senators should vote ‘no’ on BCRA as it stands today. After holding out hope that the Senate would develop a bill more in line with our priorities, we are extremely disappointed that the Senate’s health care legislation is no better and actually worse than what was introduced in the House of Representatives, the American Health Care Act. The draft that was introduced yesterday makes sweeping changes to the health care system that directly contradict ACEP’s principles and endanger patient safety and patients’ lives. It is a step backwards from improving the health of the nation.

“Of immediate concern is the gutting of Medicaid coverage for millions of Americans who will likely be uninsured or underinsured as a result. The inevitable consequence of people losing their insurance is increases in patient loads and crowding at emergency departments, which are already seeing record numbers of patients. Similarly, when patients have insurance with astronomical deductibles, they delay regular care until a problem becomes so acute they end up in the emergency department. This new legislation will create burdens on ERs that are unsustainable and dangerous.

“In addition, the loss of guaranteed coverage for emergency care – which was one of the essential health benefits of the Affordable Care Act – is basically a gift to insurers, who historically have always chosen to deny coverage when given the option. Access to emergency medical care is critical to all Americans, as is insurance coverage for that care. In a recent poll, Americans overwhelmingly — 95 percent— wanted health insurance companies to cover emergency medical carei.

“We also have grave concerns that this bill does nothing to address the epidemic of opioid and drug dependence in the country, which led to a 99 percent increase in emergency department visits between 2005 and 2014.ii No members of the medical profession see the scourge of opioid addiction more than emergency physicians. The amount of money set aside by BCRA for treatment of the disease of addiction is no better than pocket change.

“Next week, Senators have an opportunity to offer amendments to address the numerous problems that currently exist in BCRA. We hope they are given ample opportunity to discuss and amend the gaping holes in this legislation. Our concerns, which are shared by virtually every other medical group, should serve as a wake-up call to all members of Congress. Without significant improvements, ACEP cannot support this bill and urges members to vote ‘no’ on BCRA.”



ACEP Board: Statement on Rapid Transitions of ED Contracts

The following statement was issued by the ACEP Board of Directors on January 27, 2017

The ACEP Board of Directors and its leadership have had multiple communications with the parties involved and others affected by the recent abrupt emergency department contract transition at a health system in Ohio. The ACEP Board met recently and discussed the matter extensively.

Rapid transition of emergency department contracts may lead to serious disruption. Assuring that any such process is as smooth as possible is critically important to our specialty, and to ACEP.

ACEP is committed to promoting the highest quality of emergency care. To effectively achieve our mission, we are committed to supporting and protecting the interests of our specialty, patients, all members, residents in training programs, and academic and research elements of emergency medicine.

ACEP will be developing a white paper regarding best practices for how contract transitions should occur. When completed, it will not only be disseminated to the emergency medicine community, but also to hospitals and their administrators. We will also be publicizing to our members the availability of existing resources regarding ED contract provisions, negotiations, and other related materials.

We welcome the input of our members and others as we develop supportive resources.


ACEP Statement on Summa Health System in Ohio

In response to a January 1 emergency department staffing contract change at Summa Health System in Akron, Ohio, the president of the American College of Emergency Physicians Becky Parker, MD, FACEP, released the following statement:

“We are deeply concerned about the continuity and stability of training for the emergency medicine residents working in the Summa Health System following the abrupt shift in contracted emergency physician services from Summa Emergency Associates to U.S. Acute Care Solutions. Hospitals and health systems change staffing contracts routinely, but what is not routine at Summa Health is the abruptness of the change. Typically, it takes 90 to 120 days for a transition to be completed, to allow for adjustments to personnel, schedules and infrastructure. We are concerned about what plans Summa Health has to ensure smooth transition for the residency program and the residents directly involved.

“One of Summa Health’s top priorities must be to preserve the integrity of the training and support of its emergency medicine residents. Residency is a critical part of any physician’s education, and a clear plan, executed quickly, by Summa Health, is crucial to its residents’ education, training and well-being. The three years of residency are intensely focused on putting into practice, under stable supervision, the skills that are essential to a lifelong career in emergency medicine. Disruptions to that training can have damaging reverberations.

“We look forward to hearing about a more detailed plan from Summa Health on a seamless transition while continuing to provide a first-rate education to their emergency medicine residents of today and for the years to come.”


