Archive for category Leadership & Advocacy Conference 09

Why Go Inside the Beltway?

Are you a political animal?  If not, you may wonder why anyone would want to go inside the beltway.  You may not even have any idea what the beltway is.  It’s a piece of interstate highway – I-495, known as the Capital Beltway – that loops around DC and provides a metaphorical dividing line between the thinking of those inside and outside.  If you live, work, eat, sleep and breathe the Federal Government, you are a Washington Insider, an inside-the-beltway type.  If not, well then, you’re normal, like everyone else.

 

I’ve been coming here every spring since 1994, trying to get my elected representatives – and, sometimes even more important, their senior staff who are health policy wonks – to understand that emergency medicine isn’t just the center of my universe, but the center of THE universe – and that what matters most in life is that everyone in these United States has access to an adequately (dare I say generously?) funded, high quality system of emergency medical care.

 

If you do what I do for a living, and especially if you see it (as I do) as not so much a living but a calling, then you understand what I mean.  But people inside the beltway often don’t.  They require much education – and re-education, which means not sending them off to a camp in the Chinese countryside but coming back here every year to reinforce the old messages and add important new ones.  Once you get used to this ongoing need they have to be indoctrinated … I mean informed … then you realize that trips to DC at other times of the year and the occasional visit to the office in the home district can also be useful.  After a while they recognize you and know your name, and you’re on your way to building relationships with your elected representatives.  In politics, as in so many other facets of life, getting what you want is all about building relationships.

 

The immutable foundation of our message is that what we want is what is best for our patients and the nation’s healthcare system.  We’re the guys and gals with the white hats, the ones who take care of the least fortunate among us – and the most fortunate in their worst moments.  We’re there 24/7/365, and all we ask is that we be provided adequate resources to enable us to do our job the way it should be done.

 

Think you might be interested?  Call the Washington office (202-728-0610) and ask how you can get involved.  And then put on your white hat and saddle up!

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Approaching the Launch of LAC

It is now four days from the start of the Leadership and Advocacy Conference on April 19th. Figuring out what to write about for this pre-LAC blog was a challenge. The key I figured was to keep it short since we are all busy with work, home, life, and advocacy. So what to write about?
I thought I would tell you about the exciting track at LAC this year for residents and first-timers. This year EMRA (Emergency Medicine Residents’ Association) and YPS (Young Physicians Section) of ACEP have worked together to come up with a dynamic event. With great lectures, exciting roundtable discussions, media training, and a reception with the leaders of our specialty, it will be an exciting start to the conference on Sunday. Even if you are not a resident or first timer, I encourage you to come and start LAC off with a bang if you are in the area. Having the presence of the veterans would also inspire the many first-time visitors to the conference to keep coming back.

I have the honor of giving the first lecture and welcoming you all to the Resident and First Timer’s Track this year. I have been working hard to hopefully make it an entertaining introduction as well as informative. Jen Wiler and James Eadie of YPS will be following with excellent discussions of the current challenges, economics, and quality issues that are going on right now. They are both lectures not to be missed if you can make it.

I am also excited to say that all attendees at LAC this year will receive a copy of the EMRA Emergency Medicine Advocacy Handbook, supported by an ACEP educational grant. It is an original publication by EMRA members, but for all emergency physicians. Especially for those that have interests in subjects that they may not be as familiar with, the handbook will be a valuable launching point for you. I hope that you find it helpful. I also welcome feedback on areas for improvement, additional topics, or any other comments as we look forward to future revisions of the handbook.

Best close as this is already longer than many would want to read. I look forward to seeing many of you there. It should be a successful and exciting event! Safe travels and see you this weekend.

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Loving DC

The first time I visited DC, I was 3. Needless to say, I don’t remember much.

The second time, I was 13 and in the 8th grade. You see, the big reward for making it through my rather strict and academically challenging private school was the Eighth Grade Trip to Washington. Our prinicpal wanted it to be a learning experience, so trips to the beach and Disney were out of the question.

I was a military brat, so I’d been on a plane before, but only as a colicky newborn and didn’t have much memory of it. This time, I remembered.

We all met a the New Orleans airport at 5 in the morning. Imagine about 75 eight graders and their tearful moms hanging out at the gate. My dad spent most of that time comforting my mom and quoting statistics about the fact that it’s safer to fly than ride in a car, which she pretended made her feel better.

Looking back, I feel for those poor flight attendants. But, as we said in ’87,  we were, like, totally excited about the trip. And when we descended into Washington, we all craned our necks to see the sights from the airplane window.

That is when I fell in love with Washington. We hit every site imaginable. I was one of two students chosen to participate in the ceremony honoring the Tomb of the Unknown Soldier at Arlington Cemetery. We went to the FBI, checked out the Smithsonian. We took a class picture on the steps of the Capitol.

