From the Man in the Red Socks: “We Can Be a Specialty!”

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Brian Zink’s History of Emergency Medicine

Last time, I covered the move toward organization of EM, starting in August 1968 by John Wiegenstein and seven colleagues as the fledgling American College of Emergency Physicians. The next major event was a national meeting called by Reinald Leidelmeyer, MD in Arlington, Virginia on Saturday, November 16, 1968. Leidelmeyer welcomed 32 self-proclaimed emergency physicians, including the eight Michigan physicians and a few others.

Wiegenstein spoke and described the Michigan initiative, and his vision for a national organization that could help educate emergency physicians. The next speaker was Alan McIntosh, MD, from the American Academy of General Practice (which became in 1969 “Family Practice”), who invited the emergency physicians to join their group. This was not met with enthusiasm.

Next up was R. R. Hannas, MD, who was also working for the AAGP in their move toward specialty status for family practice. Hannas was a wiry, frenetic man with a red crew cut who had served in the Marines during World War II, then graduated from Harvard Medical School and went in to general practice in rural Oklahoma for 14 years. He always wore red socks, as a tribute to his young son, who one year bought him red socks for Father’s Day from the local general store. Hannas had started to work part time in emergency departments by this time, and liked the variety and intensity of this work.

Hannas stood up and took command of the room. His vision, even though he was very new to the field, was that the group should not aspire to just an organization, but should push for a new medical specialty. This was a concept that no one else in the room had advanced. Hannas pulled out a long sheet of paper, later referred to as “that toilet paper thing”, that listed what would be required to form a specialty of emergency medicine: definition of content, graduate training programs, medical school departments, a board with a certifying exam, continuing education, and research to expand the body of knowledge. The specialty organization could be the catalyst driving all this forward.

As an organizational geek who had already done much of this work in family practice, Hannas loved the prospect of fighting the battle to create a new specialty. The others in the room had never thought that big, but Hannas’ proposal stirred the group. In closing, Hannas said: “These guys from Michigan seem to have started something good – let’s just join them!” The gathering agreed, and the American College of Emergency Physicians was officially formed, with John Wiegenstein elected as President. Hannas was on the Board of Directors.

In many ways, the formation of emergency medicine as a new US medical specialty and board was an audacious response to the needs of patients. It took people who were audacious, and willing to push hard to make it happen. R.R. Hannas (affectionately called “R-squared” by his friends) went on to become a key early leader in EM and practiced for many years in Kansas City. I had the fascinating experience of interviewing him when he was a spritely 84 years old and still wearing red socks. He had retired to Tuscon, Arizona and bought an Irish pub. His next step, he told me, was to get involved in the national bar owners’ association. Of course!

ABOUT THE AUTHOR

Brian J. Zink, MD is a Professor and Chair in the Department of Emergency Medicine at Alpert Medical School of Brown University. Dr. Zink is also the author of Anyone, Anything, Anytime- a History of Emergency Medicine (Mosby Elsevier, 2006)

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