ACEP President Issues Revised Statement on Violence

September 25, 2016
The following statement is from ACEP President Jay A. Kaplan, MD, FACEP:

As an organization that represents more 37,000 emergency physicians around the country and the world, the American College of Emergency Physicians applauds our members who stand on the front lines of the violence that occurs in our country every day. Some of that violence makes the nightly news. Sadly, the majority does not.

Our members treat victims and perpetrators, abusers and the abused, law enforcement officers, paramedics, firefighters, prisoners, and death row inmates. We treat the destitute and the wealthy, men and women, citizens and foreigners, and Presidents and pariahs.

ACEP members do it without regard to race, religion, sexual orientation, creed, nationality, socioeconomic class or the ability to pay. We daily see in our emergency departments victims of violence and abuse who no one ever hears about and who we continue to worry about; sometimes that violence is directed against us, just as it is against the law enforcement officers with whom we work.

We are saddened by recent events that that seem to dominate the news every day, as well as by the stories we experience recurrently which do not make the news. We join the call for an honest dialogue about how to turn the tide on the lack of humanity and compassion that leads to the violence we witness outside and inside our departments every hour of every day. Until the day it ends, our members will be on duty around the country to heal the wounds that afflict the victims and our country.


From the President: ACEP Asks You to Share AHA Report on Value of EM

ACEP is pleased to provide our members with a recent publication from the American Hospital Association (AHA) “Always There, Ready to Care,” promoting the extraordinary value of emergency medicine. The AHA is promoting this report by sharing it with policymakers, media and the public.

This publication describes the invaluable role of emergency physicians who must be prepared to respond to a wide range of medical conditions and are now experiencing capacity constraints in the face of rising demands.

It also describes the challenges of psychiatric patients in emergency departments, the complex issues of rural America and the nation’s increasingly heavy reliance on 24-hour access to care. In addition, it demonstrates the crucial role of emergency medicine in responding to disasters, featuring last year’s Ebola emergency and the outstanding response of emergency physicians following the explosions during the Boston Marathon.

The report concludes with a description of the funding challenges to maintaining the emergency department’s 24/7 role in an environment of declining financial support, asking the following policy questions:

  • How will financing mechanisms need to be designed in order to support the 24/7 role in the future?
  • How can the standby role be financed in an increasingly competitive health care marketplace where payers want to pay the lowest price?
  • What is the appropriate role of government in supporting hospital-based disaster preparedness and relief?
  • Should all health care facilities be required to support the community’s standby capacity and care needs?
  • What steps can be taken to promote greater access to and utilization of primary care among low-income vulnerable populations to improve their health status and reduce the need for ED care?

Please share this report with key leaders and policymakers in your community and state and promote through social media.


Michael J. Gerardi, MD, FAAP, FACEP
ACEP President
Rich Umbdenstock
AHA President and Chief Executive Officer
AHA Horzontal


From the President – Ebola Screening Resources Available

RosenauBy Dr. Alex M. Rosenau
ACEP President

As emergency physicians, we are skilled in responding to disasters and treating every kind of medical condition as part of our daily routines. We also are critical to America health care response to infectious diseases. This is because patients often show up first in emergency departments, as we saw during the anthrax attacks after 9/11 and in Dallas, Texas, yesterday when the first case of Ebola was confirmed in the United States. Clearly this disease deserves our attention and emphasis from health care providers across the country.

Ebola is a serious communicable disease. Heightened vigilance for case presentations and strict adherence by health care personnel to CDC advice, public education and a pre-planned medical response is necessary. Hospital physicians and entire health care teams have planned for these types of medical threats. Like SARS, MERS, and Hantavirus, newly identified serious population health threats continue to occur.

Even if this Ebola case is isolated, it is incumbent upon emergency physicians and other health care providers to properly screen and manage potential Ebola presentations. The CDC, the Emergency Care Coordination Center and the Assistant Secretary for Preparedness and Response, have provided materials that are excellent resources for emergency physicians and other staff in the ED to have readily available for dissemination.

These resources are available on ACEP’s website at

They include screening criteria and case definition.

The CDC recommends two initial steps in screening for Ebola Virus Disease:

  1. The symptoms are likely to be fever, headache, joint and muscle aches, weakness, fatigue, diarrhea, vomiting, stomach pain and lack of appetite, and in some cases bleeding.
  2. Travel to West Africa or other countries where EVD transmission has been reported by the World Health Organization within 21 days of symptom onset.

If both of these criteria are met, the patient should be moved to a private room, and standard-contact and droplet isolation precautions followed during further assessment.

