RS: One of the questions you asked was about forming a group. In my case, it just sort of happened. My first partner was Nat Rose. We were in the Navy and got out in July 1972. We started working 16-hour nights for the first two years, rotating, Nat and I, and we were getting about $20 an hour. We had an 80 percent contract to start. About four months into it, the hospital CEO said, “This doesn’t work. We think we want to pay 60.” That pushed us into independent billing. Inadequate Medi-Cal payments were a big issue. That made it clear that CAL/ACEP was a vehicle that we absolutely needed to have to make all of this work, and so three of us in my group, Bill O’Riordan, Roland Clark, and I, all became presidents of CAL/ACEP. We just evolved into things we needed to be and developed affiliate organizations, whether it was billing, insurance, or marketing, in order to make it all work. There was no plan. It was serendipity, but it turned out pretty well.
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ACEP Now: Vol 35 – No 12 – December 2016KK: So necessity bred invention. What about John and Harry? Did you feel that the support and development of ACEP helped you and your group?
JS: There was national ACEP, but California was a little ahead of Kentucky. We didn’t even have a state chapter when Harry and I started. In fact, I got together with three other physicians around the state; we actually formed the Kentucky chapter of ACEP. National ACEP was huge because it gave us contact with other physicians who had common problems. There were meetings, and it provided a tremendous educational resource for us.
KK: Zach, from your perspective, what is the reputation of emergency medicine now among students who are deciding what specialty they want to practice?
ZJ: I think, reflecting on a couple of things that were said, that there have always been challenges in emergency medicine, and the challenges 40-plus years ago are a little bit different than the challenges that today’s physicians are facing. It sounds like ACEP and other organizations are crucial in addressing these challenges, and I’m glad that those organizations are still around to help us today. I think a lot of people don’t appreciate the history as much as everyone who was there and fighting these early battles. Nowadays, I think students probably take for granted that emergency medicine is a well-respected specialty with lots of resources within its own department at most every single major academic medical center and that emergency physicians are respected members of the health care team. Emergency medicine gets more and more applicants every year. It’s very popular. I think that it seems on the same level as any medical specialty now, thanks to all the hard work from our pioneers.
5 Responses to “Emergency Medicine Founders Discuss Origins of the Specialty, How It’s Changed, and What the Future Holds”
December 18, 2016
Cindy Pearsall Sussman MD FCEPI was sorry to not see a credit given to Dr David Wagner, the real “grandfather of Emergency Medicine” in your article. Dr Wagner was a general surgeon at the Medical College of Pennsylvania in Philadelphia and noted the immense need for an Emergency Medicine residency program. His was the first, and paved the way for many more to come. As a graduate of that program, I am proud to say that we were well prepared for just about anything that came our way. Dr Wagner deserves credit for having the foresight and energy to get the field on its feet.
December 18, 2016
Cindy Pearsall Sussman MD FCEPCorrection- Dr Wagner was a pediatric surgeon
December 18, 2016
MarianKevin,
Thank you for an insightful article regrading the history of emergency medicine and where we are headed.
I find it ironic that there are two articles in this edition of ACEP eNow discussing diversity in emergency medicine, however, your interview panel lacked diversity. I am certain that this was not intentional, but it certainly highlights the unawareness at times of this particular issue.
December 19, 2016
Kevin Waninger MD FACEPEven more important, Dr. David Wagner was a great role model and a really nice man. I am a better doctor, and even more important, a better colleague, friend and father, because of my interaction with Dr. Wagner.
November 22, 2018
Kathleen Nakfoor, Ed.D, MBA, MSIS, RNI had the privilege of working with Dr. John Wiegenstein, MD and Dr. Eugene Nakfoor, MD from 1970 to 1975. I was told “history is being made in this emergency room” and know this to be a fact. I recall working with Dr. Wiegenstein the nights before he head off, yet, to another meeting to battle for EM as a speciality. He entertained us with stories of his less than impressive luggage when checked into the presidential suite. I was well aquatinted with stories of progress being made in EM.
What has been overshadowed by the enormity of ACEP formation and EM becoming a specialty, are the historical changes that were made in emergency department management. I recall Eugene Nakfoor, MD, also a founding ACEP member, telling me stories of the fact no one knew how to bill for services, such a practice was unprecedented. He garnered “departmental status” in which he controlled all hiring and firing of the entire staff.. He and the nurses developed the original scribe system, not the one in existence today. There has never been such a well managed emergency department using the scribe; actually a pivotal individual with whom the department was organized.