AAEM Submits Written Testimony on Ebola Outbreak to House Subcommittee

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Written Testimony of Mark Reiter, MD MBA FAAEM, president, American Academy of Emergency Medicine submitted for the record to U.S. House Energy and Commerce Subcommittee on Oversight and Investigations, October 16, 2014.

Chairman Murphy, Ranking Member DeGette and members of the Committee, thank you for the opportunity to provide comments on your hearing focusing on the Ebola outbreak and efforts by the U.S. Government and our health care system to identify, treat, and protect the public health from this infectious disease.

The American Academy of Emergency Medicine (AAEM) is the specialty society of board certified emergency physicians, representing 8,000 members across the country. Whether it is an athlete suffering from a broken bone, an infant struggling to breathe, a victim struggling to survive a gunshot wound, or a patient dealing with debilitating symptoms from an infectious disease, our emergency physicians serve on the front lines everyday combating life threating conditions. Our emergency physicians, nurses, and medical support teams provide this type of care in often overcrowded, underfunded, and overburdened systems. A typical emergency department (ED) could see 100 patients a day while a more populated one could see 300. According to the CDC, in 2010 the number of visits to an ED was 129.8 million. This number continues to increase. Despite the well-intended efforts of the Affordable Care Act to direct non-critical and non-emergency patients to primary care providers, Americans frequently still choose EDs as their first option for care. EDs are, in particular, a first point of care for many immigrants and travelers who seek treatment in the United States.
Like many Americans, we are saddened by the toll Ebola has taken on the lives of many in West Africa and other countries and now the United States. We share in the concern for our fellow caregivers who appear to have contracted the disease from their efforts to save a now deceased patient. We are proud of our physician colleagues who are battling against Ebola in West Africa under challenging conditions in an effort to save lives and prevent further infections. Unfortunately, this disease poses significant challenges not only to the global health system but to our health system as evidenced recently in Texas, Georgia, and Nebraska.

Save the Date!

VIIIth Mediterranean Emergency Medicine Congress 
September 4-9, 2015
Rome, Italy

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The VIIIth MEMC is jointly organized by the American Academy of Emergency Medicine (AAEM), the Global Research on Acute Conditions Team (GREAT) Network & the Mediterranean Academy of Emergency Medicine (MAEM). In conjuction with the Italian GREAT Network Conference — organized by the GREAT Network.

www.aaem.org/education/memc

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Update from the President: Progress in California

I have recently participated in several media interviews where I raised AAEM's concerns regarding Tenet Health's plan to replace its independent emergency medicine, hospitalist, and anesthesiology groups in California with a national physician staffing company.

AAEM feels this would be highly disruptive to its hospitals and could compromise quality of care. These media interviews had much exposure in the local press and helped Tenet and the community to better understand our concerns. On September 5th, I participated in a conference call with Tenet Health leadership, an attorney for the Coalition for Quality Hospital Care, and the California ACEP President Dr. Osmundson. During the call, Tenet's leadership informed us they were no longer considering using one national physician staffing company for all of the involved California practices.

In addition, Tenet committed that they would begin contract renewal negotiations with the independent emergency medicine groups staffing its California hospitals, and attempt to partner with them to achieve their goals of better coordinating care across services. We are encouraged by these positive developments. We will continue to work closely with the involved independent emergency medicine groups and monitor this evolving process.

During the call, a position supported by California-ACEP (that it does not favor any physician group practice model over others) was erroneously attributed to AAEM as well (per a follow-up letter from Tenet). AAEM has always endorsed practice models based on fairness, transparency, financial equity, physician autonomy, and the best possible care of patients - qualities that we believe are exemplified by independent, local, democratic, physician-owned medical groups. AAEM responded with a follow-up letter to Tenet Health's Western Region CEO.