We see dozens of patients each week, and particularly at this time of year, many will have a common cold or influenza. All health care professionals in the emergency department should know the protocols and what to ask so we can do everything possible to ensure that this Ebola case in Dallas remains isolated.

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ACEP Mid-Year Update

Dr. Alex M. Rosenau


By Alexander M. Rosenau, DO, CPE, FACEP

As we come upon the halfway point of my Presidency, I’d like to offer ACEP members an update and share news about exciting things we’re working on for the coming months. For me, the past six months have been intense, as I’ve connected with individual members, groups, organizations and legislators in concert with our strong Board of Directors, expert staff and amazing volunteer physician members. Dialogue, conflict management for a better result, as well as bringing together the right folks for both the challenges at hand and those just over the horizon are daily activities. I’ve cherished every minute. Emergency physicians enjoy a tremendous relationship with each other, and I know we’ve done some things in the past six months to make our bond even stronger – and to appreciate our past even more. In all things emergency medicine, my mantra is “them is us and us is them,” meaning that the common bond we share is much stronger than the forces tugging at us in disparate directions. When you read this update, please know that I will continue to work hard for you over the next six months, and I welcome any feedback. I hope to see you at our Leadership and Advocacy Conference next month and ACEP14 this fall, and please don’t forget to say, “Hey.”

Report Card Garners Major Media Attention
Although we don’t like the results we saw from the release of the 2014 State-by-State Report Card on Emergency Medicine, an overall grade of D-Plus nationwide could have a positive impact on health care moving forward.  Our Report Card fostered many a conversation with state legislators.  Media outlets have pointed out what we already knew – that several states don’t have the resources and policies in place to support high-quality emergency care. Stories about the Report Card appeared in major newspapers, including The Washington Post, The Chicago Tribune, The New York Daily News, Forbes, The Huffington Post, The Los Angeles Times, San Francisco Chronicle, The Philadelphia Inquirer, Houston Chronicle and The Seattle Times, to name a few. Along with print stories, nearly 800 broadcast stories aired on news organizations including ABC’s World News Tonight with Diane Sawyer, MSNBC, CNN, Fox News’ Your World with Neil Cavuto, Fox Business News, CNBC’s Kudlow and Kramer, WNBC New York, and Telemundo as well as dozens of local television stations across the country.  The estimated audience reach was 72.2 million people. Our dedicated spokespersons will continue to make sure the results of this study resonate nationwide. Keep up with the progress at

ACEP Working on Several Federal Advocacy Efforts
One of the most critical federal advocacy projects we’re currently working on is the support of H.R. 36/S.961, the “Health Care Safety Net Enhancement Act of 2013,” introduced by my 911 key contact, Rep. Charlie Dent (R-PA) in the House and Sen. Roy Blunt (R-MO) in the Senate. The bill provides medical liability relief for physicians providing care under the EMTALA mandate. The House bill continues to gain support and reached nearly 70 co-sponsors last month. Our advocacy team is working diligently on SGR repeal in concert with a number of allies. Although the CBO rated an SGR fix the most affordable ever, Congress failed to settle the offset funding issue and we didn’t get the permanent fix. The previous work of our Washington office in collaboration with our specialty and AMA allies assured prevention of a seriously damaging 24 percent cut in Medicare reimbursements for one year; also extending dozens of other expiring health care-related provisions. ACEP will continue to work with the AMA and other medical specialty societies to encourage members of Congress to take action this year on the permanent repeal of the SGR. We’ve also been working very closely with the Emergency Medicine Action Fund (EMAF) to address regulatory reform under the Affordable Care Act, including areas related to quality measures reporting and reimbursement.

ACEP Now Launched
When the calendar flipped to 2014, ACEP turned its monthly publication up a notch. We wanted to blend the needs of our membership with an edgy editorial vision related more closely to the world we work in. Beginning with a round-table discussion cover story and a compelling piece on breaking down racial barriers in the ED, the new-look ACEP Now hit mailboxes in mid-January and began receiving rave reviews from ACEP members.  I hope you like the direction of our new medical editor-in-chief Kevin Klauer, DO, EJD, FACEP, and our new publishing partner, Wiley Press. The new ACEP Now is not only bigger, it features more incisive opinions, “you are there” real articles regarding our decision making and advice from some of emergency medicine’s most  renowned physicians. The news from ACEP and events related to the College will always be a part of the magazine, so none of that has changed. What has changed is the attention to detail and open dialogue when opinions differ on controversial issues. If you haven’t seen ACEP Now lately, grab a copy soon. Your feedback is welcome at .

