Fall 2010 Issue

From the President
Jeremy Rogers, MD

Conference Dates Changed

Each year, Alabama ACEP’s Southeastern Chapters (SEC) conference in SanDestin, Florida has become one of the best in the southeast. Our conference continues to grow each year. The number of attendees increased significantly this past year, and we had the most exhibitors we’ve ever had.

We continue to add new states that are joining our regional conference. Next year, we will welcome South Carolina to our conference! This makes 7 states that support this conference! Mark your calendars for the new dates for the AL ACEP conference on June 5-9 in SanDestin.
 

EM Practice News

As you know, Alabama recently passed a new EMS bill. A public hearing on the Proposed EMS Rules will be held November 30, 2010, at 10:00 a.m. in Montgomery at the RSA Tower, Suite 1586. Written or oral comments will be received until the close of the record December 3, 2010, at 5:00 p.m. All comments and requests for copies of the proposed rule should be addressed to:

Dennis Blair
Alabama Department of Public Health
Office of EMS and Trauma
201 Monroe Street, Suite 750
Montgomery, Alabama 36104

CME Requirements Reminder
Remember that the Alabama Board of Medical Examiners has increased the CME requirements for 2011. The CME requirement for physicians and physician assistants licensed in Alabama is 25 AMA PRA Category 1 credits™ or equivalent annually.
Read more…

Chapter Survey Still Open
The ALACEP Board of Directors would like to make sure we are meeting the needs of our members. We invite you to fill out the following survey to help guide our efforts. It should take no more than ten minutes to complete and will give us invaluable information for future planning. Please provide your responses by Friday, November 19th. As a bonus, if you complete the survey, you will be entered in a drawing, the winner of which will have their registration fee for the 2011 Southeastern ACEP Conferences (June 6-9th, 2011) waived.
Click here for the survey…

High Priorities for Health-Care Reform Implementation
ACEP analyzed every word of the law’s more than 2,000 pages and proposed new priorities and tactics to the Board of Directors, which they approved in June. ACEP will turn up the volume in the coming year to clarify the priorities of emergency medicine to policymakers.
Read more…

On-line Medical Control Web Course
The Alabama Department of Public Health, Office of EMS & Trauma (OEMS&T) is proud to announce the transition of the Medical Directors Course from the pencil and paper format to a web-based program. Effective immediately, all initial Medical Directors Course offerings and all required annual refreshers will only be available via the web-based course. The complete course will be available for physicians needing their initial Medical Direction Physician Identification Number (MDPID) and for the physician re-activating an old number. The refresher course will be an annual requirement to update all active medical direction physicians on any changes to State EMS protocols as approved by the State Emergency Medical Control Committee (SEMCC).

Upcoming Meetings

Emergency Department Directors Academy - Phase I
November 15-19, 2010
Omni Dallas Park West - Dallas, TX

Governmental Affairs Conference
Medical Association of the State of Alabama
February 5-8, 2011
Washington, DC

Reimbursement Trends and Strategies in Emergency Medicine
February 16-18, 2011
Caesars Palace - Las Vegas, NV

Advanced Pediatric Emergency Medicine Assembly
American College of Emergency Physicians
April 11-13, 2011
Hotel Del Coronado - San Diego, CA

Leadership & Advocacy Conference
American College of Emergency Physicians
May 22-25, 2011
Omni Shoreham Hotel - Washington, DC

Annual Meeting
Medical Association of the State of Alabama
May 26-29, 2011
SanDestin, FL

Southeastern Chapters (SEC) Conference
Alabama Chapter, ACEP
June 5-9, 2011
SanDestin, FL

Clinical News

CME Article on Sore Throats Now Available
Originally printed in ACEP News, the “Focus On” series of articles brings the latest literature and best practices to help the busy emergency physician. This issue’s topic, “Sore Throats -- What Really Works?,” will help the emergency physician review the incidence of strep pharyngitis in different populations, understand present guidelines regarding the diagnosis of strep pharyngitis, and develop a plan of care for treating your next patient with a "sore throat." 
Read the article online and then take the CME quiz.