Take care,
Mark

Mark Reiter, MD MBA FAAEM
President, American Academy of Emergency Medicine

Austin City, No Limits

www.aaem.org/AAEM15

View from the Podium
Joseph Lex, MD MAAEM FAAEM 

I am excited about what’s happening as we plan our 21st Scientific Assembly, scheduled for February 28 through March 4, 2015 at the Hilton Austin in the Texas Capital. First and foremost, our invited keynote speaker has accepted our invitation to speak. Simon Carley, Professor of Emergency Medicine at Manchester Metropolitan University, Consultant in Emergency Medicine, and co-founder of the BestBets website (www.bestbets.org) and the St. Emlyn’s website (http://stemlynsblog.org) in mythical Virchester will visit with us in Texas. Dr. Carley has published more than 100 papers related to disaster medicine, diagnostics, evidence base medicine, and medical education. He is associate editor of the Emergency Medicine Journal and co-director of the Master of Science in Emergency Medicine program at Manchester Metropolitan University. He will give three talks, including our keynote session on “Evidence, Data, Belief, Denial and Cognitive Delusion: How Do We Really Practice Emergency Medicine.”

The second exciting bit of news is the development of a separate subcommittee to develop the immensely popular pecha kucha (PK) (chit-chat) sessions. The group chair is Joelle Borhart, MD FAAEM, of Georgetown. You may have heard Joelle speak at prior Scientific Assemblies. She is joined by Gentry Wilkerson, MD FAAEM, from the University of Maryland, and the husband-wife team of Zachary Repanshek, MD, and Jennifer Fisher-Repanshek, MD, from Temple University in Philadelphia. Zack was the 2012 AAEM Resident of the Year. The final member is Siavash Sarlati, MD, from LSU/Charity, who was a resident winner of the 2014 YPS Open Microphone Session in New York City.

Message from the President: Coalition for Quality Hospital Care

Dear members,

I wanted to update you on an escalating issue of concern to our members in California and nationwide. As many of you know, AAEM has voiced its strong opposition to Tenet Health's plan to replace emergency medicine, anesthesiology, and hospitalist groups at up to 11 hospitals in California with one out-of-state physician staffing company, using the profitable emergency medicine contracts to eliminate their anesthesiology and hospitalist subsidies (see my recent President's Message on the topic).

In addition, on July 11, I sent a letter to Tenet on behalf of our organization detailing our concerns (PDF). The letter states that AAEM believes Tenet's plan is "bad for Tenet, bad for its hospitals, bad for its physicians, bad for its patients, and likely runs afoul of federal fee-splitting laws and California's corporate practice of medicine laws." If Tenet moves forward with its plan, other hospital networks may be emboldened to take a similar approach in other parts of the country as well.

The leaders of several groups affected by the current scheme have contacted AAEM and asked for our assistance. I have spoken at length with many of these physicians; have sent letters outlining AAEM’s concerns to the relevant hospital leaders, hospital boards, and medical staffs. Recently, a coalition of concerned physicians, the Coalition for Quality Hospital Care, has been formed and has contacted us for assistance - the Coalition seeks to inform as many physicians as possible about this issue and generate more support against Tenet's plan. The Coalition is not asking for monetary contributions - but requests that AAEM members show their support by joining the coalition. The larger the group voicing concern, the greater chance we have to defeat Tenet's plan.

Time is running out for these physician groups. Tenet plans to meet with the chief executives of its California hospitals on August 31st to address this issue and then a decision is expected shortly thereafter. If you would like to show your concern about Tenet's plan, please take a moment and join the coalition at www.coalitionforqualitycare.com. Thank you for your continued attention to this issue.

Sincerely,
Mark Reiter MD MBA FAAEM
President, American Academy of Emergency Medicine

Fluids used in Fluid Resuscitation: "There's Nothing Normal About Normal Saline"

www.aaem.org/publications/podcasts/critical-care-in-emergency-medicine

David Farcy, MD FAAEM FCCM, Chairman, Department of Emergency Medicine at Mount Sinai Medical in Miami Beach, Florida, speaks with Peter DeBlieux, MD FAAEM, Professor of Medicine at Louisiana State University Health & Science Center in New Orleans.

In this episode, Drs. Farcy and DeBlieux discuss the fluids used in fluid resuscitation including isotonic crystalloids and albumin.

Or listen on the AAEM website 

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