Strategic Plan Taking Shape
In leading the annual Board retreat in December, top-level goals and objectives for the college from now until 2017 were debated, prioritized and built for impact. Goal 1: Care transitions and reform of the health care delivery system continue at full gallup. Goal 2 received particular attention with the formation of the Membership Engagement Task Force, the Membership Bylaws Task Force and the Residency Visit Task Force. Your fellow member leaders of these groups, their Board of Director Liaisons, and assigned top level staff are poised for success in member engagement and satisfaction.  Here’s an overview of the Strategic Plan:

Goal 1 – Reform and Improve the Delivery System for Emergency Care

  • Objective A – Identify, support, and promote delivery models that provide effective and efficient emergency medical and acute care in different environments.
  • Objective B – Promote quality and patient safety, including development and validation of quality measures.
  • Objective C – Pursue strategies for ensuring fair payment and practice sustainability.
  • Objective D – Pursue solutions for workforce issues that ensure access to high quality emergency care.
  • Objective E – Advocate for meaningful liability reform at the state and federal levels.
  • Objective F – Communicate the value of emergency medicine as an important component of the health care system.

 Goal 2 – Enhance Membership Value and Member Engagement

  • Objective A – Increase total membership and transitioning resident retention.
  • Objective B – Provide robust educational offerings, including novel delivery methods.
  • Objective C – Support member well-being.
  • Objective D – Ensure adequate infrastructure to support growth.

Building Bridges and Strengthening Relationships

My other mantra is to connect ACEP with others who share our passion for quality health care. If we build bridges and enhance our synergy with other health care organizations, we benefit and so do our patients. We’re currently working to provide input to ABEM for recognition of Clinical Ultrasound for subspecialty certification. This will improve education, continue to allow Ultrasound use for patient care by all members meeting ACEP guidelines and validate point of care as a reimbursable item. This contributes to our value. Our relationship with CORD continues to grow, as does our joint work with CORD and SAEM in GME matters. EMRA has a new executive director and our relationship with EMRA could not be stronger. We’re proud to announce the recent ACEP/SEMPA Advanced Practice Provider Academy drew rave reviews and more than 300 physician assistant and nurse attendees. I participated as our two organizations penned a new five-year management service contract in New Orleans last month. I directed a new task force be formed to reach out to identify opportunities for collaboration with the Society of Hospitalist Medicine.  When it comes to building bridges, there are many organizations whose activities, benchmarks and plans have relevance to us. That is just one reason our executive director, Dean Wilkerson, has been such an asset to our organization for the past decade. We meet by phone at least weekly, communicate via email most days. Your Board members are out and about on a national scale gathering information, forming relationships and honing the judgment that all of you expect your elected leaders to use. I personally appreciate their diplomacy and expert work.

Two Clinical Policies Reviewed
ACEP reviewed two Clinical Policies recently. In response to the Council- and ACEP Board–adopted Amended Resolution 32(13), the “Clinical Policy: Use of Intravenous tPA for the Management of Acute Ischemic Stroke in the Emergency Department” is being reviewed. The Clinical Policies Committee, as per council, accepted comments until March 24. Findings and any recommendations regarding the policy will be reported to the ACEP Board in June. Also, per the resolution, future clinical policies will include a 60-day comment period before finalization. A Clinical Policies Subcommittee of ACEP completed a draft clinical guideline in late March, “Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients with Suspected Acute Non-Traumatic Thoracic Aortic Dissection.” It’s open for comments until May 28, 2014. To view the draft policy and comment form, go to For questions, please contact Rhonda Whitson at

Quality Measures and Reimbursement
ACEP has accepted donated emergency medicine quality measures from other organizations, and we’re developing our own for member benefit (both for CMS incentive and avoidance of CMS penalty). These steps, in addition to our continuing education on reimbursement and coding, add value to your bottom line and salary. We’ve had several recent articles, webinars and a spring conference devoted to Reimbursement and Coding, helping you prepare for reimbursement issues, the eventuality of ICD-10 and PQRS benefits in concert with ABEM.

ACEP’s Official Mobile App Improved
The official ACEP mobile app, an essential resource for members and other emergency care providers, received an upgrade early in 2013 to make navigation easier and to improve the design. The next phase of upgrades is currently being implemented. This includes the addition of several links to education resources from ACEP’s bookstore, audio recordings from the monthly Education on Demand newsletter and a section where emergency medicine news published in ACEP Now can be found. You can also find a secure Member Directory, a personalized Member Guide that reflects your chapter and sections, an events calendar and ACEP’s clinical policies. If you don’t have ACEP’s app on your phone, download it today for iPhone or Android devices.