The Effective Physician: Chest Pain in the Emergency Department
Over 8 million people seek emergency department (ED) attention every year for assessment of chest pain. The American Heart Association recently issued a scientific statement to give guidance on rapid, effective approaches to the assessment of such patients. Conclusions: Most patients who present with chest pain to ED settings do not have acute ischemia: Less than 5% have an ST segment elevation myocardial infarction, and up to 25% can have a non–ST segment elevation event. Up to 7% of patients with chest pain after cocaine exposure have infarctions. At the same time, up to 2% of patients with acute coronary syndromes (ACS) are inadvertently discharged from EDs with potentially twice the risk-adjusted mortality of patients admitted for management of acute ischemia.
Read the Entire Article

Combination of Two Oral Drugs Shows Promise for HCV in Small Study
A combination of two oral drugs for reducing viral load in hepatitis C patients had good safety and tolerability in a small, phase I study. The finding, published online Oct. 15 in the Lancet, points the way toward an alternative to the current standard of care – subcutaneous pegylated interferon-alfa plus oral ribavirin – which has limited tolerability and efficacy. The novel therapies that were tested in this study are RG7128, a nucleoside polymerase inhibitor, and danoprevir, a protease inhibitor, wrote Dr. Edward J. Gane of Auckland (New Zealand) Clinical Studies Ltd., an early-phase clinical pharmacology unit, and his colleagues.
Read the Entire Article

Nominations Accepted for ED Director of the Year

The Emergency Medicine Foundation (EMF) is now accepting nominations for the 2011 Blue Jay Consulting/EMF Award for Emergency Department Director of the Year. 

The award was created to identify and recognize an individual who has made significant strides in developing collaborative relationships with nursing to implement and improve operational and clinical standards in five specific areas -- quality patient care, operational effectiveness, education, community service, and a synergistic approach to leadership within the hospital or hospital system. 

Because successful emergency departments have strong collegial relationships between physicians and nurses, these collaborations can make lasting improvements in quality care and patient satisfaction. 

“The collaborative nature of emergency medicine is reflected in the goals of the Blue Jay award to recognize the successful ED director who demonstrates team work with the nursing leadership of their department,” said Mark J. Feinberg, Managing Partner, Blue Jay Consulting. “Our hope is that this award will provide encouragement to all who work in emergency medicine to continue to seek out every opportunity to improve patient care in the ED.”

To be considered, the nominee will have created and sustained a high degree of patient satisfaction with emergency care delivery and will have implemented creative and innovative strategies to improve all areas of the emergency department.

Dr. Rex G. Mathew, vice president of emergency medical clinical operations at Thomas Jefferson University Hospital in Philadelphia, was honored with the inaugural Blue Jay Consulting/EMF Award during the April 2010 Emergency Department Director’s Academy (EDDA) in Dallas, Texas. 

With almost 80 nominations from some of the best and brightest directors in emergency medicine, the selection process was challenging. Dr. Mathew was ultimately chosen because of his demonstrated leadership abilities and clinical knowledge in working with leaders throughout the hospital to improve care in the emergency department.

The three finalists for 2010 included Dr. Patrick J. Crocker, chief of emergency medicine at Dell Children’s Medical Center of Central Texas in Austin, Texas, who was instrumental in working across disciplines to create the Comfort Zone Program  addressing the comfort, anxiety, and pain perception of patients. Dr. William Dalsey, chairman of the department of emergency medicine at Kimball Medical Center in Lakewood, NJ, was also a finalist because of his collaborative approach to patient care that earned Kimball Medical Center top honors for the last 5 years in patient satisfaction scores. Dr. Paul Ernest Pepe, chief of emergency services at Parkland Health and Hospital System in Dallas, Texas, was another finalist. Dr. Pepe’s strong team philosophy, work ethic, and philosophical temperament stood out in his work at one of the most visible emergency care centers in the country.

“This year the Emergency Medicine Foundation has a special desire to work with young investigators to focus on health policy and process. The medical director award provides a most appropriate extension of this goal,” said EMF Chair, Dr. Alexander Rosenau. “The award process identifies and recognizes emergency directors who utilize actionable knowledge to improve the function of their emergency departments and the effectiveness of the health care delivery system of their institution.”

