ACEP Member Questions Campaign Policy
By Liam Yore, MD, FACEP
ACEP is a large and diverse group of emergency care providers united around the core mission of providing the best possible care to the patients we serve. While we all share the same goals, there has rarely been unanimity in regard to the best way to accomplish them. Indeed, the spirit of emergency medicine has seemed to select the individualists and contrarians in the house of medicine. In a way, this makes sense: emergency physicians are the crazy ones who were told that there was no such thing as emergency medicine but founded the specialty anyway. We accomplish the impossible every day in the nation’s resource-starved emergency departments using nothing more than duct tape and baling wire. We are members of a specialty composed of doers and visionaries; the best way to get emergency physicians to do something is to tell them it cannot be done.
Getting 30,000 fractious and energetic emergency physicians to agree on anything has always been a challenge, and it has led to some “lively” debates throughout the history of the College. Some very vivid and larger-than-life personalities have emerged as leaders of the Council over the years. Whatever the issue, there was one thing you could be sure of: emergency physicians would not shrink from the debate.
That is why it is so discordant that the ACEP Council Steering Committee has approved a policy restricting the free speech rights of candidates for leadership in the College. In this novel and unusual step, the College has prohibited any candidate for Council office—including the Board of Directors and president of the College—from granting interviews with any media other than ACEP Now.
The Steering Committee, in setting this rule, was presumably well-intentioned in its stated goal of creating the environment for a fair election. Regardless of the intention, the effect is exactly opposite of what the leadership should strive for: the appearance of transparency and avoidance of perceived bias.
First and foremost, this is an unconscionable prior restraint on the free speech rights of the candidates. Under this policy, candidates who wish to explain their policy opinions and vision for the future direction of the College to an independent outlet may not do so. While the College is a private organization that may make its own rules, the principle of the First Amendment demands that any restrictions on freedom of expression be narrowly crafted to serve a compelling interest. The Committee has, to date, offered only a vague and unsupported assurance that this restriction will make the election more fair.
I would argue the contrary: that the more exposure our candidates get and the more viewpoints they address and the more questions they answer, the better off the College is. We are not afraid of a robust debate—it strengthens us and better informs the Council electorate.
The perception created by this policy, however, is that the College is afraid of partaking in debate in a venue it does not control, that its candidates are unprepared to answer questions relating to College policy, and that disagreement about policy is best handled by stifling rather than engaging dissent. While nothing could be further from the truth, ACEP is ill served by promulgating a rule that fosters this impression.
To the degree that there exists valid disagreement and criticisms of the manner in which ACEP is governed and in its policy decisions, the College is best served when it meets these directly and defends its positions in open debate.
Additionally, ACEP’s core mission is to further the interests of all emergency care providers and our patients. Not all emergency physicians are ACEP members, and not all of them read ACEP Now. Restricting the ability of our future leaders to speak to independent publications reduces their ability to reach these audiences. The broader the campaigns can be, the more inclusive of all emergency physicians they are, and the more the College can further its mission and reach potential new members.
The College, in its defense of this policy, intimated that independent publications might be biased in their coverage. I have seen no evidence of this actually being the case, and none is offered by the College. If it were so, however, it is selling Councillors short by implying that they are unable to discern bias when it exists and unable to weigh and evaluate the information as presented. To the contrary, the Council may be better served by its candidates speaking to publications that have an independent editorial voice and a willingness to ask direct questions. For that matter, direct access to candidates likely will reduce any potential for bias in allowing the candidates to speak for themselves rather than requiring outside news organizations to infer candidates’ positions and qualifications. The leaders of ACEP will need to take on members of Congress, FOX News, and MSNBC after they have been elected; surely as candidates they can be trusted to handle the far-friendlier confines of industry journals and newspapers.
To the degree that there exists valid disagreement and criticisms of the manner in which ACEP is governed and in its policy decisions, the College is best served when it meets these directly and defends its positions in open debate. This gag rule creates separation between the College and its members, creates a chilling effect on the debate, and does not move the College forward in a positive direction. I call on the ACEP Council Steering Committee to work with the Council to create a set of rules that will allow for fair elections while assuring open speech rights for the candidates. I encourage ACEP members reading this to express their opinion to the designated inbox for concerns at communications@acep.org.
Dr. Yore is an emergency physician at Providence Regional Medical Center in Everett, Washington.