Next week I’ll be climbing those steps for a different reason. I’ll be climbing those steps for the patients I see everyday in the ED. Those people who are sick, but have nowhere to turn but to us at 3 in the morning. I’ll climb those steps for that lupus patient who lost her insurance because of her “pre-existing condition,” that cancer patient whose doctor quit taking Medicaid, or that person in hypertensive emergency who could not afford their medicines. They all look to us, count on us, because emergency physicians are there when people really need them.

I’ll also be climbing those steps for all the residents like me who want great training. Our training has come under attack in recent years, made tougher by patient boarding. For every boarder we have in the ED, there will be fewer new patients our residents can see. Fewer patients to help teach a new generation of emergency physicians.

For all these reasons, and more, I cannot wait to land in Washington on Saturday. I’ve learned over my lifetime, and through my previous career as a photojournalist, that just sitting around the office complaining does no one any good. It only makes me and my co-workers bitter, ticks off the boss and nothing gets done anyway.

When working as a photojournalist, I was easily frustrated by the lack of control I had over the content I submitted. It was often botched, misused, cropped all to hell or made so small you couldn’t even see the subject of the photo. One day, I’d done a story with a few photos and wrote up a little copy to go with it. I took control and decided to tell the story my own way. Although I had no idea how to work the design program, I sat down a proceeded to figure it out on my own. I made a nice little package, simple, visually appealing, and it had impact.

I presented it to my editor. He really liked the look and it ran. The lifestyle editor who had been doing the pages started to ask me for advice on how to better use photos and copy, and we began to come up with ideas that would not only showcase her writing, but used my photos well.

Over the next two years, I became the design “guru” at the paper, putting together many award winning packages and influencing the rest of the paper’s designers to look at photographs in a new way. I managed to not only improve my situation (I got a promotion and two raises out of it), but change a way of thinking that affected the entire newsroom. The other photographers who had been as frustrated as I had been started doing more projects and seemed to enjoy their work once again.

I suppose I could have continued to sit around for those two years and complain. It certainly would have been easier and a lot less work. But I was able to make a small difference in my world.

The same can be said for Leadership and Advocacy in Washington, D.C. We can sit around at work and grumble, take it out on the nurses and patients, or we can take control of the situation. We can climb those steps to the Capitol. We can donate to NEMPAC. We can call our legislators, meet with our hospital CEOs, rally the troops, so to speak. Sure, it’s a lot more work. But we’re emergency physicians – we like to take control of a situation. Let’s use the mindset we use everyday in the ED and take control of this situation. I, for one, am looking forward to going back to one of my favorite cities and making it work for me and my patients.

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Health Care System Reform in the Age of Obama

When Barack Obama was elected, I anticipated changes that might be coming with the unease felt by many who are naturally conservative – by which I mean opposed to change merely for the sake of change. But there are clearly some features of our society that are desperately in need of change, and the health care system is one of them.
If you ask a gathering of emergency physicians what is needed in health care system reform, you will discover a wide range of opinion. There are those who favor a single-payer system with the federal government as the payer. Others, of a libertarian bent, believe that is the worst thing we could do, and the focus should be on increasing competition and giving the public a much greater sense of individual personal responsibility for achieving and maintaining health.
The president, his Administration, and the Democratic leadership in Congress all seem to agree that health care is a right to which there should be universal access and for which there should be universal coverage – and that the time is now to move decisively toward making that view a reality. Efforts to achieve that kind of reform have been made several times over the last half century and have repeatedly failed. Many believe the forces aligned in support of such a sea change are now more formidable than ever and that the opposition is weak and scattered. But in a time of economic recession there will be resistance to new, very large, and very expensive government programs. Mustering the national social and political will to make universal access to basic health care an American reality will require inspirational leadership. Obama’s admirers and detractors alike perceive that ability in him. Let us see how he brings it to bear in addressing this pressing social problem.

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Health Care Reform Tops Agenda

The ACEP Leadership and Advocacy Conference begins on April 19 and you can bet that the 400 or so attendees, presenters and guests will be focused on the Obama administration’s efforts at reforming this country’s health care system. Of particular interest of course will be proposed changes to the way emergency care is delivered.

What will the government’s overarching goal be? Could we wind up hearing echos of the last administration’s ” Of course we have universal care. Just go to the emergency room.” Or will we begin to see real discussions on real issues such as boarding, crowding, ambulance diversion- and access to care?

In another week, hundreds of emergency physicians will be making the trek to Capitol Hill to talk to members of the house and senate. They will share stories of the real ER-the good, the bad and the ugly.  And they plan to hear the same from their elected representatives, the good, bad and ugly of the reform process and what the Congress and the president are really thinking.

The Central Line will be there every step of the way, keeping you up to date on the conference and what your elected representatives are saying.  Stay tuned.

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