Archive for category Leadership & Advocacy Conference 09

My Take Home Message…

It’s been my experience that conferences are often like great big pep rallies, except usually the night or day following the pep rally the big game happens.  Keeping motivation and spreading it tends to be more difficult when it comes to motivating people towards advocacy.  I decided that this time I would be prepared for my trip back home.  I loaded up with copies of the EMRA Advocacy Handbook, and filled my head with information before departing D.C., but it seems that I wasn’t as prepared as I should have been.

Once home, I found that by and large the residents that I spoke to could largely be grouped into one of two classes: 1) Those who wish that the knew more about health policy and health care legislation, but didn’t know where to find it, or 2) Those who were glad that I enjoyed “that stuff”, but it wasn’t for them.  

The first group, I’m sure all of us reading this blog are familiar with; If it isn’t us now, it was us at some point in our careers.  What I found funny was that I found more interest in the latter group.  Many of them because I knew well enough to know that the DID have a stance on health policy.  Most were surprised when they learned that many of the things that interested them not only “counted” as advocacy, but were discussed at the conference.   Whether the interest was EMS diversion, patient literacy, or on call coverage, each person had an advocacy interest; Most of them thought that their interest fell outside of the lines.

 Additionally, many complained that too often in residency we get so caught up in treating the patient, doing paperwork and making rounds that we neglect the non-clinical aspects of medicine.  Just as how EM was left out of the EMTALA talks years ago, this goes on in hospital administration today.  The sentiment seemed to be “we don’t know how, we don’t have time, so we don’t.”  This made me reflect on my biggest fault.  I an terribly guilty of the “If I Don’t Do It, No One Will” mentality.  It dawned upon me that there are many people who are ready to step up and fill in the big roles; including the resident level.  However as residents we are new to the field and what many of us need is someone who will show us the way.  Admittedly, one of my strengths is in seeking out new opportunities; however, because if my aforementioned fault I often kept them to myself.  As my residency continues it is my goal to pass those opporunities on to others for the betterment of myself, my peers and our collective careers.

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Next Steps at Home

Now home in Dayton for me and wherever you are today, the real work begins.  We had a strong start at LAC this year in Washington DC with over 400 hill visits, but that is just the beginning.  Now comes the grassroots ground effort to obtain more sponsors, gather support, and lobby for a hearing.  Whether or not you were at LAC, emergency medicine needs your help!

Write a letter.  Take the time to thank those that you met with in DC if you had the opportunity to travel.  If you did not make it to DC, write to your legislator and senator and encourage them to support the Access to Emergency Medical Services Act of 2009 (HR1188, SB 468) this year.  It does not need to be long.  Just tell them the problem of overcrowding, given them a story of their constituents, and the benefits of the bill.  For those that may not be as familiar, this bill studies the problem of overcrowding, works to develop and implement the suggested solutions, and provide funding for those that provide emergency care to encourage on call coverage and access to emergency services.  A few minutes to write a letter can make significant change!  I encourage you to lobby your partners to do the same.

Write to the papers.  It is truly amazing how willing the papers are to publish a letter to the editor from a physician.  There are standard letters that you can obtain from the ACEP advocacy folks, or write your own.  Most have a word count around 250 words, so you can make it short.  Just take the time to get the word out.

Talk to your friends/colleagues/administors/etc.  Start the conversation on the overcrowding problem.  If you suffer right now from overcrowding, use this as a launching point for change.  If you are among the lucky few who have not experienced significant overcrowding, work toward a prophylactic solution and get some of the solutions in place.

In the end, the work on DC is only a start, the real work begins at home.  Keep up the progress and the hardwork.  Make a real effort to build on the success and relationships you have formed.  We need to remind those that are going to define health care reform that the emergency department has been and will be the national safety net.  We need a seat at the table.  That only happens with your support and dedication!

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My Best Moment

Every episode of Scrubs has an overall theme summed up with a moralistic ending and a great song to drive the message home.  Most, if not all, of the characters come to the same grand realization at the end.  The episode “My Best Moment” J.D. (the lead character) was put in charge of telling a group of medical students what it was to be a doctor; instead, he reminisced over his greatest moments and challenged his staff to relive theirs.  In many ways, the L & A conference had this feeling for me.

It’s been 8 years since I was last on Capitol Hill.  I have made a few odd trips to DC for one reason or another since then, but not to the Capitol building, not with an agenda, and never with so much energy and enthusiasm.  My first trip was as a congressional intern for Dr. John Cooksey.  He was the representative for the 5th district of Louisiana and an Optholmologist in Monroe (my hometown…of sorts).   Few people that I had ever met commanded such respect and in the community, and his ability to be both a congressman and a doctor were legendary.  Dr. Cooksey was a believer that to use the title of “Doctor” you needed to actually see patients and did so 3 days a week when the congress was in session (more when it wasn’t).  

