Board Meeting Minutes

American Academy of Emergency Medicine
Minutes of Board of Directors Conference Call
October 24, 2005

In Attendance: A. Antoine Kazzi, MD; Joseph Wood, MD, JD; Tom Scaletta, MD; Robert McNamara, MD; Howard Blumstein, MD; Anthony DeMond, MD; Stephen Hayden, MD; James Li, MD; Kevin Rodgers, MD; Mark Reiter, MD. Absent: William Durkin, Jr., MD; Tracy Boykin, MD; Ghazala Sharieff, MD; Richard Shih, MD; Larry Weiss, MD. Staff: Kay Whalen, Janet Wilson.

Dr. Kazzi welcomed everyone to the call and turned the board's attention to the first agenda item.

Approval of September 1, 2005 Draft Minutes

Dr. Kazzi requested that, under the President's Report, the draft minutes be changed to read that "Sterling Healthcare has sent a check for $10,000 to help defray some costs to the physicians involved in the PhyAmerica malpractice issue after expenses are paid." Dr. Li Moved and Dr. DeMond seconded that the September 1, 2005 minutes be approved as corrected. MOTION PASSED UNANIMOUSLY.

President's Report

Dr. Kazzi reported that the recent Mediterranean Congress had been extremely successful with over 1,400 registrants. At the conclusion of the Congress, a meeting with EuSEM representation had been held to discuss future Congresses. It is likely that proposals will be received for venues in Italy and Turkey. The board expressed some concerns regarding the willingness of Americans to travel to Turkey and asked staff to survey the delegates from the Nice meeting to determine their willingness to travel to Turkey for such a Congress.

The planning for the IACEM Congress to be held in Buenos Aires is going well.

Dr. Kazzi had attempted to work with Florida ACEP in the fight against granting BCEM the same status as ABEM/AOBEM in Florida and had sent representatives to the Florida Board of Medicine's meeting when this issue was on the agenda. Unfortunately, Florida ACEP has decided not to work with AAEM on this issue, so we will need to proceed on our own.

The board then reviewed the responses that AAEM had received from the e-mail message regarding AAEM's Unity Proposal.

Dr. Hayden will work with staff and Dr. David Wald to explore ways in which AAEM and ACOEP can work together on JEM.

IFEM has asked AAEM to participate in their organization.

Dr. Kazzi then announced that he had stepped down as vice chair of emergency medicine at UCI to accept a position as chair of emergency medicine at the American University in Beirut. Therefore, he will not run for reelection to the AAEM presidency at the end of his current term. He provided these comments as a point of information to the board.

Treasurer's Report

In Dr. Durkin's absence, Ms. Whalen briefly reviewed the September 2005 financial statements that had been included in the agenda materials. AAEM continues to be in a strong financial position. At this point, it is difficult to determine the profitability of the 2005 Congress in Nice since not all of the expenses have been received.

Executive Director's Report

Ms. Whalen reminded the board that any new members who join AAEM after September 30 th are considered members for the following calendar year. She also reported that full-voting membership had increased 12% between 2004 and 2005.

The board then discussed the possibility of helping AAEM members in the Gulf region affected by the recent hurricanes. Dr. Blumstein moved and Dr. Wood seconded that any member residing in the Gulf region could request a dues waiver for 2006. MOTION PASSED UNANIMOUSLY.

Team Health Fact Sheet

Dr. Kazzi asked Dr. Reiter to compile a fact sheet on Team Health similar to the fact sheet that he had drafted on EmCare. The board then discussed the best communication vehicle for this information. Dr. McNamara moved and Dr. Rodgers seconded that AAEM send two e-mail messages regarding EmCare and Team Health. MOTION PASSED UNANIMOUSLY.

Corporate Practice of Medicine

Dr. McNamara reported on several physicians who have contacted AAEM regarding corporate practice of medicine issues in their states. Dr. Wood moved and Dr. Li seconded that Dr. McNamara be allowed to speak for AAEM on these issues and report back to the executive committee. MOTION PASSED UNANIMOUSLY.

