Emergency Medicine is a young specialty within the house of medicine. We have unique challenges and needs. As such there are times when MOCEP advocates on its own with the powers-that-be. This is the case with the CME burden imposed on all emergency providers (physicians and nurses) an unintended consequence of Missouri’s Time Critical Diagnosis (TCD) law. While a formal announcement is still forthcoming, MOCEP wrote letters to the Department of Health & Senior Services and joined in a series of phone calls where we outlined our objections to the way that state regulators have been interpreting the TCD law’s regulations. We got DHSS to agree to a modification that should greatly reduce the annual CME burden on Emergency provides while still working to improve stroke, STEMI and trauma care in the Show Me state.
More often instead of going it alone, MOCEP finds it advantageous to work with other stakeholder to amplify our voice and gain the attention of the legislature and opponents. MOCEP has been working for a number of years toward the creation of a state Prescription Drug Monitoring Program. As many know, Missouri is the only state not to have a PDMP in place to help combat narcotic diversion and reduce inappropriate prescribing. While we haven’t been successful, we are part of an alliance that has coalesced around this and similar issues. Many of those groups, such as the Missouri Hospital Association (MHA) and Missouri State Medical Association (MSMA) can be powerful allies. We don’t always agree but when there is common ground we try and coordinate our efforts. MOCEP with other medical specialties, insurers, public health advocates and patient groups have over the past many years worked on Tort Reform, Pharmacist and Nurse “Scope of Practice” and physician payment issues. MOCEP along with many of these groups is deeply interested in the legislature’s actions related to Medicaid expansion.
Narcotic addiction and the appalling rise opiate overdose-related deaths are issues where emergency medicine is front and center. We were recently asked to join with a consortium of stakeholders including MSMA and MHA to try and address the fallout of this epidemic of overuse and abuse. ACEP put out a Clinical Policy on Appropriate Opiate Use in 2012. Maryland College of Emergency Physicians (MCEP) was successful in getting a policy enacted a few years ago. Groups in Missouri are working to come up with a similar guideline that emergency departments across the state can use to combat this ongoing problem. Not unexpectedly what MOCEP espouses is not fully endorsed by other stakeholders – compromise is critical in drafting these types of guidelines. Our goal is to come up with guideline that can be embraced and implemented in most emergency departments in Missouri without being overly directive or placing a new unwieldy administrative burden on emergency providers.
As 2015 ends, know that MOCEP will continue to work with others that share our goals and objectives, and if necessary stand alone, as we strive to advocate for Missouri’s emergency providers in 2016 and beyond. Your support and involvement are always appreciated. Consider giving the gift of time this holiday season by setting aside January 27th to attend MOCEP’s Advocacy Day in Jefferson City. Join with us as we battle for the needs of Missouri’s Emergency Physicians
In your service,
Douglas Char, MD FACEP