Find Your “One Thing”
By John Matheson, MD, FACEP
In the movie City Slickers, Curley (a seasoned old cowboy played by Jack Palance) holds up his index finger and tells Billy Crystal’s character, Mitch, that the secret to life is “just one thing.” Mitch asks him what the one thing is. Curley, smiling, responds “that’s what you have to find out.”
Each of us has something in our life that is of great meaning—something that brings us fulfillment, joy, and satisfaction. Too often, with our busy lives and multiple demands on our time and energy, we focus on other seemingly more urgent issues at the expense of these more meaningful pursuits. Of course, we intend to make time for them as soon as the current crisis has passed. But, we get another urgent email that needs our attention, and other fires flare up that need to be put out. Those activities and endeavors that feed our souls become ignored (or repeatedly postponed) because of all of the other things that have to get done.
As emergency physicians, we have a number of professional demands that we must balance with our families, personal lives, and other endeavors. Each is important. Finding the ideal balance that satisfies all interests is not easy and often might not seem possible. Burnout among physicians, unfortunately, is not uncommon as we are asked to do more and more with less and less, and it is particularly significant among emergency physicians. Physician wellness is one of my priorities. I am honored recently to have been named to the national ACEP Well Being Committee, and I look forward to helping find strategies and provide resources for clinicians to help prevent and reduce burnout among emergency physicians.
That “one thing” is different for each of us, but we all need something beyond our careers that brings greater meaning and happiness to our lives. I encourage you to identify what that is for you and then to nurture it. Make it a priority. Schedule it. Avoid the pitfall of allowing the other demands of life and career to overwhelm it. Doing this will bring you greater satisfaction in life and in your career, and it might just add longevity to both.
WA-ACEP Board of Directors Approves Slight Increase in Dues
Chapter dues increased from $190 to $225 on membership invoices that were mailed over the summer. The WA-ACEP Board of Directors approved the increase in February to keep pace with rising expenses, including the cost of retaining a contract lobbyist in Olympia.
“We felt WA-ACEP needed a full-time presence in Olympia to monitor legislative activity and ensure emergency medicine’s voice is heard,” said John Matheson, MD, WA-ACEP President.
For the 2015 Legislative Session, WA-ACEP retained the services of experienced healthcare lobbyist Susie Tracy of Northwest Advocates. Susie’s list of clients includes the Washington State Medical Association, Washington Academy of Eye Physicians and Surgeons, and the Washington Ambulatory Surgery Center Association.
Susie worked to help draft new legislation and, perhaps more importantly, defeat legislation counter to the interests of the chapter.
2015 marked the first time in several years that the chapter increased membership dues. In fact, dues for similar-size chapters -- like Arizona, Virginia, Minnesota and Maryland -- range from $265-$375 annually. The chapter continues to work to be fiscally responsible and provide the services of a large chapter for the dues of a medium chapter.
EDIE-PMP Integration Update
The Emergency Department Information Exchange (EDIE) and the Prescription Monitoring Program (PMP) now are linked in 72 of the state’s 93 facilities. One Health Port and Collective Medical Technologies are working together to provide notification of potential “at risk” controlled substance utilization by providing PMP data as a part of an EDIE query. PMP data will be sent if any EDIE trigger is met or if specific controlled substance triggers are met. This will accomplish two tremendously important objectives:
Improved utilization -Removal of the current cumbersome process of accessing information through the PMP. Providers will no longer have to sign on and access data. The information will be automatically pushed and embedded within EDIE alerts.
Removal of provider bias –The systematic process and automated notification will increase awareness of risk patients, not just the patients who “raise our antennas.”
If the EDIE and PMP are not yet linked in your facility, or if you have any questions on the status the integration, contact Pauline in the WA-ACEP office at email@example.com.
Washington State Supreme Court Halts Effort to Expand Certificate of Need
The Washington State Supreme Court agreed with a WA-ACEP-supported amicus brief challenging the Department of Health’s rule expanding the reach of the Certificate of Need (CON) review program. The court decided unanimously July 9 that the Department of Health exceeded its scope of authority with the 2013 rule that would have dramatically expanded the purview of the CON in Washington State. The amicus brief, submitted by the Washington State Medical Association with financial support from WA-ACEP, expressed concern that the rule might require a CON review for arrangements such as new agreements between physicians and medical practices with hospitals, exclusive contracts between physician specialty groups and hospitals, and any other type of joint services agreements with hospitals. Since emergency medicine providers enter exclusive contracts, this would have risked these
contracts having to go out to formal bid and CON process at each renewal which would have represented an increased cost without benefit to the providers, hospitals, or more importantly, the patients.
