Common Sense

The Meaning of an Election

Issue: January/February 2020

Author: Andy Mayer, MD FAAEM
Editor-in-Chief, Common Sense


We are approaching election season again, which in our current world brings up many mixed emotions, and sadly can tend to disintegrate into complaints and allegations related to the system and the individuals involved. Certainly, there can be endless discussions related to the Electoral College, the primary system, and outside influence. In this article, I want to foster discussion related to the election process in some of our emergency medicine societies and discuss and contrast some aspects in this process.

One of the founding ideals of AAEM was related to the election of the organization’s board of directors and executive committee. A more direct election process was envisioned and established. The structure of the election process is an example of representative democracy where each full member has one vote and is eligible to vote directly for the President-Elect, Secretary-Treasurer and At-Large Directors. There are no councilor or special nominating committee for the election of members of the board of directors for AAEM. Each is elected directly by the members of the organization. This process was felt to represent a more democratic and fair way for a member to become a leader in our organization.

The next AAEM elections will occur in Phoenix at the Scientific Assembly. Elections occur every year in person at the Scientific Assembly. The President-Elect and Secretary-Treasurer are elected every other year along with several At-Large Directors. On the alternate year only At-Large Directors are elected. Candidates for any of these positions can be nominated by a member or can self-nominate if they chose to do so. Each candidate submits a position statement which is published in this publication in advance of the election. Full voting members are encouraged to go to the candidates’ forum which is held each year during the Scientific Assembly. During this session, candidates make a statement related to their candidacy and can be asked questions by any member in the audience. I encourage anyone who has not attended one of these sessions to do so and witness democracy in action. However, any member unable to attend the Scientific Assembly is still eligible to vote electronically. The official details of the AAEM election process are below:

AAEM Election Process

Any Academy member may nominate a full voting member for the board and any YPS member may nominate for the YPS director position. You must be a YPS member to be eligible to run for the YPS director position. Self-nominations are allowed and encouraged.

The candidate statements from all those running for the board will be featured in an upcoming issue of Common Sense and will be sent to emeritus, full voting, and YPS members.

Elections are held concurrent with the AAEM Scientific Assembly each year. Although balloting arrangements will be made for those unable to attend the Assembly, all members will be encouraged to hold their votes until the time of the meeting.

The Scientific Assembly will feature a Candidates’ Forum, in which members will be able to directly question the candidates before casting their ballots. Winners will be announced during the conference, and those elected will begin their terms at the conclusion of the Assembly.

ACEP Election Process

ACEP elections have a different process. I have never attended an ACEP election, but have read and discussed their process and the rules related to them can be viewed on the internet. The process is another form of representative democracy but it seems more in line with a parliamentarian system. Each chapter elects or appoints councilors who are the ones who elect the officers. This seems to be analogous to members of parliament in Britain voting on a prime minister. Below are some of ACEP’s election rules from their webpage:

Section 8 — President-Elect: Any member of the Board of Directors excluding the president, president-elect, and immediate past president shall be eligible for election to the position of president-elect by the Council. The president-elect shall be a member of the Board of Directors. The president-elect's term of office shall begin at the conclusion of the meeting at which the election as president-elect occurs and shall end with succession to the office of president. The president-elect shall be elected by a majority vote of the councilors present and voting at the annual meeting of the Council. The president-elect shall succeed to the office of president at the conclusion of the first ensuing annual meeting of the Council following the meeting at which the election as president-elect occurred and shall end at the conclusion of the next annual meeting of the Council, or when a successor is seated.

Rational arguments can be made for and against each system. One might argue that having only seasoned veterans who have been on the council or board of directors for a significant period of time should be eligible for higher office. It can be reasonable to think that institutional knowledge and experience is necessary for high office and that this can only be obtained by a long presence in the council or on the board of directors. Having a young maverick rise too quickly can lead to chaos or lead the organization down the wrong path. The alternative view is that the ability of a member relatively new to the organization or one who had not previously been politically active can passionately feel that a change is necessary and that the organization definitely needs new blood and new ideas at the top. I see both points of view but I personally lean towards having the entire membership decide on what is needed and which direction they want to point their professional organization towards.

The concept of individuals paying their dues and deserving a leadership position as a reward or honor related to their years of service to an organization personally bothers me. I do not think that just because a member has spent a certain amount of time on committees or doing the background necessary work needs to be repaid with a title. There is a danger in sitting in a room with the same faces year after year and thinking that one of them deserves or is entitled to a particular office due to their seniority or dedication to the society. Certainly, any organization needs to have some senior members to help prevent a rash or politically unwise policy or stance on any issue which might misrepresent the general membership’s position on a major issue. The balance between seasoned veterans and young and dynamic enthusiasm is probably the correct path but this is an issue to consider.

The prospect of outside influence on holders of high office also must be considered. ACEP and AAEM, I believe, want to represent the broad spectrum of emergency physicians and their various practice types. There are many issues which affect every emergency physician and obviously need to be discussed and a platform presented and supported by any society’s officers and board. However, emergency medicine is practiced in so many different ways and each can have significant challenges which can be the crucial issue in one practice type and be of no concern for another. Each type of practice needs representation and support from the officers and board of their organization. Both AAEM and ACEP have officers who work for corporate management groups. Their employment type should not exclude them from office, but certainly the board should naturally contain a balance of individuals from corporate, academic, independent, government, and other practice environments. There is a danger if one type of physician dominates. There cannot be even the perception that an officer is there to represent the interests of anyone or anything other than the membership at large.

I think that an election in either form is crucial to our specialty. Any emergency physician has to believe that the leadership of the emergency medicine specialty society whom they look up to will represent their interests. They need to believe that the said leadership was fairly elected and will represent the interests of the membership.


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