ACEP 1999: What’s coming ‘around the bend’
ACEP 1999: What’s coming around the bend’
"There are a number of different areas we are focusing on for 1999 of major interest to ACEP and emergency medicine," says John Moorhead, MD, FACEP, ACEP president and professor of emergency medicine and public health and preventative medicine at Oregon Health Sciences University.
"The environment is changing so quickly and will continue to affect the practice of emergency medicine. We are finding the ED caught in the middle of a lot of issues. There are many challenges but I am excited to work on them on behalf of our physicians and patients," says Moorhead. "We have an ambitious agenda this year, but have a lot of good people working toward these goals."
Here are several issues that ACEP is focusing on this year:
Patient rights legislation. "At this point, 18 bills have been introduced and we supported 16 of them. We expect to support other bills which will be introduced this session," says Moorhead. "We are very optimistic because of bilateral support from both parties, and because the public is extremely interested in this."
Uninsured. "The issue of uninsured patients and our ability to protect our role as safety net providers is extremely threatened due to high levels of unreimbursed care," says Moorhead. "We have put a task force together to look at this issue."
Fraud and abuse. "Documentation guidelines that all physicians need to follow have been developed through HCFA. Unfortunately we are seeing some liability for individual ED physicians on the basis of simple miscoding," notes Moorhead. "We have to work very diligently with both HCFA and the Department of Justice to make sure we are all using the same approach."
The issue of coding is not black and white, Moorhead stresses. "Coding is not scientific and is open to interpretation. However, it’s being prosecuted as if it were true fraud," he notes.
Graduate medical education. "We are addressing the needs of academic physicians, and have a strong liaison with the Society of Academic Medicine to collaborate on this issue," says Moorhead.
Work force study. ACEP is repeating a landmark study done two years ago which showed that 32,026 physicians were clinically employed in the specialty of emergency medicine. "The new study will focus on changes in the emergency medicine task force," reports Moorhead. Trends in the number of clinical practitioners will be identified, and environmental factors impacting the demand for emergency care will be examined.
"This is extremely important to our residents and practicing physicians," he says. "The study will be completed this year and has been approved by the board. We hope to work with the Emergency Medicine Foundation, our major funder of research, to financially collaborate support this."
The previous study provided the first empiric data on how many people are actually practicing clinical emergency medicine, says Moorhead. "With all the concern about Medicare viability and graduate medical education being looked at by several national groups, we need additional data. We need to know what changes are occurring in the work force so we can have an appropriate position to advocate for our training program."
Mentoring program. "We are working with emergency medicine residents to implement one of our first mentoring projects," says Moorhead. "It’s a project that will be important to residents and young physicians entering practice who want to get more involved with their specialty through their local chapters." At a Washington, DC, legislative meeting in April, ACEP will unveil a model for this project, which will be fully implemented by October.
Residency graduates should be encouraged to practice in nonurban settings, says Moorhead. "The continued maldistribution of emergency physicians mandates new approaches to make nonurban practice sites attractive for residency grads," he says. "Emergency medicine residency curricula must be reexamined to look at not only what kind of training is provided, but also where residents are trained."
Collaboration. "Our goal is to get all emergency medicine organizations working together on these issues," says Moorhead. "We are a young specialty, and have a lot of young organizations. We are redoing our core curriculum content and database for board examinations, and need all of our groups and societies working together and collaborating."
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