Posts Tagged Washington DC

Join the Fight: Don’t Blame the Emergency Department For Everything

PhotobucketEditor’s Note: Nathaniel Schlicher, MD, JD, is the Associate Director of the Patient Safety Organization, TeamHealth and the Legislative Chairman, Washington Chapter of ACEP.

Did you hear?  “The ER physicians and hospitals have been abusing their privileges as providers of ER services for years,” according to the Chief Medical Officer for the Washington State Medicaid Program. 

These are the statements that make involvement in organized medicine and participation in leadership at all levels critical.  But where do we acquire the skills to combat these misperceptions and outlandish statements?

In May every year, there is a one of a kind event in Washington, DC called the ACEP Leadership and Advocacy Conference.  It is an intimate conference with about 500 attendees, representing leaders in emergency medicine from across the country. 

The conference focuses on principles of leadership, current issues in advocacy, media training, and practical everyday leadership challenges that will confront leaders in every state.  It is also an excellent opportunity to network with colleagues from across the country.

When I first attended 5 years ago, I went as a member of the EMRA Chair’s Challenge and the incoming Legislative Advisor for EMRA – a neophyte to organized medicine by all accounts.  It was an eye-opening experience to be talking with the leaders of our specialty.  These were the people and faces that went with the legendary names I read about in Annals and ACEP News.  Now I was talking with them, learning from their experiences and stories, and finding out how varied the opportunities were in emergency medicine. 

From chairs of departments, leaders of advocacy groups such as the AARP, AMA delegates, speakers of the council, and so many others, I had the chance to see and live the history of our specialty.  Then on the final day of the conference, we put it all together and walked up to Capitol Hill as hundreds of physicians representing our millions of patients to share our stories with elected officials and change the face of medicine.

This year it is my privilege to share with you my experience in Washington State, having put these skills into action on the local level.  When I joined the Washington ACEP Board of Directors, I never imagined I would use so much of what I learned at LAC.  From media training skills in doing press interviews and the gotcha journalism warnings, to relationships I have leaned on for statistical assistance in fighting misleading information, and the practice of speaking with legislators – these are all invaluable skills. 

If you have the slightest of desire to join the leadership of emergency medicine in your hospital as a facility medical director, at the state level in an ACEP Chapter, nationally on a committee, or be involved in one of the hundreds of other ways possible, I encourage you to attend ACEP’s Leadership and Advocacy Conference in May.  It is the conference that I walk away from every year re-invigorated and ready to take on the challenges of caring for our patients in the halls of our department, but also and more challenging often, the halls of the Legislature.  You will not regret coming to DC, but you might just regret missing it!

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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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