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Explore This Issue

ACEP Now: Vol 36 – No 02 – February 2017

Photos (top left to bottom right): Eric Klotz, Tom Quimby/Russ Johanson, Elizabeth Nicholson, Ryan Brass, Siri Daulaire, Mark Wright, Laurie DuBois Doty, Leela Sirotkin

We share and discuss cases. We inspire one another to stay current on evidence-based medicine. We laugh at ourselves and each other. “JAFERD” is a nick name that some EM Docs have taken on as an inside joke after one member told a story of a patient who was angry with her for refusing to fill his opioid prescription. She said that this unnamed patient walked out and said to her, “You are just another f***ing ER doctor.” She abbreviated it to JAFERD and it stuck. “Own it,” many said. Another member made T-shirts, and some even put it on their car license plates. We fight among ourselves on some issues, but we stand up for our profession and for each other. We are out of isolation and have a united voice now.

Heated Discussion

EM Docs survived the election with mostly respectful discourse. There continue to be occasional heated discussions that allow us to learn from one another on (usually) divisive topics such as abortion, gun control, gender issues, and the Affordable Care Act. Some members participate in the discussions, and many more follow it. Even when the discussions get a little dramatic, all sides are heard.

The connection and communication between the bedside physicians and our professional organizations are faster now. It helps the fiercely passionate bedside physicians be heard, and it helps our trailblazers in leadership know our most pressing struggles so that emergency medicine can better address our challenges right away.

Metrics

One EM Doc, who will remain anonymous, posted about door-to-doctor time, door-to-disposition time, patient satisfaction scores, and similar measures, stating that these metrics have unintended consequences such as “encouraging physicians to sign up before they are really ready for a new patient just to stop the clock,” which “does nothing to actually improve patient flow.” The member discussed how patient satisfaction scores “can lead to inappropriate medications and tests. Performing to timed metrics may lead to poor charting and increased risk for errors. The end result is physician dissatisfaction and fewer EM Docs willing to serve in leadership positions.” “Time to take back control of our profession,” another EM Doc said, but from whom—the Centers for Medicare & Medicaid Services, government intrusion, third-party payers, corporate medicine?