Winter 2011

From the President
Gary R. Katz, MD, MBA, FACEP

This edition of the Ohio ACEP E-news is dedicated to the Top 10 of 2010; the top activities and achievements of the Ohio Chapter in 2010. Please take the time to review our chapter Top 10 list! And what a great year it was! Yet, as we turn the corner into 2011, the physician leadership and chapter staff are planning for even more in 2011.

The Ohio chapter has gained over 200 members in the past seven years. As of December 31, 2010, membership stood at 1,233. Standing 1,233 strong allows the Ohio Chapter ACEP to elect 13 Councillors in 2011 to represent Ohio’s emergency physicians at the Council meeting in October in San Francisco, CA. The ACEP Council consists of members representing ACEP’s 53 chartered chapters (50 states, Puerto Rico, the District of Columbia and Government Services), its 30 sections of membership, the Association of Academic Chairs in Emergency Medicine (AACEM), the Council of Emergency Medicine Residency Directors (CORD), and the Emergency Medicine Residents' Association (EMRA). Each year the Council elects members to the Board of Directors and ensures "grassroots" involvement in the democratic decision-making process. The Council is a deliberative body that meets once a year for two days in conjunction with the College’s annual Scientific Assembly. The Council votes on resolutions which may be introduced by any member.

As our chapter has grown, we have been fortunate to be able to invest back in you, our members. In February, The Board and staff of Ohio ACEP will welcome the 3rd Ohio ACEP Leadership Development Academy class members. The Leadership Committee selected eight emergency physicians for the class which will focus on skill development for leaders, familiarization with organized medicine, and a pathway for physician leadership within the state chapter, the national College, or the local arena.

On June 7, 2011, Ohio ACEP will welcome Ohio’s EM residents and programs to the 10th Annual EM Residents’ Assembly. The Residents’ Assembly is a ½ day “Life After Residency” program geared towards practice options, interview skills, reading and negotiating a contract and information on medical malpractice and professional liability insurance. This is a great opportunity for residents and experienced community emergency physicians to interact, so plan to attend no matter your station in your career. The program includes attendance at the Ohio ACEP All Member Annual Meeting. The Annual Meeting features elections to Council and to the Ohio ACEP Board of Directors; the opportunity to network with emergency physician colleagues from across the state, continuing medical education options and more! Mark your calendar to join us in Columbus on June 7, 2011.

The Ohio ACEP calendar highlights the meetings and education opportunities sponsored by the chapter; don’t miss Basic Emergency Medicine Ultrasound, the chance to fast track through your LLSA readings and tests, or the 27th Annual Emergency Medicine Review course (EMR). After 27 years helping physicians to pass a board exam, to get CME, or to benefit from a focused academic review of the core content of emergency medicine, Ohio ACEP IS your board review resource. EMR is conducted with two 5 day Long Track courses and one 3 day Fast Facts and Fundamentals course in 2011.

In 2011, I hope you will resolve to become engaged in your profession. Whether simply through informed membership, through volunteer leadership of the chapter, through participation on an Ohio ACEP committee; or even if YOU would like to represent Ohio’s emergency physicians as a chapter Councillor; the opportunities to share the challenges, possibilities, and capacities of our profession are open to you. Please contact me or Executive Director, Laura Tiberi, if you would like to be more engaged in chapter activities or have questions about what the chapter can offer to you.                

Yours in Service, Gary R. Katz

Ohio ACEP’S Top Ten in 2010

Ohio ACEP’s “Top 10” achievements in 2010 (in no particular order) highlight just how hard the volunteer physician leaders and chapter staff are working for Ohio ACEP and for the advancement of emergency care. We might have missed something and certainly apologize if we did not highlight YOUR Top 10 picks. If we missed the mark, let us know! 

