The Trauma Issue
President’s Letter
Dear MOCEP Members,
It is an incredible honor to serve as the President of the Missouri College of Emergency Physicians (MOCEP). I am humbled by the opportunity to represent the outstanding emergency physicians, residents, fellows, medical students, and emergency medicine advocates who care for patients across our state every day. Missouri’s emergency departments stand on the front lines of healthcare.
My journey with organized medicine started during medical school at Mizzou with the Student National Medical Association (SNMA), where I was chapter president for two terms, then moved into regional leadership as the Associate Regional Director, and finally served as Regional Director and a member of the national Board of Directors.
Congratulations New ACEP Fellows
Congratulations to our newest FACEP:
Seth Stratton, MD, FACEP
St. Louis, MO
For more information on how to become an ACEP Fellow, please visit the ACEP Fellowship page.
Traumatic Brain Injury
Written by Jennifer Cooper-Lewis, DO, FACEP
Traumatic Brain Injury (TBI) is sustained by an estimated 1.7 million people in the United States annually. The highest rates of TBI are seen in a trimodal distribution, children less than 5 years, adolescents 15 to 19 years and adults over 75 years. The most common cause of TBIs in all age groups is due to falls. The symptoms of TBI are broad and range from mild to moderate to severe TBI. Severity is determined most commonly using the Glasgow Coma Scale (GCS), duration of loss of consciousness and post injury amnesia. Forty-three percent of patients hospitalized for TBI report a residual disability one year after their initial injury. There are over 55,000 deaths annually attributed to a TBI in the United States.
Read MoreThe Case for Physician Unionization: A Double-Edged Scalpel
Written by Joseph Schuster IV, DO
For most of the 20th century, physicians practiced as independent professionals — owners of their time, their practices, and their clinical decisions. That era is largely over. Beginning in the early 2000s and accelerating sharply through the 2010s, private equity firms and large hospital systems began acquiring physician practices at scale. The pitch was appealing — competitive salaries, liability relief, and freedom from the administrative burden of running a business. What many physicians received in return was something far less appealing — loss of autonomy, and a seat at a table where they were no longer invited to speak.
Read MoreCareer Transitions
Written by Douglas Char, MD, FACEP
Career transitions are an essential part of the evolution of one’s professional life. Transitions can take place at any time and for a variety of reasons. The most obvious transition is entry into practice at the end of residency or fellowship. As physicians get older, they face a period of transition during which they must decide whether to continue practicing or retire from a life in medicine. Dr. Sonia Ramamoorthy (Clin Colon Rectal Surg 2023) notes that crafting your career is one of the most important things we do with our lives. She says it is no different from other important life decisions and will have significant repercussions for years to come.
Read MoreMOCEP Research Grant Results Published
In 2021, MOCEP awarded a Resident Research Grant to Ian Ferguson, MD at Washington University. Dr. Ferguson worked with his preceptor, Chris Carpenter, MD, on this project entitled “Evaluating ACEP Clinical Policy Awareness and Trustworthiness Among Emergency Medicine Residents and Attendings.” MOCEP is pleased to share with you that the research project has been published in Journal of Public Health and Emergency.
Read MoreWeighing the Utility of Serum Lactate in Obese Patients with Sepsis
In addition to the recently published MOCEP Resident Research Grant project, MOCEP is also pleased to share an article from another grant-supported research team. This piece, focused on weighing the utility of serum lactate in obese patients with sepsis, offers a closer look at the project and its relevance to emergency medicine practice.
Written by: Manoj Arra, MD, PhD, Christopher Holthaus, MD
Sepsis remains a prevalent but sometimes puzzling disease in emergency departments throughout the world, challenging ER physicians with frequently changing diagnostic criteria, common disease mimics, and financial implications of “appropriate” management. Sepsis is defined as a pathological host response to infection characterized by vital sign abnormalities, organ dysfunction, and ultimately death. It exists on a spectrum from low-mortality disease to high-mortality shock states. The Surviving Sepsis Campaign (SSC) was founded over 30 years ago as an attempt to improve disease identification and mortality, especially when sepsis progresses to septic shock. Subsequently, a standardized approach to disease treatment was established, composed of early antibiotics, fluid resuscitation, and vasopressors. An important component of sepsis detection involves measurement of serum lactate, a non-specific biomarker that can potentially serve as a measurement of disease severity.
Read MorePediatric Emergency Medicine (PEM)
Resource Page
Did you know MOCEP has a dedicated Pediatric Emergency Medicine (PEM) Resource Page? This page was designed to support hospitals and providers across Missouri, especially those who may not have immediate access to a pediatric hospital or pediatric specialty resources in their area. The site includes evidence-based clinical practice guidelines, pediatric antibiotic recommendations, disaster preparedness resources, suicide prevention and gun safety tools, PEM podcasts, transfer center information, and more. We encourage members to take a few moments to explore the content, share additional resources that may benefit others, and pass the page along to colleagues who may find it helpful.
PEM Resource PageMissouri Emergency Medicine Symposium Brings Together Physicians, Residents, and Students at the Lake
The Missouri Emergency Medicine Symposium was held May 29, 2026, at Margaritaville Lake Resort in Osage Beach. It was a fantastic day of education and connection with a wonderful turnout from emergency physicians, residents, and students from across the state.
Read more about the SymposiumMOCEP Recognizes 2026 Award Winners
During the 2026 Missouri Emergency Medicine Symposium, MOCEP was proud to recognize several outstanding members of Missouri’s emergency medicine community. This year’s awards reflected a refreshed recognition program designed to honor excellence across many areas of emergency medicine, including student achievement, resident research, education, community practice, innovation, leadership, and lifetime service.
Read MoreMissouri Delegation Advocates for Emergency Medicine at ACEP LAC 2026
The ACEP Leadership and Advocacy Conference (LAC) took place from April 26-28 in Washington, DC, bringing together emergency medicine leaders from across the country. Representing Missouri, Drs. Kene Chukwuanu, Jonathan Heidt, Robert Poirier, Sai Rajaramsiva, and John Verhey participated in this important event.
During their time in DC, the Missouri delegation met with Rep. Bob Onder and staff from the offices of Rep. Wesley Bell, Rep. Emanuel Cleaver, Sen. Eric Schmitt, and Sen. Josh Hawley. They discussed key legislative priorities, including “Protecting and Preserving Medicare’s Promise,” “Restoring Autonomy and Safety in the Emergency Department,” and the “Addressing Boarding and Crowding in the Emergency Department Act.”
The delegation reported successful meetings and felt their efforts made a meaningful impact on the future of emergency medicine. Their advocacy underscores the importance of continued engagement with policymakers to address critical issues facing the field.
MOCEP Members in the News:
Dr. Joan Noelker Recognized for Teaching Excellence
MOCEP congratulates Joan Noelker, MD, Vice Chair for Education at Washington University Emergency Medicine, on being recognized with the Distinguished Service Teaching for Clinical Care Award.
According to Washington University Emergency Medicine, Dr. Noelker was honored for the clarity and commitment she brings to the learning environment, as well as the impact her teaching has on Phase 1 medical students at Washington University School of Medicine.
We are always proud to see MOCEP members recognized for their leadership, service and dedication to medical education. Congratulations, Dr. Noelker, on this well-deserved honor.
Congratulations to Missouri’s Graduating and Incoming Emergency Medicine Residents
MOCEP congratulates the 2026 graduating Emergency Medicine residents across Missouri and welcomes the incoming classes joining programs throughout the state. We are proud to recognize these physicians as they move into practice, fellowship, and the next stage of their Emergency Medicine careers, and we look forward to seeing the impact of the newest residents entering training this year.
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