The Emergency Medicine Foundation, founded in 1972, is dedicated to serve as a catalyst to advance education and research in emergency medicine. To date, EMF has awarded nearly $10 million in research awards to advance emergency medicine science and research. For more information on the foundation, please visit our website. 

For a nomination form, visit www.emfoundation.org/directoraward. Nominations are due by February 18, 2011, and the 2011 award will be presented at the Emergency Department Directors Academy (EDDA) on May 2, 2011 in Dallas, Texas.

Town Hall Meeting Addresses ACEP’s Health Care Reform Priorities

With the nation’s health care reform law in place and no real expectation of its repeal, ACEP leaders discussed the College’s priorities for the law’s implementation process at a Town Hall session during the ACEP Council Meeting in late September.

“This is probably the most significant moment in our careers. Our Washington office is already working on all of this, but the discussions will heat up after the November elections,” said ACEP President Dr. Sandy Schneider. “We are all going to have to work together with one message. This is a time to build emergency medicine into a stronger emergency medicine.”

During the meeting, ACEP Immediate Past President Dr. Angela Gardner distributed a chart of the Patient Protection and Affordable Care Act of 2010 that matched provisions in the law with ACEP’s strategy. Some of the key priorities include:

• Extend the “prudent layperson standard” to grandfathered health plans to eliminate the need for prior authorization.
• Improve emergency department efficiencies.
• Improve the physicians’ quality reporting system.
• Recognize the important role emergency physicians play in providing the full continuum of care to Medicare beneficiaries.
• Raise concerns about new Medicare payment mechanisms, such as bundled payments.
• Distribute additional residency positions to emergency medicine residency programs.
• Highlight the education and training needs of emergency medicine as the work of the National Health Care Workforce Commission proceeds.
• Represent the emergency medicine perspective in identifying research priorities and establishing and implementing the research project agenda.
• Extend medical liability coverage and review the unique requirements of physicians who provide EMTALA-related services.
• Considered how the Federal Tort Claims Act may be applied to ensure the availability of emergency and on-call physicians.

“We will have to be diligent” as the lengthy and complex regulatory process continues, said Gordon Wheeler, ACEP’s Associate Executive Director for Public Affairs. “There will likely be attempts to slow funding for the law’s implementation, attempts to undercut and undermine its intent.

“As imperfect as the law is, there are a lot of things we would like to see happen in there,” he said.

To bolster the efforts of ACEP’s Washington, DC office, the ACEP Board of Directors approved a budget modification to provide more health care reform resources, including hiring two new staff members and contracting with a legal firm that specializes in regulatory law.

Dr. Steve Stack, an ACEP member and secretary of the AMA, said, “We need to focus on how we can work within this law. We are hopeful that there is not coverage without access. If all the uninsured (patients) have coverage, we know the ED patient volumes will go up and they are only going to get larger.”

Comments from members of the Council focused on concerns about emergency physician payments, projects that ultimately were cut from the reform package, and at what tables ACEP needs a seat now to protect and promote the interests of emergency patients and emergency physicians.

“The tables I want to be at are small tables in someone’s office, the people who are actually writing the regulations,” said Dean Wilkerson, ACEP Executive Director.

Mr. Wilkerson also explained that emergency physicians can and should get involved in the process, as well, by staying informed and informing ACEP of crucial issues at the state and local levels, joining the 911 network or the spokespersons network, writing concise newspaper editorials, staying active in their chapters, and donating to NEMPAC.

Emergency Medicine Foundation Expands its Funding Priorities

The Emergency Medicine Foundation (EMF) is pleased to announce an area of special emphasis for its fully funded grant categories in the 2011-2012 grant cycle. To better improve emergency patient care, illustrate value in emergency medicine research, and assist the practice of emergency physicians in a changing health care environment, the EMF Board of Trustees is emphasizing innovative health services and health policy research. 

