Steadfast in the Midst of Uncertainty
Issue: May/June 2020
Author: Lisa A. Moreno, MD MS MSCR FAAEM FIFEM – President, AAEM (2020-2022)
Things just don’t feel the same. I would like to say that it’s the excitement of stepping up to my role as the first female President of AAEM, and indeed, that is exciting. But this is not the kind of party a Latinx family from the South Bronx would be having when their mama becomes President. No, the social distancing, the cancellation of Scientific Assembly, not being able to thank you in person for the confidence you have placed in me, not having physical contact with my family, not having my house full of medical students and residents, not having big, loud, happy dinner parties when I’m not travelling, not visiting residency programs to talk about AAEM—that’s what feels so different. Without a doubt, these are unprecedented times. With uncertainty, we seek that which is familiar, and we depend on that which is reliable. The Academy is what it always has been: the Champion of the Emergency Physician, the uncompromising proponent of workplace fairness, a consistent voice for the emergency patient, reliably putting patient before profit. Like our members, your Board is at work, caring for COVID-19 patients. We understand the conditions that you are working in, because we work in those same conditions. Unlike the corporate executives who run the CMGs, AAEM board members are on the frontlines, working with inadequate personal protective equipment, striving to understand the novel aspects of unprecedented levels of hypoxia, determining the best time to intubate and the best settings for patients whose lungs remain highly compliant. We know what it is like to have to deny a family the right to be at a dying patient’s bedside. We know what it’s like to ponder ventilator rationing. Your Board is elected democratically: one member, one vote. And we are our members: working emergency physicians.
The Academy is taking dozens of calls each week from physicians who have been threatened with termination for speaking out about unfair and unsafe work conditions. The Legal Committee has formed a task force to respond to these calls individually and to provide resources and referrals. We are tracking the types of concerns expressed by members and non-members alike, so that we can represent the needs of emergency physicians. We listen when members report pay cuts and work hour modifications about which they were never consulted, decisions in which they played no part. Throughout the COVID pandemic, I have called for multiple ad hoc meetings of the Board to address emergent concerns of members, and we have responded to your concerns by developing eight policy statements on physician rights. We have asked every other emergency medicine society to sign on to these statements and have been joined by the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), the Society for Academic Emergency Medicine (SAEM), and the American College of Osteopathic Emergency Physicians (ACOEP). Board members have answered the call for interviews to elucidate the conditions under which we are working and to clarify our position on pertinent issues:
- South Florida Sun Sentinel – Dr. David Farcy – South Florida hospitals preparing for potential cases of coronavirus
- Univision – Dr. David Farcy – Coronavirus
- CalMatters – Dr. David Farcy – Facing doctor shortage, will California give nurse practitioners more authority to treat patients?
- AP – Drs. David Farcy & Mark Reiter – PPE shortage during COVID-19 pandemic
- AP – Dr. Mark Reiter – Triaging in hospitals overwhelmed by COVID-19 patients
- NPR – Dr. Lisa Moreno – Termination due to use of personal PPE during COVID-19
- EM News – Drs. Lisa Moreno and Robert McNamara – Termination of Dr. Lin
- Fox News – Dr. Lisa Moreno – Ventilator shortage during coronavirus crisis forcing doctors to decide who lives or dies
- E.W. Scripps Company – Dr. Lisa Moreno – If states’ should have additional efforts in place to track the number of cases of medical professionals contracting COVID-19
- The Wall Street Journal – Dr. Jonathon Jones – Research on TeamHealth
- The New Republic – Dr. Lisa Moreno – Early intubation of COVID-19 patients
In addition, I asked the Government Affairs Committee to form a COVID-19 Response Task Force under the leadership of Dr. Andy Walker. The Task Force created the letters that AAEM sent to President Donald Trump, the leaders of the House and Senate, and the Governors of all 50 states requesting that sovereign immunity be extended to us by raising the standard to prevail in a malpractice suit from ordinary negligence to gross negligence/willful misconduct, or both during COVID-19. We signed on to the American Medical Association’s letter to Secretary Azar requesting emergency funding for physicians under the CARES Act. The EM Work Force Committee and the Past Presidents Council then worked under Dr. McNamara’s leadership to write a letter of clarification to Sec. Azar taking the positon that this money should go to the DOCTORS and not to the CMGs or hospital groups who contract with doctors. We signed on to the Society for Academic Emergency Medicine’s letter to the public, urging social distancing and other safe practices during the pandemic. Dr. Farcy and I worked with AAEM staff to create a resources page for the website, which is constantly being updated so that you can find what you need to treat and test your patients, get help with transportation and housing, and the most recent guidelines from government agencies. Through our partnership with the American College of Medical Toxicology, we are bringing our members and the physician community updates on epicenter cities, best practices in PPE use, and conversations about emerging treatment strategies for a disease that is like no other we have ever treated. Dr. Farcy and I were both featured speakers in this series. A newly formed AAEM/RSA task force led by Dr. Haig Aintablian is working on language for proposed legislation to forgive medical school loans for residents and attendings who are serving during the pandemic. Dr. Antoine Kazzi is working with Past Presidents Council to create a task force to propose the government create a Fallen Heroes fund for physicians who contract COVID and for the families of physicians who die as a result of occupational exposure.
Nothing is different about the Academy. The only thing that has changed is that we are working harder to serve you better at a time when you are working harder to serve our patients better. We continue to be the Champion of the Emergency Physician, the voice for our patients and to work alongside you in the emergency departments. Well, another thing that has changed is your President. I am beyond proud that the Academy continues to champion diversity and to insure that AAEM looks more and more like America’s emergency physicians. I am beyond proud that you have elected me to represent AAEM as your President. I commit to serve you to the very best of my ability, to represent you well, and to be available and responsive to your needs always. I commit to stand on the shoulders of the giants who came before me to ensure that AAEM retains our proud heritage as what it always has been: the Champion of the Emergency Physician, the uncompromising proponent of workplace fairness, a consistent voice for the emergency patient, reliably putting patient before profit. In the midst of uncertainty, you can depend on AAEM.