ACEP Council Meeting 2015
Christine Sullivan, MD FACEP
Larry Slaughter, MD FACEP
The annual ACEP Council meeting occurred in Boston, MA on October 24-25th. Missouri’s Chapter had 6 representatives among the 373 Council representatives from 53 chapters and 33 ACEP sections. Additionally, representation from the Association of Academic Chairs in Emergency Medicine, the Council of Emergency Medicine Residency Directors (CORD-EM), the Society of Academic Emergency Medicine (SAEM), and the Emergency Medicine Residents’ Association (EMRA) are included in the Council.
The agenda was full with 46 resolutions put forth as well as elections for leaders of ACEP. For the first time in recent years, the Missouri Chapter brought forth 4 resolutions and co-sponsored an additional resolution. Dr. Thomas Pinson spearheaded the resolutions and he and the board should be congratulated for their efforts in that all resolutions were adopted by the Council! The resolutions put forth by MoCEP directly impact our members’ practice of emergency medicine and included:
- ACEP refine the current policy statement defining urgent care centers to protect patients by ensuring accurate consumer information, provider qualifications, resources available, and costs are available to guide patients when seeking care. Additionally, the resolution requested that ACEP work with CMMS and related hospital and regulatory organizations to determine appropriate credentialing standards for these facilities to ensure public awareness regarding services available when presenting to such care facilities.
- CME burden in that board certification attests to appropriate knowledge in emergency medicine and that the State of Missouri through its Time Critical Diagnosis (TCD) initiative mandating 8 hours of CME for 3 diagnoses only will diminish education in other clinical areas important to our practice. The resolution requested that ACEP work with organizations (such as American Hospital Association and American Heart Association) to understand the comprehensive knowledge base of board certified/eligible EM physicians.
- That ACEP develop a policy statement to address current regulations regarding minimal arbitrary procedural numbers for credentialing and work with organizations such as TJC, CMMS, and the American Hospital Association to recommend appropriate credentialing standards for EM physicians. As an example, many EM physicians (particularly in small and/or rural hospitals) may be required to perform 5 central lines a year but may remain competent in this skill without having the opportunity to place that arbitrary number of lines.
- That ACEP issue a statement declaring that EM physicians should be reimbursed for ultrasound performance and interpretation as part of EM care in the ED and support efforts to reduce payment denials.
- A co-sponsored resolution to increase the number of EMRA Council representatives from 4 to 8 members. In 1992 EMRA was given 4 seats on the Council when it had 2,500 members and currently has over 6,500 members in addition to several thousand medical student and alumni members. As this organization represents the “future” of EM we should encourage early active participation of EMRA members.
Many other resolutions were adopted by the Council. To highlight, this includes:
Governance, Membership, Advocacy, and Public Policy:
- eliminating the requirement for a letter of recommendation from the state ACEP chapter or 2 letters of recommendation from current fellows to be submitted on behalf of ACEP members seeding fellow status;
- in an effort to address unethical expert witness testimony, ACEP can admonish non-members and report this to the expert’s clinical society, medical organizations, and state licensing boards;
- allow access to a searchable database for all prior council resolutions for Council members.
- ACEP will work with pharmaceutical companies to ameliorate drug shortages affecting emergency medicine, including ways to disseminate data regarding alternative use of drugs and establish relevant policies to support.
Emergency Medicine Practice:
- enable access for the use of epinephrine for anaphylaxis;
- establish clinical practice guidelines for the treatment of patients with benzodiazepine and/or opiate withdrawl;
- establishing state and national physician orders for life-sustaining treatment, including end-of-life registries;
- development in collaboration with ENA a policy statement endorsing the use of sub-dissociative ketamine as an analgeisic;
- ACEP acknowledges that patient satisfaction scores can be associated with many indicators of poor quality medical care and should not be used for physician credentialing or for EM practice incentives or dis-incentives;
- work with other organizations and stakeholders to develop multi-society definitions for boarding and crowding, including limiting the number of boarding hours and volume as a patient access and safety concern;
- develop policy to address concerns regarding telemedicine, supporting remote access to specialist care that also assures establishment of an appropriate doctor-patient relationship;
- work with radiology organization to define and develop guidelines for critical communications for ED radiology findings
Council adopted resolutions become College policy only after reviewed and approved by the ACEP Board of Directors. Additionally several other resolutions were referred to the BOD for further consideration and included: the use of patient satisfaction surveys in EM, standards for fair payment of emergency physicians, state board review of EM practice, and the use of body cameras worn by law enforcement in the ED. All in all, the meeting was very productive with a lot of important topics that should be on all MoCEP members’ minds.