Board Meeting Minutes

American Academy of Emergency Medicine
Minutes of Board of Directors Conference Call
July 10, 2006

In Attendance: Tom Scaletta, MD; Larry Weiss, MD, JD; Howard Blumstein, MD; Robert McNamara, MD; Anthony DeMond, MD; Stephen Hayden, MD; David Kramer, MD; Kevin Rodgers, MD; Andy Walker, MD; Mark Reiter, MD; Brian Potts, MD. Absent: Joseph Wood, MD, JD; Tracy Boykin, MD; James Li, MD; Richard Shih, MD. Staff: Kay Whalen and Janet Wilson.

Dr. Scaletta welcomed everyone to the call and turned the board’s attention to the first agenda item.

Approval of May 16-17, 2006 Minutes

Dr. DeMond moved and Dr. McNamara seconded that the May 16-17, 2006 board of directors minutes be approved as drafted.

President’s Report

Dr. Scaletta stated that the release of the IOM report had been interesting. The Washington Post had printed a letter from Dr. Scaletta as AAEM’s president. The board felt that this should be publicized to the membership.

The planning for MEMC 4 is moving forward. Dr. Scaletta had participated in a recent oversight planning committee conference call. Dr. Philip Anderson is serving as the AAEM executive chair. Dr. Antoine Kazzi continues to be involved.

Staff was asked to explore the costs of producing copies of the DVD containing the debate between Drs. Bob McNamara and Art Kellerman that was held at Temple University.

Dr. Scaletta also reminded the board that, as they had seen in e-mail messages, a new CMG has been awarded the contract for Northwest Community Hospital. Some of those involved with the situation there have contacted AAEM for advice. They are also seeking legal counsel.

A hearing for one of the groups that AAEM has been working with has been scheduled in Texas at the end of July. Dr. McNamara will be there to testify.

Dr. Scaletta continues to represent AAEM on an advisory panel to JCAHO on medication management.

Treasurer’s Report

Dr. Blumstein reported that the financial information included in the agenda materials was the same information that had been presented in May. We hope to receive the 2005 audit soon. Dr. Blumstein also noted that more money had been spent in legal fees than was budgeted for 2006.

JEM Update

Dr. Hayden reported that JEM has completely transitioned to an electronic submission process. The backlog of papers has also been reduced. AAEM will appoint two associate editors.

Executive Director’s Report

Ms. Whalen reported that AAEM’s full-voting membership is 8.8% ahead of the 2005 membership pace.

Fairness Document

The board then reviewed the Fairness Document that had been circulated via e-mail. Dr. Scaletta moved and Dr. DeMond seconded that the following be approved:

AAEM Certificate of Excellence in Emergency Department Workplace Fairness

The American Academy of Emergency Medicine strongly supports fair working practices for emergency physicians. Consequently, it will certify that an emergency department meets standards for employment excellence if its physician employees are guaranteed the following five workplace conditions:

• A reasonable due process policy.
• A reasonable policy of financial transparency that protects physicians against financial exploitation.
• A reasonable policy of financial equity that allows physicians to share in the department’s profits.
• A reasonable policy of political equity that allows physicians to improve their own working conditions.
• Employment arrangements that do not impose post-contractual restriction.

The Academy recognizes the existence of many different emergency department business models. The following examples are provided as guidelines that comply with the principles outlined above. These guidelines are not absolute, but reflect the spirit of fairness encouraged by the Academy. Thus, any group that believes it meets conditions for fairness is encouraged to submit an application for a certificate of excellence. Applications will be reviewed by the Academy. Departments that are deemed to fall outside fairness criteria will be provided direct feedback and given ample opportunity to reapply.

Principle	Examples of fair employment practices
Due process	Unilateral termination without cause and without rights defined in the medical staff bylaws is acceptable only during a provisional period of employment, not to exceed one year. Termination with cause requires a fair hearing upon request of the terminated physician.
Financial transparency	Partners are automatically provided information on total group charges, collections, management, and operational expenses, and other group income distribution on at least a quarterly basis.
Financial equity	For democratic groups, full partnership opportunities are available through a predefined process that does not exceed three years. Share distribution among partners is transparent.
Political equity	Governance procedures are published, with processes for election of leadership and partners, appointment of medical directors and administrators, and bylaws amendments.
Political equity	Practicing physicians must make all practice decisions (including those involving hiring, firing, staffing levels, and clinical processes) and have a primary fiduciary responsibility to their patients, not to a corporate entity or shareholders. No layperson (defined as a non‑physician or non‑practicing physician) can have a commercial interest in the practice or the right to control the professional judgment of any practicing physician. No layperson may be a corporate officer or director or occupy a position of similar control. Physician employment by hospitals or non‑profit entities is permissible when in accordance with state law.
No restrictions	Non-compete or similar clauses that affect where a physician may work upon leaving the group or upon group turnover are not conditions of employment.

MOTION PASSED UNANIMOUSLY.

North Carolina Board of Medicine

Dr. Blumstein reported that he will make a statement later this month before the North Carolina Medical Board regarding AAEM’s stance on board certification. AAEM has asked other EM organizations to prepare a written report to the Board as well.

Disaster Medicine Board Opposition Statement

There was much discussion regarding the statement included in the agenda materials. While the board endorsed the concept, they felt that the document needed to be edited. Dr. McNamara moved and Dr. Walker seconded that the board approve the intent of the position statement on a disaster medicine board, but empower the executive committee to approve final language. MOTION PASSED UNANIMOUSLY.

UCI Medical Student Conference

The board discussed the possibility of not only endorsing, but also sponsoring the UCI Medical Student Conference. Dr. Potts moved and Dr. Rodgers seconded that AAEM sponsor the UCI Medical Student Conference by matching the AAEM/RSA contribution up to $1,000. MOTION PASSED UNANIMOUSLY.

Guideline Approval

The board next discussed the request of the committees to have draft guidelines approved.

First, the urticaria or angiodema practice paper was discussed. Dr. McNamara moved and Dr. Rodgers seconded that the urticaria paper in the agenda packet be approved and posted on the website along with the appropriate disclaimer language. MOTION PASSED UNANIMOUSLY.

After the board had discussed the need to have consistency in the way that practice guidelines are approved by AAEM, Dr. Scaletta moved and Dr. DeMond seconded that any practice guidelines be sent for board review for a limited time. If no board member raises an objection and the guidelines have been submitted electronically to JEM for peer review, the guidelines will be posted on the AAEM website. MOTION PASSED WITH DR. DEMOND ABSTAINING.

Next, the board reviewed the ED Crowding document. Dr. McNamara moved and Dr. Scaletta seconded that the ED Crowding paper in the agenda packet be approved. MOTION PASSED UNANIMOUSLY.

Honorarium

The board then returned to the discussion that it had in May regarding an honorarium for board members who presented for AAEM at residency programs. After discussion, Dr. Scaletta moved and Dr. McNamara seconded that AAEM board members who give the AAEM informational presentation to residency programs that are located over 100 miles from their homes will be entitled to a $500 honorarium in order to partially compensate them for the time away from their practice. MOTION PASSED UNANIMOUSLY.

There being no further business, the conference call meeting was adjourned.

Respectfully submitted,

Kay Whalen
Executive Director