EMF Continues Endowment Push

Since October, EMF has launched a new logo and continues the momentum of the ACEP $1 million match to bring the endowment to maturity with a corpus of $2.5 million. To help achieve this goal, for every dollar contributed to EMF before June 30, EMF will match it with a contribution of 50 cents toward the endowment. EMF has a new board and a new Strategic Plan. It’s Goals and Objectives are to:

  • Goal 1 – Position EMF as the principal sponsor of scientifically rigorous research and education to to improve the care of the acutely ill and injured and policy research that aligns with emergency care priorities
  • Goal 2:  Increase EMF’s capacity to engage more people in emergency medicine research and award more grants
  • Goal 3 – Position EMF as the premier 501(c)(3) emergency medicine foundation
  • Goal 4 – Increase EMF revenue to fund more research grants and education projects

Please go to, and make EMF your charity of choice.

Annals Added to eCME Options
In collaboration with ACEP’s online education program, articles from the Annals of Emergency Medicine are being offered as a CME component. As of April 2014, there were 13 Annals-based articles available to members. ACEP looks forward to seeing this educational offering become a robust element of ACEP’s overall online education program. Learn more at

Concurrent with the inauguration of the eCME program, Annals announced that it would continue its relationship with long-time publisher, Elsevier. The five-year contract runs through December 2018, and provides a solid and stable financial basis for journal revenues. The contract provides a generous editorial office stipend along with a guaranteed minimum royalty, enabling Annals to contribute substantially toward the overall financial success of the College.

ACEP Continues to Add Value, Enhance Image
The continued strength of our specialty requires us to do some heavy lifting in areas such as keeping prudent layperson as a recognized part of the ACA, working toward an SGR fix and changing perception about the cost of emergency care. Working together, we will make progress. As a result, our place in the House of Medicine will be enhanced. And we’re building strong connections with others while providing service to our chapters as they protect the interests of our members. Chapter efforts in Washington state and most recently in Virginia underscore the need for our teamwork. We believe that Steve Stack will become the AMA’s first ever Emergency Physician President.  We have a real chance for the AMA to continue its re-invigoration with a clear view of EM’s contribution to the house of medicine because of his upcoming service.  If you have any membership dollars available in your professional budget, I hope you consider making this year one in which you might become an AMA member to bolster our ACEP delegation at the AMA.  There are certain things that are more do-able when we have a strong delegation within the AMA, whether advancing our cause within the house of medicine or in our negotiations at the RUC.

Spring Conferences in Full Swing, LAC Coming Up
ACEP’s busy spring conference lineup began in February with the Reimbursement and Coding Conferences in New Orleans. With the upcoming changes in coding and the implementation of the Affordable Care Act, payment topics have become even more popular and necessary. More than 200 emergency physicians participated in the February 2014 conference. Your next chance to brush up on your knowledge in this area is March 2015 when the R/C Conferences move to Las Vegas.

The 2014 Advanced Pediatric Emergency Medicine Assembly was held in New York City in March and drew more than 550 four-day registrants. This is the highest number in four years.

ACEP’s newest offering, the Advanced Practice Provider (APP) Academy, recently wrapped up. More than 300 attendees received a crash course in emergency department essentials. Held in conjunction with SEMPA, this conference is vital for emergency department providers who might be new to the ED or need help in certain areas. The demand for this conference was high and feedback positive, so ACEP and SEMPA have decided to hold a second installment of Phase I in August. The conference has also been renamed Emergency Medicine Academy.

ACEP’s Leadership and Advocacy Conference will be May 18-21 in Washington, D.C. If you’ve never been to this conference, you’re missing one of the best three days of education and networking available. Thought-provoking, inspiring and challenging sessions by nationally recognized speakers and key decision makers will provide you the inside information and skills you need to maximize your impact as an emergency medicine leader and advocate. Invited Speakers for the Conference include: U.S. Sen. Ron Wyden (D-OR); U.S. Rep. Andy Barr (R-KY); Amy Walter, Political Analyst for the Cook Political Report; Patrick Conway, MD, Deputy Administrator for Innovation & Quality & CMS Chief Medical Officer. Please plan to come to Washington, D.C., next month to network with ACEP leaders and advocate for your specialty.