Dr. Carol S. Rivers Preparing for the Written and Oral Board Exams in Emergency Medicine: In January 2010, Ohio ACEP accepted the honor and responsibility for the continued publication of the internationally renowned ‘Rivers’ board review texts and ancillary study materials. We celebrated the complete revision in order to publish the 6th edition of the Preparing for the Written Board Exam in Emergency Medicine (release date January 24, 2011.) Dr. Rivers’ educational wisdom, insight, and successful educational philosophy have been continued in the 6th edition. Although she passed away prior to the completion of the book, she was intimately involved and guided the process of this text until her passing. The 6th edition of Dr. Carol Rivers' Preparing for the Written Board Exam in Emergency Medicine is dedicated to Dr. Carol S. Rivers and her devotion to the lifelong improvement of emergency medicine. Medical Education staff is currently working on plans to revise and issue the 10th Edition of the Preparing for the Oral Board Exam in Emergency Medicine.

Ohio ACEP unveiled a new website in July 2010: Balancing the information needs of members, fast & secure online transactions for products sales and class registrations, and the ability to continue to brand Ohio ACEP as an EM Education resource led to a revamped website in July. Better colors, crisp images, and more pictures help drive and assist visitors to our site. Visit today! You can also follow us on twitter!

Access to Emergency Care/ Senate Bill 86: In 2010, Ohio ACEP Government Affairs Chair, Dr. Catherine Marco, led the chapter’s efforts to introduce a bill offering limited liability protection to ALL physicians providing EMTALA-related care. Senator Steve Buehrer (R – Delta) introduced Senate Bill 86 to grant qualified civil immunity, using the willful and wanton standard, to a physician who provides emergency medical services, first-aid treatment, or other emergency professional care in compliance with the federal Emergency Medical Treatment and Active Labor Act (EMTALA) or as a result of a disaster. After months of questioning and wonderful testimony delivered by Ohio ACEP members including Dr. Gary Katz, Dr. Catherine Marco, Dr. Medard Lutmerding, Dr. Mark Gebhart and Dr. Michael Frank, the bill passed the Senate Civil Justice Committee with amendments and was debated on the Senate Floor on May 19, 2010. The bill was passed by the Senate by a vote of 22-10. The General Elections of 2010 interrupted our progress with this initiative, but the chapter lobbyist and government affairs team are preparing to introduce this measure again in 2011 in the 129th General Assembly.

General Elections 2010: Ohio ACEP Political Action Committee (PAC) supported the successful re-election efforts of Supreme Court Justice Maureen O’Connor to become the Chief Justice of the Court and Justice Judith Lanzinger. The Ohio Supreme Court has ultimate authority for interpreting state laws – many of which directly impact how we live, work and learn. The issues that come before the Ohio Supreme Court impact education, tax rates, utility bills, jobs, and more. The economic downturn has taken a toll on Ohio communities, making it critical that Ohioans elect justices who interpret the law and maintain Ohio’s stable and predictable judicial environment. The resulting philosophy of restraint is considered critical to continuing support of Ohio’s legislated tort reforms. For a complete election report, click here.

Emergency Medicine Review Courses: Ohio ACEP conducted two of them in 2010! Two Long Track courses and one Fast Facts and Fundamentals course for a total of 13 days of emergency medicine review in the 26th year of the chapter’s board review course. More physicians than ever attended these offerings. One e-mailed us this past week and said, “Throughout residency I scored below the 5th percentile every year. I took your course and I passed on the first try. Enough said.” Enough said indeed! Dr. Ann Dietrich, Ohio ACEP Medical Education Director assembles a top class faculty each year to bring you the best in EM Board Review with, as always, discounts for Ohio ACEP members!

ITLS Ohio and the Emergency Care Conference: Ohio ACEP is the state lead agency for ITLS Ohio. ITLS Ohio is a Chapter of International Trauma Life Support. The purpose of ITLS Ohio is to advance formalized pre-hospital trauma education and to represent the interests of Ohio’s pre-hospital providers. The Emergency Care Conference - Ohio’s premier pre-hospital conference features nationally known speakers and Continuing Education credit for Ohio’s EMTs at every level. Between 400-600 EMTs attend every year. ITLS Ohio continues with the 19th Annual Emergency Care Conference at the Crowne Plaza Columbus North, February 24-27, 2011.