Medical Expert Standard of Care

Dr. Blumstein reported that the "extraordinary cases" website was in the final stages of preparation. Staff was asked to send the URL for this site to the entire board.

Position Statement on Malpractice

Dr. Scott Plantz had requested that AAEM approve a position statement on malpractice. Dr. Blumstein presented a draft statement for the board's approval. After some modifications to the draft statement, Dr. McNamara moved and Dr. Li seconded that the following position statement be adopted:

AAEM Statement on Ethical Expert Conduct and Testimony

The American Academy of Emergency Medicine believes the following principles to be essential to the ethical conduct of an expert offering opinions or testimony in medical legal matters. Violation of these principles constitutes a violation of the Academy's Ethics policy and may be subject to sanctions as described there-in

Expert Testimony as Medical Practice

Provision of opinions, reports, reviews or testimony as a medical expert is part of medical practice. As such, an expert witness providing such services is subject to all applicable rules, regulations and standards as well as the oversight and authority of the appropriate state licensing body.

Qualifications of Expert

An expert witness offering testimony related to emergency medical care must be

1. board certified by The American Board of Emergency Medicine or the American Board of Osteopathic Emergency Medicine; and

2. actively engaged in the provision of emergent medical care to patients.

Scope of Testimony

An expert witness offering testimony should

1. offer testimony only about care that falls within the expert's area of expertise and training;

2. conduct a thorough review of relevant material including, but not limited to, medical records, test results, and witness statements or depositions prior to offering testimony or opinions;

3. review and be prepared to describe medical literature relevant to the care provided, including that literature provided by other witnesses when possible;

4. offer complete testimony (whenever necessary to avoid incomplete or inaccurate testimony, the expert must offer appropriate qualifications or clarifications); and

5. explicitly state whenever an opinion offered is not conclusive, as well as explain the reason(s) why it is not.

Duty to the Court

At all times, an expert witness offering testimony must

1. impartially assist the Court and its officers on relevant matters within the expert's area of expertise;

2. not advocate for the party who engages him or her as an expert witness;

Duty to Confer

At the direction of the court, an expert witness will confer with other witnesses to

1. attempt to reach agreement on matters within the field of expertise of the expert witnesses;

2. prepare and sign a joint witness statement describing matters of agreement and disagreement among the witnesses, along with the reasons for disagreement. 

In following the court's direction, the expert must exercise independent and professional judgment and must not act on the instructions or directions of any person to withhold or avoid agreement.

Professional Reimbursement

An expert witness, being engaged in the practice of medicine, shall be entitled to fair reimbursement for all work performed. In establishing a fee structure, the expert witness shall refuse payment based on case outcome.

MOTION PASSED UNANIMOUSLY.

AAEM Services Update

Dr. Scaletta reported that Dee Breaux will be able to outline the types of services for democratic groups that would be available through AAEM Services. In addition, the AAEM Practice Committee intends to produce a white paper on how to start a democratic group in the next year.

The AAEM Services board is working to establish an editorial board for the new templates.

Election Procedure Bylaws Change

The board then discussed the eligibility of candidates for the associate position on the board. After discussion, Dr. Wood moved and Dr. Li seconded that section 8.3 of the bylaws be amended as follows:

An EM resident in their final year of an accredited residency program may run for the associate member position on the board of directors, otherwise only those who are associate members at the time the nomination period is closed may run for this position. If the elected person becomes board certified during their term they may complete the year on the board.

MOTION PASSED UNANIMOUSLY.

The board also discussed the fact that it may be possible for the president of AAEM/RSA to also be elected as the association member of the board. In this instance, the board felt that the vice president of the AAEM/RSA should have a seat on the board.

New Business

The board then discussed the request to provide rental of AAEM's e-mail list. This discussion was tabled as Drs. Hayden and Rodgers will make a proposal regarding this issue for the next meeting.

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

Respectfully submitted,

Kay Whalen
Executive Director