ED Directors: Register for the 2015 WA-ACEP Emergency Medicine Leadership Summit
Wednesday, Nov. 4, 2015
The Conference Center at the Seattle Tacoma International Airport
Located behind the Hawaiian Airlines/Lufthansa ticket counters
EM Leadership Summit topics include:
EDs in the ACO Environment
Imagine a World without Backboards and Cervical Collars
Narcotics in the Emergency Department: A CORE-REMS Program
Working with the Media
Open Panel Discussion
Full Schedule and CME Information
Directions and Parking
Why become an ACEP Fellow? Just ask your WA-ACEP colleagues
“It's a nice distinction that recognizes contributions beyond the clinical practice of emergency medicine. It shows that you are invested in your colleagues and advancing emergency medicine as a specialty. It also signals to other specialties within the house of medicine that Emergency Medicine is a distinct, academic specialty.” - WA-ACEP Secretary/Treasurer Pat Solari, MD, FACEP Class of 2014
“Being a fellow demonstrates active involvement in EM and commitment to improving the specialty. It also should reflect a desire for continued involvement in activities which promote advancing the care of our patients and solidifying EM as a specialty. For me it is signifies my desire to enrich my experience beyond the ‘clinical only’ arena. This may be related to organizational leadership (at institution or system level), education, academics, research, or administration. It represents individual commitment to the ACEP group effort. - WA-ACEP BOD Member Cameron Buck, MD, FACEP Class of 2014
The FACEP designation means more than just board certification – it indicates a true leader in emergency medicine. Eligible members must apply by Aug. 15 to be inducted at ACEP15 in October. If you have questions about your eligibility for Fellow Status, contact Membership and Customer Service at 800-798-1822, ext. 5, for your personal eligibility review. Learn more. Contact Pauline in the WA-ACEP office at firstname.lastname@example.org if you need help from the chapter.
Comment on ACEP Quality Measures for CEDR by 5 pm CST Aug. 21
ACEP developed the Clinical Emergency Data Registry (CEDR), which was deemed by the Center for Medicaid and Medicare Services (CMS) as a qualified clinical data registry (QCDR) for the 2015 performance year. A robust set of measures is incorporated in the registry to “promote evidence-based medicine and address gaps in care around emergency medicine.” Read more and comment.
ACEP is hosting a CEDR overview webinar Thursday, Aug. 6 at 7 am. To join, email email@example.com.
Help WA-ACEP Win: Join ACEP’s 911 Legislative Grassroots Network
Andrew Bern, MD, FACEP, 911 Legislative Grassroots Advocacy Coordinator, recently launched the Triple E Contest (Expand, Enhance, Engage) to encourage ACEP chapters to sign up new members for the 911 Advocacy Network, as well as encourage members to get involved and take their advocacy to the next level. Chapters receive additional points when members:
• Open/read the 911 Network Weekly Update;
• Respond to an Action Alert;
• Host or participate in an ED visit for legislators;
• Meet with a legislator back home or attends a town hall meeting;
• Deliver a NEMPAC check to a fund raising event;
• Attend the Leadership and Advocacy Conference or School of Political Advocacy at ACEP 15; and
• Participate in a teleforum to learn more about a key legislative issue and how to take action.
The top three chapters with the greatest number of new 911 Network members enrolled or the greatest percentage of overall members enrolled, combined with points for the above activities will be recognized at the ACEP Council Meeting in Boston on Oct. 24 and 25.
Click here to learn more and join. You will have to sign in with your ACEP username and password for access to the site.
Check out the new WA-ACEP website: We’re so 2015!
The WA-ACEP website is now mobile friendly. Use your smart phone to check out the latest EM news and register for CME events. And you can even follow us on Twitter @WashingtonACEP.
POLST reaches important milestone as Nursing Commission issues guidance for caregivers
Last week, the Department of Health Nursing Commission issued a new advisory opinion and FAQ document clarifying that nursing assistants may honor a no-CPR order indicated in a patient’s POLST form (Physician Orders for Life-Sustaining Treatment). This change in guidance will make it possible for more bedside caregivers to honor patient decisions to refuse CPR.
The Nursing Commission advisory opinion and FAQ are available online.
Measles Outbreak Highlights the Need for Infectious Disease Containment Protocols in the Emergency Department
Emergency physicians and emergency department leaders are challenged to develop a rational and consistent approach to patients. Read More
CME Article: What Is the Best Ratio of Plasma, Platelets, and Red Blood Cells for Massive Transfusions?
A 23-year-old male presents to the ED with multiple gunshot wounds to the chest. Read More
Mark Your Calendars!
UW EMS and Trauma Conference
Hilton Seattle Airport and Conference Center
Sponsored by Harborview Medical Center and Airlift Northwest
Oct. 26-29, 2015
2015 Emergency Medicine Leadership Summit
Wednesday, Nov. 4, 2015
The Conference Center at Seattle Tacoma International Airport
2016 WA-ACEP Summit to Sound
Washington ACEP Board
John Matheson, MD, FACEP
Enrique Enguidanos MD, FACEP
Nathan Schlicher, MD, JD FACEP
Patrick Solari, MD, FACEP
Cameron Buck, MD, FACEP
Russ Carlisle, MD, FACEP
Brian Livingston, MD, FACEP
Heather Marshall, MD, FACEP
Steven Mitchell, MD, FACEP
Darin Neven, MD
Susan Stern, MD
Jennifer L'Hommedieu Stankus, MD, JD
Liam Yore, MD, FACEP
Julianna Yu, MD
Stephen Anderson MD FACEP
Past President (Non voting)
Christopher Kang MD FACEP
Past President (Non Voting)
Hayes Wong, MD
2001 Sixth Avenue
Seattle, WA 98121
(206) 441-9762 ext. 3038