Carol S. Rivers, MD, Emergency Medicine Foundation Established: Dr. Rivers passed away May 18, 2010, after complications from heart surgery. A colleague noted that Dr. Rivers was the first icon of the second generation, the trained-in-EM generation. Dr. Rivers devoted her life to the improvement of the emergency medicine profession, and one physician at a time, she improved patient care through her educational efforts. Internationally known for her dedication to emergency medicine and her devotion to assisting residents and physicians to learn better medical skills and pass the board exams, her passing was a loss to the entire emergency medicine community.

Ohio ACEP announced plans to honor Dr. Rivers as the Emergency Physician of the Year at our Annual Meeting on June 9, 2010 and acknowledged her leadership and service to emergency medicine with the establishment of the Carol S. Rivers, MD, Emergency Medicine Foundation, intended to grant financial awards to assist EM residents. Donations can be made to the Foundation by mail: 3510 Snouffer Rd., Ste 100, Columbus, Ohio 43235.

There’s an APP for that! Ohio ACEP joined the age of smart phones and iPads with an Emergency Medicine Quiz Questions iPhone App. 700 multiple choice, fact based word association questions for emergency medicine review.

Leadership Development Academy: In December 2010, the Ohio ACEP Leadership Development Committee with Dr. Sara Laskey, Chair, selected the third class for the Ohio ACEP Leadership Development Academy. The next group of up-and-coming physicians will participate in a yearlong program designed to learn skills in advocacy at the national and state level as well as develop their own leadership skills. Participants will enhance their interpersonal effectiveness, management competencies and strategic decision making skills. The group will form a cohesive peer network and be matched with appropriate experienced mentors. The 2010-2011 class includes: Purva Grover, MD; Venkatesh Kambhampati, MD; Gerald Maloney, Jr., DO; Michael McCrea, MD; Mohamad Moussa, MD; Michael D. Nauss, MD; Sarah Orlousky, MD; and Matthew J. Sanders, DO. Congratulations to the new academy class!

Last, but never ever least, Ohio ACEP MEMBERS: In 2010, Ohio ACEP grew to 1,233 members. This wonderful collection of Buckeye State EM physicians told us in a member survey in October that most of them (70%) work clinically in the ED full-time (more than 28 hours a week); Ohio ACEP members think of Membership (66.7%) when they think of Ohio ACEP, followed by EM Board Review (64.2%); Legislative Advocacy (60.5%); and Education (59.8%). They find Advocacy efforts (56.9%) and the EM Board Review (56.9%) most useful and valuable. A whopping 87% prefer e-mail as their PRIMARY communication preference. Our members told us a lot with this survey and we appreciate it! Ohio ACEP is a member organization - our members come first. By the way, Steven D. McMahan, MD won the $100 Amazon gift card for participating in the survey! It pays to participate!

The Patient Experience - Where Empathy Meets Innovation

Beginning in September 2010, the Cleveland Clinic’s entire workforce of 43,000 began participating in a new initiative called the Cleveland Clinic Experience. Launched by the Office of Patient Experience and the Office of Learning and Performance Development, it is the most extreme step ever taken by a major U.S. medical center in the name of empathy, patient satisfaction and employee engagement. It’s tough being a patient. New programs that emphasize empathy aim to make it much easier. Ohio ACEP Board Member, Tom Tallman, DO, FACEP got a first hand look at both the doctor and patient side. Click here for the full article. 

ACEP Leaders Visit with Officials About Children and Disasters, Express Concerns

ACEP President Dr. Sandra Schneider, President-Elect Dr. David Seaberg and Ohio Chapter member Dr. Sharon Mace met with the National Commission on Children and Disasters recently to discuss the agency's October 2010 Report to the President and Congress. ACEP leaders promoted the role of emergency physicians in pediatric emergencies and disaster response, and expressed concern about the agency's use of a misleading statistic that only 6% of the nation's EDs have the equipment to treat children (a statistic that dates back to an exhaustive list of equipment, much of which is not essential nor kept in the ED).

