Twenty-five years ago, I was the Assistant Residency Director of the Emergency Medicine Residency Training Program at Charles R. Drew University of Medicine and Science, Martin Luther King, Jr./Charles R. Drew Medical Center.
Comedian Richard Pryor (1940-2005) once said “I was a Catholic until I found out I could never be Pope.” I was an ACEP member for a very brief time until I realized that there was no way that I could ever be President of that organization! In my opinion, ACEP was “all about the Benjamins” back then, i.e., all you needed to do was pay those high dues, whether you were Emergency Medicine (EM) trained, board certified or not!
Then, along came the invite 25 years ago to start an organization for board certified, emergency residency trained emergency physicians (EP) only! A democratic organization. How refreshing! The Mission Statement of the AAEM (the Academy) says it all. The declaration “[t]he personal and professional welfare of the individual specialist in emergency medicine is a primary concern to the AAEM” is a powerful message and true to form of the Academy.
Unfortunately, one change that I have seen in the practice of EM is less focus on the history and physical examination and more “blanket” ordering of tests, whether warranted or not. I have seen residents and interns look at a triage note or MSE note and order hundreds of dollars in tests before they have even introduced themselves to the patient! Triage nurses are ordering tests “per Protocol.” Less time is being spent in dialogue with patients. To me, this is disturbing. Some insurance companies are no longer paying for tests that “they” feel are unnecessary. In that regard, the patient is left with the burden of satisfying the bill. Aristotle (384BC-322BC) said that the “hand is second only to the eye.” I believe that the EP needs to go back to the basics of clinical reasoning. Look at the patient, engage and examine the patient. This may seem trivial to some, but I hope AAEM considers and addresses this issue. In the long run, it’s the patient that suffers from unnecessary testing. Let’s get back to talking to and examining our patients!
On a lighter note, I remember going to an AAEM Scientific Assembly in a room at the now defunct Riviera Hotel here in Las Vegas. I can’t remember if this was the first or the second Scientific Assembly. The room was not large, but it was packed. The energy in that room was incredible. The topics covered were important to my clinical practice. The fellowship was rewarding. It is exciting to see how the Scientific Assembly has grown, yet never lost its focus!
I am proud to be a founding member of AAEM and excited about its growth and development. I am especially ecstatic that Dr. Lisa Moreno-Walton will be AAEM’s first woman President! She is truly a phenomenal woman!