EMF has been committed to supporting emergency medicine research by helping young investigators. Grants currently fully funded by EMF are the EMF Health Policy Grant ($50,000), the EMF Fellowship ($150,000 over two years), and the EMF Career Development Grant ($50,000). For this grant cycle, EMF encourages applications with a focus on health services research, including but not limited to, health policy, practice, medical liability, regionalization, patient safety, and hospital utilization. However, it is important to note that EMF welcomes all applications, including research that is not health services-based.

“The Emergency Medicine Foundation has committed to supporting actionable research that directly impacts the care of our patients,” said EMF Board Chair Alexander Rosenau, DO, FACEP. “EMF will continue to underwrite a wide variety of research. The EMF Board of Trustees believes that this new era in health care reform is not only momentous, but pivotal. It demands serious investigation by the best that emergency medicine researchers have to offer in health services and health policy research.”

The Emergency Medicine Foundation also offers several co-sponsored grants, including:  
EMF/SAEM Medical Student ($2,400 each, two available), due January 5, 2011

EMF/EMRA Resident Research ($5,000 each, three available), due January 5, 2011

2011EMF/ENAF Team Grant ($50,000,one available), due January 5, 2011 

EMF is pleased to announce two new co-sponsored partnerships: 
EMF/Medical Toxicology Foundation Resident Research ($5,000, one available), due January 5, 2011

2011EMF/Emergency Medicine Patient Safety Foundation ($10,000, one available), due January 5, 2011

Also new this year will be two directed research grants. The first is underwritten by Baxter in sub-cutaneous infusion ($50,000, one available) (due January 5, 2011) and the other is underwritten by Genentech in regionalization and stroke care ($100,000, one available) (due February 1, 2011).

Go to our website to upload your application and instructions. Grant deadline is January 5, 2011 for all grant categories except for the EMF/Genentech grant, which has been extended until February 1, 2011.

NEMPAC Receives Record Support

NEMPAC, ACEP’s Political Action Committee, reported record fundraising efforts during the Scientific Assembly in Las Vegas, spurred by upcoming November elections that could change the political landscape in Washington, DC.

Members of the ACEP Board of Directors and Council donated more than $155,000 at the meeting. An additional $5,000 was donated at the NEMPAC Booth in the Exhibit Hall. Coupled with the $681,000 raised from ACEP’s general membership prior to the meeting and the collective contributions from individuals in physician group campaigns, NEMPAC is well on its way to exceeding our record of $1,167,342 set in 2009.

Outstanding EM group efforts during Scientific Assembly included CEP America’s contribution of $100,000 through its advocacy fund; EMP’s collection of $106,000 from its individual ACEP members; TeamHealth’s donations of $50,000 from its ACEP members and goal of $100,000 by year’s end; and EMA’s NEMPAC campaign among its eligible ACEP member physicians with a target of $60,000 by year’s end.

NEMPAC also is conducting an ongoing campaign with the general ACEP membership to reach this year’s goal of $1.25 million. A member-wide survey and solicitation from NEMPAC will be mailed in the next week. NEMPAC is currently the 4th largest physician specialty PAC behind the anesthesiologists, orthopedic surgeons and radiologists – with a goal to become number one.
 

In November’s mid-term elections both House and Senate seats will be at stake, with the possibility of dramatic change in party alignment in one or both houses of Congress. With the ongoing health care reform implementation process, it is more important than ever that emergency medicine has a strong PAC that gives the specialty an important voice and an influence in DC.

Welcome New Fellows

Kevin Barlotta, MD, FACEP
William S. Herring, MD, FACEP
Marquita N. Hicks, MD, FACEP

Welcome New Members

Nima Bahraini, MD
Jason Booton, MD
Wyman W Cabaniss
Stephen A Daugird, MD
William C Ferguson, MD
Courtney Gibson, MD
McKenna Healy, MD
Rachel E Jones
Shruti Kant, MD
Brandon D Lokey, MD
Derek Patterson
Adam Rowe, MD
Martin F Schreeder
Hugh W Shoff
Brian Spears, MD
Adam White, MD

Copyright © 2009 Alabama Chapter ACEP. All rights reserved.

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