Each year, ACEP’s Council elects new leaders for the College at its meeting. The Council, which represents all 53 chapters, 40 sections of membership, the Association of Academic Chairs of Emergency Medicine, the Council of Emergency Medicine Residency Directors, the Emergency Medicine Residents’ Association, and the Society for Academic Emergency Medicine, will elect four members to the ACEP Board of Directors when it meets in September, along with a new President-Elect.

The candidates for Board of Directors will be featured in the September 2024 issue of ACEP Now.

Candidates for ACEP President-Elect responded to this prompt:

How will you mitigate the threat of losing members of the College when encountering divisive topics that may make large portions of the membership feel alienated or disenfranchised?

L. Anthony Cirillo, MD, FACEP

Current Professional Positions: EM residency-trained emergency physician working clinically as a Regional Traveler; Director of Government Affairs, US Acute Care Solutions

Internships and Residency: Transitional internship, George Washington University Hospital; emergency medicine residency, UMASS Medical Center, Co-Chief Resident

Medical Degree: MD, University of Vermont College of Medicine (1990)

Response: Sometimes, in order to see clearly into the future, you have to look to the past. On August 16, 1968, John Wiegenstein, MD, and seven other emergency physicians met in Lansing, MI and founded ACEP. The founders had come together with a singular goal to “facilitate the exchange of information among physicians practicing emergency medicine.”

The founding of ACEP seems so long ago, and you might think that it was easy to start the specialty of emergency medicine back then, since those were “simpler times.” The reality of 1968 however, was anything but simple, and historians have deemed 1968 to be the “worst year of the 20th century.” 1968 saw the assassinations of Martin Luther King, Jr, and Bobby Kennedy, which prompted month long violent riots in Washington, DC, Chicago, and Baltimore. The Vietnam War escalated with the Tet Offensive. Another wave of riots occurred in Chicago after the Democratic National Convention. Governor George Wallace of Alabama ran as the American Independent Party candidate on a segregationist platform winning electoral college votes of five states in the Presidential election. And yet, despite this turmoil, Apollo 8 successfully orbited the moon, the Civil Rights Act of 1968 was passed and signed into law by President Johnson, and yes, the American College of Emergency Physicians was founded.

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So, what’s with the history lesson? Even during a year of national turmoil, dissension, and violence not seen since the Civil War, the founders of ACEP brought the College to life by focusing on a singular common reason. The founders joined together with a shared common purpose to create an organization that would improve the care of patients seeking emergency care and to establish that those physicians who chose to practice emergency medicine would be recognized for their unique knowledge and skills. Somehow, despite all of the issues that were dividing the country, the founders were able to put aside personal opinions on those topics and work together to create the specialty of emergency medicine because that was the work that needed to be done for the greater good of the nation and future emergency physicians.

So here we are 56 years later. The nation is once again (or maybe still) divided on a number of issues. Some of the issues are new, and some remain wounds that refuse to heal. These divisive issues have hyperpolarized the nation, fueled by a 24/7/365 social media and news cycle that deliberately stoke the flames of discord and disagreement. Every day, it feels that both our society at large, and our community of emergency medicine are being pulled further apart, especially by those who choose to tear apart rather than build together.

And yet, every day the patients come … and every day we care for them. Despite the myriad of issues that divide us, both as a society, and as a College, everyone in this country needs the emergency care system to be there in their time of need. That’s the common thread that binds us … doing the incredibly hard but rewarding work of being the bedside healers of a nation. In a recent update of our Mission, Vision, and Values, the mission of the College now reads: “To support and advocate for emergency physicians and to promote quality emergency care for our patients and the public.” Seems like that although the words may be a little different (who doesn’t love a little wordsmithing), ACEP’s mission hasn’t significantly changed since 1968. Despite all of the difficult and divisive issues that we have faced since 1968, are facing today, and will face tomorrow, ACEP’s strength will always come from the work that we all do together, advocating for our patients and our profession. That’s why every emergency physician should be a member of the College … because just like in 1968, we have common work to do to enhance the specialty of emergency medicine and the support the physicians who provide it.

Jeffrey M. Goodloe, MD, FACEP

Current Professional Positions: Attending emergency physician, Hillcrest Medical Center Emergency Center, Tulsa, Oklahoma; professor of emergency medicine, EMS section chief, and director, Oklahoma Center for Prehospital & Disaster Medicine, University of Oklahoma School of Community Medicine, Tulsa; chief medical officer, medical control board, EMS System for Metropolitan Oklahoma City & Tulsa; medical director, Oklahoma Highway Patrol; medical director, Tulsa Community College EMS Education Programs

Internships and Residency: Emergency medicine residency, Methodist Hospital of Indiana/Indiana University School of Medicine, Indianapolis; EMS fellowship, University of Texas Southwestern Medical Center, Dallas

Medical Degree: MD, Medical School at University of Texas Health Science Center at San Antonio (1995)

Response: I will not alone; that is for certain. However, WE, working together can make ACEP an even more welcoming organization to any residency-trained, board-certified emergency physician or emergency physician in training ahead and all current members. The foundation of my beliefs—in ACEP, in ACEP’s potential, and pointedly in US as ACEP members, is how much WE share in common. Let us acknowledge differences and how what we then share helps us navigate these differences when they occur.