The Council Responds: Clarification on Campaign Rules
By Kevin M. Klauer, DO, EJD, FACEP
The ACEP Council Steering Committee’s decision not to allow candidate interviews by emergency medicine publications outside of ACEP for the 2014 campaign demands clarification. First, and most important, I must say that the intent of the Steering Committee was altruistic and meant to ensure fairness in the campaign process for all candidates, maintaining the internal campaign process that has been in place for decades. There is not any motivation to control messaging or to inhibit members from learning more about the candidates as some have suggested. The Steering Committee is open to modifying these procedures. However, given time constraints, the Steering Committee was not prepared to endorse an outside campaign process without fully considering the implications, potential benefits, and unintended consequences. The Steering Committee addresses Council matters while the Council is not in session. However, it should not act unilaterally on matters that require broader consideration by the Council (367 Councillors representing approximately 33,000 members). The Steering Committee comprises 15 Councillors appointed by the speaker and the vice speaker. Steering the ship away from icebergs is appropriate, but setting sail for uncharted waters is not. I know we are slow to change, but that’s part of the democratic process. Although being nimble and quick to action is important in some circumstances, careful consideration before action is important in others.
Perhaps visiting the history of this process will shed some necessary light on why any changes are made cautiously. The Council campaign and elections process is deeply rooted in tradition and ceremony that has been consistently conducted with little change for decades. The rules have been very restrictive, including the submission of standardized written materials, a data sheet, disclosure statement, responses to written questions, and a single campaign handout. Campaign materials, such as campaign buttons, may not be distributed at the Council meeting. Even the number of official endorsements is limited to one endorsement from a component body (chapter, section, or other voting Council entity) or a single joint endorsement from two component bodies. Interview-style questions have historically been limited to the Council Candidate Forum, which is held prior to the elections at the annual Council meeting. The rationale for these restrictions has always been to avoid pressuring College leaders and candidates into spending valuable time and financial resources to gain an edge over others with more effective campaigning.
Historically, no outside organizations or publications have participated in the campaign and elections process by conducting interviews or any
other activities, and no such requests have ever been received.
Historically, no outside organizations or publications have participated in the campaign and elections process by conducting interviews or any other activities, and no such requests have ever been received. Thus, this would be a material and substantive change for our campaign process that the Steering Committee did not feel would be appropriate to decide without further consideration and broader input. Some may ask how this differs from other campaign rule changes. An excellent example is the removal of social media restrictions. The ACEP Council candidate campaign rules have always disallowed any use of social media for campaigning. This year, the ban was lifted, allowing unrestricted use of personal social media sites to promote candidacies. This sounds like a “material and substantive” change, doesn’t it? It certainly is. However, in contrast to outside publications conducting campaign interviews, the use of social media for campaigning has been discussed for the past three years (by three different Steering Committees) and has been fully evaluated, with Council consensus supporting this change reached.
To effect meaningful change, I would respectfully request that we conduct our discussions in the most appropriate context, that of a medical specialty society’s campaign process, and avoid expanding the conversation beyond what is applicable. Some have raised questions regarding First Amendment Constitutional rights, in particular freedom of expression (speech) and freedom of the press. For clarification, freedom of speech allows individuals to express themselves without constraint or interference from the federal government, while freedom of the press prohibits the federal government from interfering with the printing and/or distribution of information and/or opinions. Neither of these is impacted by our campaign rules. In addition, our candidates were not requesting to do interviews; they were being asked to grant them, and two candidates expressed concern about the process and the request, necessitating careful consideration of the concept.
The Steering Committee has discussed this at great length and has appreciated the input provided to date. If the Council and membership would like to see this process modified, we’ll certainly modify it. If the Council and membership feel that ACEP’s current communication tools may not be adequate for disseminating campaign information, we will consider including other innovative strategies within ACEP and in collaboration with non-ACEP organizations/publications. However, we ask for your understanding with respect to the process to make certain we make appropriate changes and that all of those are desired or necessary.
Personally, I have contacted several members and past leaders to poll their opinions and interest in changing the ACEP campaign processes. I have received many excellent suggestions, including consideration of broad reform of the process. To effect meaningful change as quickly as possible, the Steering Committee has appointed a task force of various stakeholders to evaluate the campaign process and make recommendations for change. The task force will have its recommendations finalized prior to the ACEP Council meeting in Chicago.
Thank you for your interest, input, and participation in making certain the ACEP candidate campaign process meets the needs of our membership.