This trip to D.C. and meeting up with old colleagues now serving as staffers reminded me of those good times. “My Best Moments”, however, will be the times sitting around with my new physician colleagues trading stories on our starting points, our most difficult and most rewarding patients.  The talks about the best (and worst) of being a doctor.  Now, the most gratifying moment of the trip was the opportunity to share all of these stories with our representatives who were eager to hear first hand stories of the true “life in the ER”.  They were exceptionally receptive to our ideas.

Unfortunately for me, of Louisiana’s 3 physician representatives, I was only able to meet with 1 (don’t fret, members of the LA-ACEP chapter met with them all).  Dr. Cassidy (Congressman for the 6th district) embodied the best of what I remember about Dr. Cooksey.  Considering himself to be first a physician, he told us all that if he could not properly treat his patients he would not stay in D.C.  He also understood the lack of input by physicians into the current health care debate and felt a calling to speak on behalf of both physicians AND patients.  That through his time working on policy he could ensure better care for a greater number of patients.  Admittedly, only a small portion of our time was discussing the bills being presented; he majority of our time was spent discussing the needs of our patients and our desires to serve.  It gave you a sense of relief to meet a representative who cared so much.

So…the end of that episode of Scrubs.  Everyone recognized the great things that had come before, and that better things could come if they were to build upon that experience.  Oh, and the song at the end of the episode…”Joy to the World” by The Butties.  Fitting, indeed.


Next Installment: My Take Home Message…

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What a day

So I was a newbie today. Actually, the three people from my delegation were newbies.
But was it fun!

Now, I think it has a lot to do with the fact that we’re from Alabama. I mean, good ole Southern boys are not only fun to talk to, but they have no interest in being politically correct. They tell it like it is.

Our first stop was with Congressman Bright’s health liason. She was nice and listened to us, but I was hoping to catch the Congressman. You see, he used to be the mayor of my town and my husband is the photo editor of the city’s newspaper. So over the years, he has photographed the Congressman many times.

I thought we were out of luck. However, as we were standing in the hall, who should come up the stairs to his office, but Congressman Bright!

“Mayor Bright?” I asked. Apparently, everyone still calls him “Mayor.” I can’t help it.

He looked up from his Blackberry and said, “Yes?”

I introduced myself and said, “My husband is David Bundy, the photo editor of the Montgomery Advertiser.”

“Dave’s your husband?” he asked. “Well, he sure married up! He’s a good guy. Tell  him I said hi!”

I pitched our Bill briefly and he said he’d try to help. Gotta follow up on that later.

How fortuitous.

We met with the senators’ advisers, which was nice and all. They listened, but I’m not sure how much actually got through.

Our next meeting was kind of fun. Congressman Griffith is a freshman from the northern district of Alabama. He’s also a retired radiation oncologist.

Right away, he put us at ease. He was very straight forward and asked us our opinions on health care reform.

We began to discuss the importance of the AEMSA, and began to bring up our problems with on-call specialist coverage.

The Congressman said, in his wonderful Southern drawl, “Them neurosurgeons in North Alabama… They only want to do elective cases! They don’t want to take call! Well, that’s BULLS**T!”

My mouth dropped open. And here is how we found our way in. A fellow physician who was familiar with our workforce issue, and a Congressman who knew about some of our colleagues “dark underbellies” as he put it. That some people don’t want to take care of patients (or, certain patients). We showed him the Report Card, with Alabama’s grade of D+. “Now that’s the ammunition I’m lookin’ for,” he said. “Call me up and I’ll help clear that waiting room. If I had to do it all over again, I’d be an ER doc.” (I know, I know, but I thought it was cool he was willing to get in there and see patients, unlike some of our colleagues in other specialties.)

My attending, Dr. Kathleen Bowen, and I had wonderful meeting with him, and have much to follow up on. But I believe we made a great start.

Well, I’m tired and I will give part 2 of my day tomorrow! Good night!

Author’s note: Apparently I fell asleep typing this at around 3 a.m., literally with my hands on the keyboard. I’m currently in a Starbucks in the Charlotte airport finally posting this. More to come later.

Author’s note on the author’s note: My apologies. This darn thing wouldn’t post earlier. Finally, here it is.

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Storming the Hill!!!

I have always thought that unique and life changing opportunities are available around every corner.  This has been no clearer to me than yesterday afternoon when I and some colleagues from the Louisiana ACEP chapter where standing on the steps of the Russell Senate building reflecting on the talks we had with our congressmen and senators and pondering the swirling emerald green clouds above the capitol building.  A storm was indeed brewing in Washington; both figuratively and literally.  As many of us know, health care is very high on the current administrations agenda and the stresses of our current system have been made known to our representatives. However, what I noticed in many of the talks is that our nations leaders have no clear plans on how to best implement change.  In Louisiana, we are fortunate in that we have 3 congressional members who are also MD’s and understand some of the challenges that face health care change from the provider side; BUT, the great majority of offices do not have that advantage.  Many of them are seeking answers and advice from people within the system.  Ladies and Gentlemen, the health care storm is coming, and it is up to us to decide if EM will caught out in the rain.


Solutions Shopping?

