Diversity of Priorities and Talents
Issue: May/June 2021
Author: Andy Mayer, MD FAAEM
Editor-in-Chief, Common Sense
This last year will be one of those times long from now that you will tell your grandchildren stories about and reflect on the trials and tribulations, which you have faced. I suspect this will be similar to our elders reminiscing about the Great Depression, Pearl Harbor, the Kennedy Assassination, or similar epic type events from our communal past. The turmoil related to COVID, George Floyd, and the 2020 election will probably stand out in our minds forever. On a professional level in regards to emergency medicine, COVID will certainly stand out in our collective memory as one of the great tests of our medical infrastructure and the abilities and fortitude of each doctor on the frontlines of the pandemic.
The events of the last year will probably also go down for other significant reasons and will have long-lasting effects on our profession. The expansion of the independent practice of Non-Physician Providers (NPPs) was accelerated by the pandemic. The expanded used of these same NPPs by corporate management groups as a cost cutting measure will probably be long remembered. The possible glut of new emergency medicine graduates that has been predicted for several years may be finally becoming a reality. The decrease in emergency department patient volumes at the same time of record numbers of new emergency medicine residency graduates may present a perfect storm for graduating residents trying to land their first job. Recent comments and articles related to the difficulty of new graduates finding jobs is troubling. Just read the January 4th Washington Post article entitled, Young ER doctors risk their lives on the pandemic’s front lines. But they struggle to find jobs and see if you are concerned for our young colleagues as they try and enter the job market many with large student loan debts.
The reason I am discussing this is in regards to priorities onto which we as a profession need to place our focus on in the near future. Our collective prospects as a specialty are at stake and deciding where and how our efforts and energies should be prioritized is a question we must face in the short run. This is especially true as it relates to our organized emergency medicine societies. AAEM is no longer an upstart organization and is now over 25 years old. AAEM is also no longer a small group of vocal emergency physicians crying out in relation to board certification, the loss of independent practice, the dangers of corporate management groups, due process, and the other core issues, which prompted the founding of our organization. AAEM has developed into a broader and more mature organization and has attracted a broad group of emergency physicians who all recognize the necessity of our focus on these core values of AAEM. This same group also has, as they should, a broad spectrum of talents, interests, and priorities. We all come to emergency medicine with a different history. Each person has their own set of battle scars from their past and has a calling to try and make the world and our profession a better place.
This leads to a discussion about priorities for AAEM. Let us all remember that AAEM has a set of core values as outlined in our Mission Statement. Please review them and believe that the board of directors believes in these and works for you and advocates for each of you holding the valves below to be our core mission.
The American Academy of Emergency Medicine (AAEM) is the specialty society of emergency medicine. AAEM is a democratic organization committed to the following principles:
- Every individual should have unencumbered access to quality emergency care provided by a specialist in emergency medicine.
- The practice of emergency medicine is best conducted by a specialist in emergency medicine.
- A specialist in emergency medicine is a physician who has achieved, through personal dedication and sacrifice, certification by either the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM).
- The personal and professional welfare of the individual specialist in emergency medicine is a primary concern to the AAEM.
- The Academy supports fair and equitable practice environments necessary to allow the specialist in emergency medicine to deliver the highest quality of patient care. Such an environment includes provisions for due process and the absence of restrictive covenants.
- The Academy supports residency programs and graduate medical education, which are essential to the continued enrichment of emergency medicine, and to ensure a high quality of care for the patient.
- The Academy is committed to providing affordable high quality continuing medical education in emergency medicine for its members.
- The Academy supports the establishment and recognition of emergency medicine internationally as an independent specialty and is committed to its role in the advancement of emergency medicine worldwide.
The values above are a good starting point and remain the focal point of the Academy’s advocacy and focus. However, I do not believe that they have to be our only focus and that our organization does not need to exclusively limit itself as we mature as an organization under the tent of organized medicine. The Academy now has among our membership a group of talented emergency physicians with a diversity of interests besides our founding principles. Our publication has been including articles from many of the newer sections, committees, and interest groups as each of these groups organize and mature within the Academy. I am proud to publish their articles, which can lead to a broadening of our understanding of the issues and concerns of groups within the emergency medicine community, which have not been the historic focus of our efforts.
Our long-standing committees related to education, international emergency medicine, and academic affairs are now mature and our educational and international meetings are something that the Academy can look to with deep satisfaction. The Academy now also includes committees, sections, and interest groups focused on various clinical topics like ultrasound, critical care, pain and addiction, clinical practice, EMS, geriatrics, observation medicine, palliative care, etc. The Academy has deepened our focus on our traditional core issues with committees related to emergency medicine workforce, government and national affairs, legal, operations management, employed physicians, etc. We have also been fortunate to have groups of talented emergency physicians interested in what could be considered newer interests including women in emergency medicine; diversity, equity, and inclusion; social emergency medicine; wellness, etc. These committees, sections, and interest groups each attract a subsection of our membership who has a particular interest in these particular issues.
I bring this up as the editor of Common Sense. I have received some comments related to the broadening of the Academy’s committee structure and their submissions to Common Sense. Some members have commented to me that these sections and articles, which they produce, are diluting the message and the focus which the Academy needs to focus upon. I would strongly disagree as AAEM has grown and developed and has room for a broadening of our perspectives and activities. Our professional society is showing maturity and is serving as a platform for multiple points of view. Each member does not and should not be expected to agree with all of these ideas. The point is that I do not believe that the Academy expanding into these areas diminishes our focus on our core values as expressed in the mission statement. Instead they show that we are able to include many points of view and a diversity of ideas and priorities without losing sight of the major threats to our profession as emergency physicians.
Working in our committee structure has allowed our membership to meet and discuss issues which are important to them and work towards improving many aspects of our specialty. I ask you to consider that the cores values of our long-standing mission statement still ring true and remain AAEM’s main focus. Each individual member can also work on and become dedicated to other priorities at the same time. You as an individual will not and should not have to agree with every committee objective or article which it produces. I ask you to become more involved if you have a different idea or priority. Emergency medicine is a big specialty with an incredible mix of extremely talented physicians and we should bring all of our interests and passions to the table in our ongoing effort to improve our specialty. Please contact the editor if you would like to express your opinion related to this topic. Frank and honest discussion of the issues which we face and how we respond to them is crucial.