New State Government Updates

Gov. John Kasich announced he is creating a new office charged with consolidation and cost savings in the state’s $13 billion annual Medicaid program. Greg Moody, a former Taft Administration official, was named to head the Office of Health transformation, which will be responsible to implement modernization and cost-containment priorities and direct related initiatives in the eight state agencies that deal with Medicaid. The Department of Job & Family Services will remain the single administrator for the program. In addition, Kasich named John McCarthy, currently the Medicaid director for the District of Columbia, to serve as Ohio’s Medicaid director; and Theodore Wymyslo, MD, a longtime medical educator and administrator who worked at Miami Valley Hospital for 18 years, as director of the Department of Health. Wymyslo spent 18 years as director of the family practice resident program at Miami Valley Hospital. Most recently he has been advocating for the patient centered medical home model of primary care. John McCarthy was the Medicaid director in the District of Columbia. McCarthy has previously worked with ODJFS and the Ohio Department of Developmental Disabilities on a number of Medicaid redesign projects and is familiar with Ohio and its structure. Michael Colbert, who had been interim director of the Ohio Department of Job and Family Services (ODJFS) since the beginning of the Kasich administration, was named permanent director early in February. Kasich noted Colbert’s nearly three years as ODJFS’ chief financial officer as the deciding factor in his appointment.

Separately, Kasich named Lt. Gov. Mary Taylor as state insurance director and signed an executive order that gives her authority to review Ohio’s business regulations with the aim of repealing unnecessary, burdensome rules. Taylor is a CPA. She has also been assigned the task of implementing the governor’s “Common Sense Initiative” to simplify the state’s regulation of small businesses.

Other cabinet appointments of interest to Ohio ACEP include the Director, Dept. of Alcohol & Drug Addiction Services - Orman Hall. Hall will focus on the fight against prescription drug abuse in the state, beginning in Scioto County, which has ranked nationally in abuse as county officials seek to shut down "pill mills" that provide prescription drugs to abusers.

Ohio’s Opiate Epidemic: A Summit on Policy, Prevention & Treatment

You’ve seen the headlines, now learn how to stop Ohio’s Opiate Epidemic from further damaging lives and communities. On Tuesday, April 5, 2011, join colleagues in gaining information tailored to your needs at the Hyatt Regency in Columbus, Ohio. Tracks specialized for addiction treatment, physicians, prevention, criminal justice and state policy leaders. Registration will be available on March 1, 2011 at www.oacbha.org. Sponsored by Ohio Association of County Behavioral Health Authorities in partnership with Ohio Department of Alcohol and Drug Addiction Services.
 

Member Kudos

Congratulations to David P. Keseg, MD, FACEP for his continued involvement with a program on Columbus TV called “EMS Perspectives”. The program is designed to make the public aware of what the Columbus Division of Fire does for the citizens of Columbus in terms of EMS care.

Congratulations to Brian L. Springer, MD, FACEP; Assistant Professor; Director, Division of Tactical Emergency Medicine ,Wright State University Boonshoft School of Medicine, Department of Emergency Medicine for being selected by the Governor’s Office to serve as the Ohio ACEP representative to the State EMS Board for a term of 2010-2013.

Congratulations to Catherine A. Marco, MD, FACEP for her commentary article in the October 2010 issue of ACEP News.

Congratulations to David F. Baehren, MD for his continued publication in ACEP News.

Congratulations to Scott Wilber, MD, MPH for being published in the November 2010 issue of Annals of Emergency Medicine.

Congratulations to Opeolu Adeoye, MD for being published in the November 2010 issue of Annals of Emergency Medicine.

