Open Letter to ACEP Councillors
Bob Solomon MD
Editors Note: This post is taken from social media. The specialty of Emergency Medicine is on fire. Profits are being priotizied over patients in the once noble specialty of emergency medicine. Our chance to bring our largest specialty society back to advocating for patients is now. The future of the American College of Emergency Physicians and whether or not we prioritize integrity ad patients over profits for external business interests rests in the hands of the ACEP council.
I am writing here because I could not be with you this weekend. My health prevented my participating in the Council meeting or attending the remainder of ACEP21. I wish I were there! I learned early today that Bob McNamara is a candidate from the floor for the Board of Directors. When I was a fairly junior Councillor, in the early '90s, Bob gave me a chuckle in a Reference Committee hearing. After I spoke at a microphone, he was next, and he began by saying, "It's tough to have to follow the wisdom of Solomon." Dr. McNamara spoke then of some of the same issues to which he has been drawing attention in recent years. They did not truly resonate with me back then, but my thinking about our profession and our specialty has changed quite a bit over the years. I am near the end of my career, and it would be easy for me to shrug my shoulders and think, soon it won't be my problem - or set of problems - that we are being taken over by private equity, moving EM further in the direction of being, first and foremost, profit-driven; that we have contracts with nary a hint of due process, so we can be removed from the schedule if we speak up about issues in quality of care and patient safety. If we don't keep our heads down and remain silent about such things, we are suddenly considered "not a good fit." It is a rare instance, indeed, that any CMG will stand behind the pit doc who is in the right, fearful of jeopardizing the contract. [I know this from personal experience: in 1994 I was working for a CMG when one of my docs annoyed a hospital VP by calling her, as the on-call administrator, in the middle of the night. The next morning I was asked by the VP to give my doc a stern remonstrance. I said I couldn't do that, because she had done exactly what she was supposed to do when a consultant refused to admit a patient or come see him and take responsibility for disposition. Shortly thereafter I was informed that my services were no longer needed.] Yes, I could think it will soon not be my problem. But I have a daughter who is a senior EM resident, and I am especially disappointed that I will not be with her in Boston this week. But there will be other ACEP meetings we can attend together in the future. She, more than anything else, is my reason for keeping the passion of my fires burning for doing what is right for us and for our patients. In this and other fora in social media, ACEP has come under harsh criticism for failing to adopt policies that might help the practicing emergency physician, focused on issues of due process and transparency in billing and more generally in financial operations. Dr. McNamara has been a compelling spokesman for these critical issues. Electing him to the ACEP Board of Directors would send a clear signal that the gravity of these issues is being taken seriously by the Council and that the Councillors want the Board of Directors to take them very seriously as well - in both words and actions. On the Board, Dr. McNamara may, at times, be a lone voice in the wilderness - a position I know can be frustrating, because I found myself there on occasion in my six years on the Board. But I believe that voice is needed, now more than ever. In all my time among you in the Council, going back more than three decades, I never voted for a candidate from the floor. If I were in Boston this weekend, it would be the first time, and I would cast that vote in the belief that it is in the best interests of the College, the specialty, and the profession.