Please remember the elevator speech when you run into your hospital leaders and legislators:
We are 4% of the physician workforce seeing 28% of all acute care visits. We are the doctors of first contact, unscheduled, federally mandated care regardless of financial status. We are over 32,000 ACEP members seeing 130 million patient visits, 24/7/365 for about 4% of the national healthcare dollar. Our customers include primary care docs who send their patients to us for complex medical diagnostic work-ups. We are the portal of entry for 75% of all hospital admissions. We are the hub of the enterprise, and are working toward being masters of transitions of care. We are not only expected to be the admittors, but also the admitting avoidance service through our work in care coordination.  And we do this in a room, in a hallway, in ‘copters and ambulances during disasters large and small every shift of every single day.

Thanks for the Past Six Months
I started my EM practice in the 1980s, and there are many reasons I value membership and the friends I’ve made over the years. I can pick up a phone and dial a colleague anywhere for advice. Like all families and all democratic groups filled with the riches of a knowledge-based constituency, we will have disagreements and some conflict. It’s all for a better result and a strong organization, as long as we stick together. The knowledge I’ve gained in reimbursement and coding and practice management has paid me back every dollar I ever contributed to ACEP, EMF and NEMPAC. The education I’ve received at conferences has made my practice better and improved the care of my patients. I was proud to join ACEP then, and I’m proud to be its President today. ACEP is growing. ACEP is dynamic. ACEP gives you a good return on your dues investment dollars. Your partners, your colleagues are the members of the committees, task forces, sections, Board, Council, and technical expert panels that create our future. Let’s connect. See you at LAC and ACEP14.


Alexander M. Rosenau, DO, CPE, FACEP
President, American College of Emergency Physicians

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ACEP Plans List of Tests for National ‘Choosing Wisely’ Campaign

ACEP President Dr. Andy SamaAfter an extensive look at ways to provide cost effective care to emergency department patients, the American College of Emergency Physicians believes there is room to improve the use of specific tests or procedures in emergency medicine to participate in the national “Choosing Wisely” campaign.

“Choosing Wisely” is part of a multi-year effort of the American Board of Internal Medicine (ABIM) Foundation to help physicians be better stewards of finite health care resources. The campaign encourages medical specialty organizations to identify five tests or procedures commonly used in their field, the necessity of which should be questioned and discussed by patients and physicians.

ACEP had previously declined participation in the “Choosing Wisely” campaign because of the challenges of this approach with the unique nature of emergency medicine, liability concerns, and a potential harm to physician reimbursement.

The College meanwhile remained steadfast in its commitment to cost-effective care and a high-value health care system, and last year, Immediate Past President Dr. David Seaberg appointed a Cost Effective Care Task Force, chaired by Dr. David Ross. The Task Force was charged with considering tests, processes and procedures with little or no value to emergency care that might represent meaningful cost savings if eliminated.

In a report to the ACEP Board of Directors this month, Task Force member Dr. Jay Schuur said that their Delphi panel and ongoing member surveys have suggested that a number of tests will meet the criteria of the “Choosing Wisely” campaign. They also determined that these tests would not increase the physician’s liability, and would not negatively impact payments for emergency physicians.

After being reviewed by experts, emergency medicine leaders, and the ACEP Board, the report’s data indicates that it would be appropriate for emergency medicine to participate in the campaign. A letter of ACEP’s intention to participate was sent to the ABIM Foundation today.

The list of recommendations should be established by June. ACEP’s Task Force is finalizing the evidence base for these recommendations, in part though the Emergency Medicine Practice Research Network (EMPRN). Attaching estimates of potential real-dollar savings to the recommendations is also being completed. Members of the Task Force and the ACEP Board believe this responsible approach will validate the substance of our recommendations, and provide assurance that there will be a real savings to the health care system while not impacting patient care.

But joining this national campaign is not the only approach ACEP is using its in journey to identify cost savings measures without compromising patient care.

In order for there to be a serious reduction in unnecessary tests and costs of defensive medicine over time, meaningful liability reform and safe harbors are vital. ACEP is encouraging ABIM and its campaign partners to lend their voices to the need for medical liability reform. This remains a top priority in ACEP’s advocacy agenda.

Additionally, the College is working on other significant and impactful efforts, including proposing an elimination of the 3-day-stay rule and better management of transitions of care.

A variety of recommendations that strive to improve patient care and provide meaningful cost savings continue to be initiated, developed, and adopted by ACEP.  We are dedicated to ensuring that our specialty can be leaders in health care system efficiency while maintaining a high quality of emergency care and patient safety.

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