What a day on the hill!  With 350 members of ACEP storming the congressional building, the chance for impact wasa real.  Unlike past years where receptions may have been brief, the report from so many was positive.  From liberal advocates of total health reform to conservative republicans, the audience this year was bigger than ever.

One of the most surprising interests came from none other than the minority leader, John Boehner’s office.  Without so much as an appointment, we were able to drop by and meet with the deputy chief of staff for 20 minutes to discuss the merits of HR1188.  This is unheard of for many in the ohio chapter.  The reality is that they were interesting in the legislation but also the support that might exist for an alternative to government run universal healthcare.  Unlike prior sessions, we had a receptive audience and a place to build from.  Other members of the minority party as well as the majority also expressed a growing interesting in the ACEP message.

This leads to the big question, are the Republicans shopping for their healthcare reform alternative?  Might the emergency physicians find a home in such a conglomerate of alternative plans?  All of these questions still remain to be seen.  The reality though is that this was one of the most successful visits to the hill in years.  With continued grassroots movements from members like you, there is a real chance that our legislation may find the light of day in congress either as a stand alone, part of medicare SGR reform, or a broader healthcare reform effort.  All of these developments should encourage the average physicians to continue the fight.  Make your voice heard!  Whether from home, DC, work, or play, we need you to speak up and support HR 1188.


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Today’s the day

Today is why we came here. OK, so the cherry blossoms are nice. But we came to storm the Capitol.
It is going to be a busy day. It’s going to be packed with meetings and convincing and jockeying for time with various representatives and their legislative advisers. But we can’t forget about our patients.
I’ll chat more later, as I’m sure there will be more to say after this new experience.


A Clear Path?

Today we have heard a variety of opinions from close observers of, and one participant in, the early phases of development of health care reform legislation.


The participant was Neera Tanden.  Ms. Tanden was a senior vice president for Academic Affairs at the Center for American Progress before being appointed Hillary Clinton’s policy director for the 2008 presidential campaign.  Then, late last June, she was recruited to become Director of Domestic Policy for the Obama campaign.  She is now the point person on health reform for the Department of Health and Human Services in the Obama Administration.  After making relatively brief remarks as the luncheon speaker at ACEP’s Leadership & Advocacy Conference, she invited questions.


Most of the questioners focused on enlarging her understanding of the emergency medicine perspective on reform of the health care system.  She did her best to assure us that our concerns were not unfamiliar to policy wonks in the Administration and among the leaders and staffers of key Congressional committees.  And she was forthright in asserting that the Administration has learned from the errors made during past, unsuccessful, efforts at comprehensive reform.  One member of the audience (can you guess who it might have been?) asked if there is reason for us to believe that the president’s “clear path” toward universal coverage does not represent more ineffective incrementalism on a “long and winding road” (apologies to Paul McCartney).  Ms. Tanden was certainly the most optimistic of the speakers who addressed us today, asserting that President Obama did not come to the White House to accomplish small things, that his approach to reform will be bold and aggressive, and that it will be weeks to months, rather than years, before we are firmly on that clear – and short – path toward the goal of covering every American.


An earlier speaker had pegged the likelihood of enacting substantial health care reform legislation this year at no better than 50-50.  Let us hope that Ms. Tanden’s optimism proves to be well founded.  As Mr. Obama has said repeatedly, the cost of inaction is unacceptable, and doing nothing is simply not an option.   

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Saving for a rainy day

This morning we heard a great “call to arms,” as it were, by our fearless leader, Dr. Nick Jouriles. He discussed something we’ve been hearing about for the past year.
There does need to be change. The problem is no one is really in agreement on how that change should occur.
Who wins these nauseatingly long and verbose arguments?
No one. And least of all, the patient. The one we started this whole med school and residency thing for anyway.
Because ultimately, that’s what it should come down to: our patients. That’s what we’re here in DC doing – advocating for our patients and for our specialty.
Now, granted, we’re here for our patients. But what really talks in the Beltway is money. It’s all about the Benjamins here. As AC/DC once said: Money talks.

In today’s economic climate, everyone is spending less and expecting more. But if you haven’t donated to NEMPAC yet, because you’re saving for that rainy day, let me tell you something, honey. It’s pouring outside. It’s raining on our patients and the emergency department is the umbrella that covers everyone. We’re it people. A storm is a-comin’ and the umbrella is about to flip inside out and carry us away.
As Dr. Jouriles says, it’s time to give a shi(f)t. Only one Benjamin for us residents, and 10 for attendings. Let me hear the money talk.

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Success! Residents Going Strong

The first day of LAC can only be described as an overwhelming success. With record residents signed up (109), the attendance at the Resident and First Timer’s Track at LAC on Sunday April 19th was beyond capacity. Over 140 people swelled the room for the lectures by Jen Wiler, James Eadie, and myself. Media training was packed. The reception co-hosted by EMRA and YPS was overflowing.

With a record start, LAC is shaping up to be one of the best this year. Your voice will add to the strength of our position on the hill. I hope to see you there!

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