With 40,000 members, we will always realize differences in opinion on practically every issue that impacts emergency medicine and our professional lives. The key to finding advocacy that we can support in advancing our specialty and our futures is to recognize that differences do not have to be oppositional junctures. Differences can prove opportunities for learning. Learning can then bring us to a “stronger together” organization. I commit to continuing transparency in my leadership, encouraging any member to communicate directly with me. If I sense that a member feels alienated or is becoming disenfranchised by an official ACEP policy or an advocacy stance, particularly when in development, that is a prime point in which to ask and listen, not assert and talk. I am a believer that the best response to evident difference(s) are these questions: “Can you help me better understand how you see this topic?” and “What am I missing in evaluating this current position?”

Often, we all simply want to be heard. We can all respect democracy and that none of us gets our first choice every time in life. As long as we can effectively communicate—via email, via text, via social media, via phone, and my favorite way, in person—and do so respectfully to each other, then the end result of hearing multiple perspectives and ideals is a product, service, or advocacy stance that is more informed and more inclusive than trying to champion our causes alone. WE really are stronger together.

WE are literally the first part of “welcome.” We should feel comfortable and “welcomed” in our differences as we share so much in common as emergency physicians. If we have never met, though we share membership in ACEP, then I know how much in common we can find. We can trust we each have a genuine interest in helping everyone that needs our skills. We can trust we each have a sincere desire to make a positive difference during some of the most challenging and terrifying moments in someone else’s life. We can trust we each had to navigate an appropriately arduous journey of undergraduate and graduate education to become emergency physicians. We can trust we each had to sacrifice a lot of immediate gratification for the “delayed rewards” of being emergency physicians. Those are just a few of the many trusts in each other we can enjoy.

That common ground, through shared values, beliefs, and commitments in selflessly serving others, affords us a wealth in opportunity that is not measured in monetary terms alone. The greatest asset of ACEP is not our headquarters in Texas or any of its physical contents. Our greatest wealth of ACEP is in each other as member emergency physicians. When we pause in our differences in topics that historically divide—reproductive rights, firearms, types of professional practices that are “best”—and in topics that are emerging—unionization, the role of artificial intelligence—we can then realize that our differences are built upon the foundation of shared experiences, values, and beliefs.

At this stage in our careers, listening, sharing, learning, and respecting may seem basic. Let us remember that basic fundamentals done consistently well produce winning teams, in sports and in life. Our often-fractured world confirms that more than ever, we all need a winning team of emergency physicians doing what WE do better than others—advocating for our patients, for our profession, and for each other!

Ryan A. Stanton, MD, FACEP

Current Professional Positions: Emergency physician, Central Emergency Physicians, Lexington, Kentucky; medical director, Lexington Fire/EMS; medical director, GMR Motorsports/NASCAR/SRX/USF

Internships and Residency: Surgery internship, James H. Quillen College of Medicine, Johnson City, Tennessee; emergency medicine residency, University of Kentucky

Medical Degree: MD, James H. Quillen College of Medicine (2003)

Response: I have always said “that if nobody disagrees, you didn’t say anything.” We have an ever-growing collection of wedge issues that are meant to divide rather than achieve progress. While I have always felt we should steer well clear of wedge issues, we must still be active advocates for our members, profession, and patients. The key is threading the needle regarding issues that are important, but also have significant political and belief system overtones. There are ways that we can plant a flag as a College without wading into the politics of the topic. The beauty and risk off our profession is that we are overall balanced along the spectrum of politics and beliefs. The diversity helps us move forward, but also means that any given topic has a similar spectrum of positions. As the VP of Communications, I have worked with our comms staff and leadership to respect the positions of our members and find the opportunities to forward our profession and our ability to care for our patients.

The reality is that no membership is guaranteed. We must continue to fight for each and every member. This includes the willingness to listen, dialogue, and find the common ground which will hopefully lead to the best positional direction of the college. Mitigating the threat of losing organizational members when encountering divisive topics requires proactive strategies that foster inclusion, respect, and open communication. Firstly, creating a culture of respect and inclusivity is paramount. ACEP must maintain and enforce clear policies that promote respect for diverse opinions and backgrounds.

Secondly, leadership must exemplify open communication and active listening. As the Board, staff, and leaders, we should encourage dialogue for members to express their views with the knowledge that it may lead to a compromise, position shift, or something in between.

Thirdly, focusing on common goals and shared values can unite members despite differences. Emphasizing ACEP’s mission and the collective benefits of diverse perspectives can help reframe divisive topics as opportunities for growth and progress.

Finally, not being afraid to take a position if it is in the best interest of emergency physicians, our specialty, and patients. We don’t have to swing at every pitch, but also don’t need to be afraid to put our foot down. This also means that we must all be flexible, open minded, and looking at the bigger picture that is emergency medicine. If there is one thing I have learned throughout my life, I don’t always get what I want … and sometimes, that’s ok.