Call for Unity

Today’s health care reform vote on Capitol Hill, while high drama, really only signals the beginning of the work that needs to be done by emergency physicians to improve access to emergency care for our patients and future patients. As I write this, I am watching the floor deliberations via the miracle of technology, and I know that the outcome will disappoint 48% of ACEP members, 48% of all physicians, and 48% of the American public, if polls are to be believed......and that will occur regardless of the outcome.

The greatness of our democracy lies in the ability of our people to freely elect their government representatives and to express themselves fully in the debate over crucial issues. Never in my lifetime has this been more apparent than during the health care reform debate. I believe that almost everyone has an opinion on health care, including many non-Americans, and almost everyone has expressed that opinion at some point.

The real challenge to our democracy, to our specialty, and to our organization is to move forward once today’s vote has been taken. We must have great care not to fall victim to Jefferson’s “tyranny of the minority.” We must move forward to create the greatest health care system in the world, befitting the greatest nation in the world, no matter the outcome of today’s vote.

There is no “win” today for emergency medicine. There is only new illumination on the path to achieving better emergency care. The real work comes as we identify areas that need our skills in innovation and problem-solving and get to work shoring up the nation’s emergency care system. My fervent wish is that emergency physicians will find a common bond in the needs of our patients, and put the rancor and division of the path to health care reform behind us in the interest of better emergency care for everyone.

Super Doctor Scam

I recently received a ballot from a Texas magazine, asking me to nominate members of my specialty that I considered “Super Doctors.” These nominees, who should be doctors that I would allow to treat my family, were to be honored in a future edition of the magazine. Imagine my surprise to find that Emergency Medicine was not one of the specialties listed.

What follows is an email exchange, copied unedited and in its entirety:


Dr. Gardner,
Super Doctors is a consumer tool for assisting in choosing doctors. As
you have noted, one does not choose one's emergency doctor. Radiologists
and pathologists are two other examples of that type of doctor.
Regards,
Marilyn

Plummer__________________________Marilyn PlummerAdvertising Projects Managermplummer@texasmonthly.com512-320-6976
Texas Monthly :
PO Box 1569 :
Austin, TX 78767

Forwarded MessageFrom: Date: Tue, 3 Apr 2007 14:59:01 -0500To: Subject: Online Feedback Form
Dear sir:
I am a physician practicing in the state of Texas, and I recentlyreceived your ballot soliciting nominations for the Texas Super Doctors2007 edition of Texas Monthly. As I read the document, I was dismayedto find that the category of "Emergency Medicine" did not appear on thelist of specialties.As a Board certified, residency trained, practicing emergency physician,I feel that this is an injustice. I am the Secretary/Treasurer of theAmerican College of Emergency Physicians, which represents 24,000practicing emergency physicians across the nation, including some 1500emergency physicians in Texas. Emergency physicians had 114 millionpatient visits across the country in 2005. Emergency physicians inTexas averaged 8,671 patient visits (each) in that same year. Youroversight is a slight to my specialty.

I realize that patients often don't have a choice of emergencyphysician, since they frequently seek care from the closest facility.However, forty percent of all inpatient admissions to the hospital originate in the emergency department. We are taking care of all theother physicians'patients at night, on the weekends, on holidays, and any other time that a patient can't see their doctor in the office. As a former president of the Texas Chapter of the American College ofEmergency Physicians (TCEP), I can attest to that fact that there are certainly "Super Doctors" performing minor miracles every day in the emergency departments across Texas.

Some of them include:
Diana Fite, MD ( Houston)
Arlo Weltge, MD, FACEP (Houston)
Brian Nelson, MD, PhD, FACEP (El Paso)
Andrea Green, MD, FACEP (Arlington)
Brian Zachariah, MD, FACEP (UTMB - Galveston)
David Morgan, MD, FACEP(Temple)

Please consider adding a category to your Ballot to honor these finephysicians and their specialty.

Sincerely,
Angela Fulgham Gardner, MD, FACEP


Further investigation proved very interesting. Once nominated, the doctor is given an opportunity to purchase a full page, half page, or smaller page for publicizing their selection. Doctors not choosing to participate in the full color, glossy pages are listed in a simple list at the end of the magazine.

Is the public really being served by this mechanism, or is this just a way to bring in dollars to the magazine? I would suggest that if the magazine really wanted a fair accounting of quality, they would use something other than the ability to purchase advertising in their selection of the best doctors in Texas.

And just for the record…………..emergency physicians have no resemblance to pathologists. We have a long way to go in educating the public……………