Dr. Klauer is speaker of the ACEP Council and chair of the Council Steering Committee.
3 Responses to “Concerns, Clarifications on Interview Policies for ACEP Officer Candidates”
August 17, 2014
lbandrewHistorically, most of our election campaign rules have been rooted in fairness and objectivity, and have included such things as precluding buttons, prizes, lavish receptions, and other tactics allowed in other medical associations on which we were modeled.
There has been a sea change in our policies, through a hard fought Council Directive, that Council now elects the President-Elect of the College (something that previously happened at the Board level, with all campaigning for this important office happening in secrecy, a practice that seriously divided the College).
Those 367 leaders who represent the 33,000 members of the College now assess and elect the P-E. They are provided with campaign statements, answers to pre-set questions and a very brief Q/A session at Council in order to come to the decision for whom to vote. There is really no time to go back to constituents between these campaign events and the elections that take place at the end of Council.
At the same time, discussions regarding candidates in ACEP sponsored forums such as the Council list serve and Section list serves has been limited if not censored, while discussions regarding candidates were unfettered in list serves and other venues operated by chapters. This deprives candidates and members of needed opportunities to explore and share topical expertise and goals with important segments of our membership. Further, under current policies those members (the vast majority) that do not participate in Council or chapter discussions have essentially NO knowledge about the candidates who will be elected to represent them for several years at Board as well as officer level.
I believe fairness would be preserved and transparency improved in the elections process if several other avenues of communication were opened to candidates, at least those for the highest elected office in the College. So I would welcome comprehensive campaign reform in this regard.
Of course, guidelines will need to be established so that candidates themselves are aware of the entirety and breadth of the process (2 of the candidates this year apparently had concerns about external communications and had no notice of the possibility), and that publications and other communications vehicles such as list serves are allowed equal opportunity to participate under the guidelines.
I would hope that the Task Force will continue beyond this year’s Council to incorporate needed changes into the system to keep the elections process fair, transparent, and effective in educating members about those to whom the future of ACEP is entrusted.
Louise B. Andrew MD JD
Past Council Speaker
October 22, 2014
lbandrewThanks for this explanation and for launching the task force. I assume its work is not fully complete, but do hope that you will post the report to Council for the benefit of all the members who will not receive it as part of the Council packet this year.
I was interested to note the endorsement policy.
“official endorsements is limited to one endorsement from a component body (chapter, section, or other voting Council entity) or a single joint endorsement from two component bodies.”
It is difficult to know how a candidate can achieve endorsement by a component body unless the body has the opportunity to discuss the candidate in some forum. I suppose chapters might be able to discuss a candidate during local meetings, but sections can only discuss a candidate face to face at the annual meeting, well before candidacy is declared for the following year.
Yet at least one candidate seemingly has received an official joint endorsement by a chapter and section this year (there could be others who did not publicize this fact).
Although I suppose consensus might be or have been in this instance obtained by some method other than via the listserve, and component bodies might devise their own methods for achieving consensus, it still does not foster fairness that chapters have their own listserves that are uncensored, yet sections do not. I hope the task force addresses or has addressed this inequality.
October 22, 2014
lbandrewCorrection: Upon closer inspection, it appears that two P-E candidates report receiving endorsement of their candidacy by a section as well as a chapter.
However, the candidate campaign rules (under 12, campaign limitations) state f. Section and committee e-lists must not be used for any campaign messages.
As a member of both the involved sections, I was never contacted about endorsement or given any information about candidates that might be relevant to the decision of whether to endorse. Last year, several members of at least one section list serve were admonished for the very mention of candidates’ names, so I seriously doubt anyone even attempted to bring it up this year.
That makes it difficult to know how a candidate could be endorsed by a section when the section did not have the opportunity to discuss or come to consensus on whether to endorse the candidate.
Personally, I favor wide dissemination of information about all candidates to reach as many members as possible. But most certainly to those members (section members) whose representative (Councillor) is empowered to vote on their behalf.
I believe that other media should also be able to interview candidates, and even endorse them if they so choose. That after all is the way democracy works.
But I do respect the right and responsibility of the Steering Committee to formally consider the issue and come to a reasoned decision about what will and will not be allowed in future elections. Let’s hope that they decide to be as inclusive as possible so that members have the broadest possible understanding of the candidates’ positions, as well as the process itself.