Common Sense

What's With All These Position Statements?

Issue: September/October 2020

Author: Jonathan S. Jones, MD FAAEM
AAEM President-Elect

 

You have likely noticed many recent position statements from the Academy. Some of these statements have been written by AAEM, while some are written by other organizations and endorsed by AAEM.

All of the Academy's position statements are published online at: www.aaem.org/resources/statements

There are several different types of statements, just click the corresponding links. AAEM has always held transparency in high regard as this is why you will always find all of the statements we have ever issued, openly published and accessible to everyone (members and non-members alike). If we feel strongly enough to issue a statement, then we won't ever try to hide it.

Dates of passage or endorsement can also be found. Due to the rapidly changing clinical and political environment, the last several months have seen a dramatic increase in the number of published and endorsed statements.

Given multiple recent questions as to why the Academy is releasing so many position statements, as well as several inquiries as to the content of the statements, on behalf of the board, I want to explain the process and answer some questions which the board has received.

How does AAEM decide what issues to address and what positions to take?

Issues are frequently presented by board members or officers. However, any AAEM member is welcome to bring any issue to the board. Other times, different medical organizations write a statement and ask AAEM to endorse it.

Decisions to publish or endorse a position statement are made by either the AAEM Board of Directors or the Executive Committee depending on the nature of the statement and timeliness of a reply. The Executive Committee is composed of the President, President-Elect, Immediate Past Present, Secretary-Treasurer, and Past-President's Council Representative. It is much quicker for the Executive Committee to discuss issues and so for timeliness sake, some statements are published or endorsed by with only the approval of the Executive Committee as per AAEM bylaws.

Regardless of who approves the statement, we always look at AAEM's mission statement and values in determining our stance. As all of our members, AAEM board members and officers have diverse viewpoints on many issues. Some would likely be described as liberal while others conservative. Some are likely democrats while others republicans and I know for a fact that one is proudly libertarian. However, while we have our own personal values and beliefs and do use these to determine the best course of action, when acting on behalf of AAEM, we strive to only consider the values of the Academy.

Why does the board not ask members how they feel prior to issuing a position statement?

The Academy is proud of its democratic principles and election process. However, just as the U.S. government is not a direct democracy, neither is AAEM. AAEM is a representative democracy. Each member has an equal vote in determining the leaders of the Academy. Those leaders are then entrusted with directing and managing the Academy in the best interest of all members. We function much like the U.S. government. Actually, we function much better with a singular focus. We debate and compromise and I assure you that no statement or position ever approved without genuine discussion.

However, it would be impractical and very nearly impossible to survey membership on every issue. Finally, it would be unclear how a membership survey should impact the decision to issue a statement as likely no issue, save our core mission, would garner unanimous member support.

All members are encouraged to communicate their thoughts to any AAEM board member, staff member, or other leader. Anyone may be contacted through info@aaem.org. Due to spam, etc. no member's, including no board member's, contact information is published online, but staff will quickly provide any board member's contact information once membership is verified.

But some of the recent position statements seem too political. Do they really have anything to do with emergency medicine?

The board feels that every position statement directly impacts emergency medicine. Otherwise we would not issue a statement. I will briefly discuss two recent statements which generated questions.

AAEM issued a joint position statement against a federal regulation which excludes transgender status from the legal definition of sex discrimination. It separately eliminated certain requirements for language translation as well as requirements for care of patients with a history of termination of pregnancy.

https://www.aaem.org/resources/statements/joint-endorsed/against-federal-regulation

AAEM also issued a joint statement on the death of George Floyd

https://www.aaem.org/UserFiles/file/AAEMReleasesStatementwithSAEMontheDeathofGeorgeFloyd.pdf

Why should AAEM get involved in race, police matters, transgender status, abortion, and foreign languages? Simply, AAEM is not getting involved in these issues as a whole. We view the federal regulation and racial inequalities in regards to our mission statement. The first line of AAEM's mission statement is: Every individual should have unencumbered access to quality emergency care provided by a specialist in emergency medicine.

The board knows that American’s and Academy member’s views differ on these issues and we respect that. The board neither supports nor opposes transgender issues in general, but we do support unencumbered access to emergency care for transgender patients. In our view, the federal regulation eliminated that access. We do not know exactly what happened in the situation with George Floyd and we are not calling for charges against the officers involved. However, we know that health disparities exist. We want every one of every race and every gender to feel welcome in the emergency department. Every individual should have unencumbered access to quality emergency care. It's really that simple.

I, our president, Dr. Lisa Moreno, and all board members welcome follow-up questions, comments, and any conversation. Common Sense encourages letters to the editor. Or contact any board member directly. AAEM is strong because of our diverse opinions coupled with our singular focus as the Champion of the Emergency Physician.