Issue: March/April 2020
Author: David A. Farcy, MD FAAEM FCCM
“Leaders are made, they are not born. They are made by hard effort, which is the price which all of us must pay to achieve any goal that is worthwhile.”
- Vince Lombardi
We are living in these times
Where the evil one has come to rob us blind, oh yeah yeah yeah
Oh people, we must understand
That it's time to wake up and do what we can, oh yeah yeah yeah
- Lenny Kravitz
As, I write my last president’s message, I have been reflecting on the last 27 months. Thank you for the amazing opportunity you gave me to earn your trust and support. My last president’s message will be a call to action. Our specialty is under attack from every possible angle… insurance companies, the threat of advanced practice provider (APP) independent practices, CMGs controlling our practice, congress “fixing” the balanced billing issue, etc.
As a specialty, we need for all emergency physicians to get involved. I often hear: “Why should I join an AAEM committee?” “Why should I write and visit my congressional representative?” “Why should I encourage others to join AAEM and get involved?” “Why should I donate to the AAEM PAC?” “I am content, I am happy where I am!” This is the “laissez-faire” attitude that got us where we are at today! Laissez-faire is a French noun meaning “attitude of letting things take their own course, without interfering”
We allowed others to make decisions for us, we allowed others to be at the table making decision for us—not just emergency physicians, but all physicians.
In one of my past presidential messages I wrote: “When people are passionate about something, it drives them to become engaged, to learn, to educate, and to want everyone else to listen too. However, most often the reality is that we are “too busy” or have “no time” to take up just another concern in our already busy personal and professional lives. I am deeply passionate about the work AAEM is taking on and my wish is for all of our members to be passionate as well.” But today, it is not an option anymore to just be passionate, it is time to wake up! Time to set aside time for your future! For our patients!
This issue was brought home to me last month as I was honored to be the Doctor of the Day in Tallahassee. This happened to be the day when the Florida legislature was considering the issue of granting APPs in Florida independent practice rights. Is it in our patients’ best interest to allow pharmacists and others to prescribe antibiotics? Physicians debate and complain to each other in-person and on social media, but I was the only emergency physician in Tallahassee that spoke to the legislature on this issue on that day. However, many APPs were present and spoke. We need more emergency physicians to be willing to inform legislators on the dangers to the public of allowing such independent practice.
It is time to take action. Posting complaints on social media is not effective if that is the only action that we take. People post and repost, giving them a sense of accomplishment. But this is far from enough. Social media is a great platform to get an idea started but unless there is action behind the words, nothing tangible is accomplished. Take, for instance, the Arab Spring — a series of protests that spread across the Islamic world in 2010 in response to an oppressive regime, anti-government for democracy, freedom of election, human rights, economic freedom, to name a few. People used social media to voice their opinion and to show the rest of the world what was happening via social media. But, there would not have been an Arab Spring if people did not also take to the streets, and strike in hope of affecting change. I am not calling for a revolution, but I am calling for action. Let your words be followed by actions that help bring about change. If your words are not followed by actions, there will be little impact. Patients will be lost in the shuffle and will suffer the complication of our broken system. Emergency physicians will be replaced by APPs and will take significant pay cuts. We will be signing thousands of charts for APPs. Pharmacists and any others who take a year or less course will be able to treat patients. Some doctors will not be able to pay their student loans and will be making more money driving for Uber/Lyft, like we are seeing in other countries. It is time to make an impact. It is time to say today is the day that I will not allow others to make decisions that affect my future. Today, I will make sure that I renewed my membership. Today, I will encourage my colleagues to join AAEM. Today, I am giving a shift a year to the Political Action Committee. Today, I will get involved and join a committee. Today is the day that I will contact my representative. Today is the day that I will take action.