Kudos to Mary Jo McMullen, MD, FACEP,  author of the recent pamphlet, “Behind the Badge. Management Guidelines for Impacts to Body Armor.”

Congratulations to Ohio members Robert I. Broida, MD; Elaine Thallner, MD, MS; and Kevin Klauer, DO for their contributions to the CORD Supplement, ‘Emergency Medicine Quality Improvement and Patient Safety Curriculum,’ Academic Emergency Medicine 2010; 17:e110-e129.

Ohio ACEP Chapter Leadership
Executive Committee

Clinical News

CMS Tweaks Hospital Sedation Policy, Again
The Centers for Medicare and Medicaid Services has revised its recently updated anesthesia guidelines, following complaints the policy was unworkable.

Hospitals are now directed to develop their own internal policies concerning what is anesthesia versus analgesia, which leaves open the option of using different guidelines in different clinical departments. The revisions also provide greater flexibility regarding pre- and postanesthesia evaluations, while particularly problematic references to propofol and labor epidural anesthesia were dropped entirely.
Read the entire article online

Food Allergy Guidelines Encourage Earlier Use of IM Epinephrine
New federal guidelines on food allergy recommend “prompt and rapid” treatment of food-induced anaphylaxis with intramuscular epinephrine as first-line therapy.

And in cases of a suboptimal response to epinephrine – or if symptoms progress – “repeat epinephrine dosing remains first-line therapy over adjunctive treatments,” the guidelines say.

The “consistency and strength” of the recommendation for prompt treatment with IM epinephrine may come as a surprise to some emergency physicians who “reserve treatment with epinephrine until patients are in shock, which is an extreme and late manifestation” of anaphylaxis, said Dr. Carlos A. Camargo Jr., an emergency physician who served on the multidisciplinary expert panel that developed the guidelines for the National Institute of Allergy and Infectious Diseases.

“Earlier diagnosis of anaphylaxis and earlier treatment with epinephrine would benefit patients,” said Dr. Camargo of Massachusetts General Hospital and Harvard Medical School, both in Boston. “The guidelines strongly encourage earlier use of IM epinephrine for food-induced anaphylaxis.”
Read the entire article online

Focus On: Best Practices for Seizure Management in the Emergency Department
“Focus On” is an ongoing series of articles that examine common complaints that present to the emergency department or highlight new literature or treatment options. The January 2011 article reviews the current evaluation, management, and disposition of patients presenting to the emergency department with seizures.

Learning objectives for this article include the ability to discuss the presentation of seizure in the emergency department and common mimics of seizure; discuss the management of first-time and recurrent seizures in the emergency department; outline an aggressive treatment regimen for status epilepticus, including the emerging role of levetiracetam in the treatment algorithm; and list several practices that will improve the ED care of seizure patients.
After reading the article, take the CME quiz online.

Emergency Medicine Foundation Call for Proposals

EMF is pleased to announce a call for proposals due April 1, 2011:

Ultrasound Grant proudly underwritten by Siemens
The goal of this $20,000, one-year grant is to gain a better understanding of the comparative effectiveness of emergency ultrasound as performed by emergency physicians.

EMF/EMPSF Patient Safety Grant
The goal of this $10,000, one year grant is to identify ways and means to improve patient safety in emergency medicine.

EMF/Baxter Grant on Rehydration
The goal of this $50,000, one year grant is to study subcutaneous rehydration for pediatric and/or adult patients in the emergency department.

EMF/ENA Foundation Team Grant
The goal of this $50,000, one year grant is to have physician and nurse researchers combine their expertise to develop, plan, and implement clinical research in emergency care.

All grants will be funded July 1, 2011-June 30, 2012.

Welcome New Members

Michael Bowen
Eashwar B. Chandrasekaran
Bradley L. Demeter
Tyler Dschaak
Clinton James Fox
Ben Glasener
Christopher McIntosh, MD
Brian Oloizia
Katherine A. Pollard
Joseph P. Tagliaferro, III
Andrew Wright
Alexander Yeh