Keeping the ACEP Leadership Fire Going

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Two rising board members share thoughts on recruiting and retaining the next generation leaders.

The first 50 years of ACEP and Emergency Medicine were so exhilarating — EPM wants to stir up the same energy today!

Aisha Liferidge and Gillian Schmitz, two exceptional young emergency physicians on the ACEP Board of Directors discuss their EM leadership journey and how their paths can inspire students, residents and young graduates to carry forward.   


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JUDITH E. TINTINALLI:  In my opinion there seems to be a decline in general interest in emergency medicine leadership, at least compared to the energy I experienced in the early years. How did you get interested in developing a leadership role in medical school and after that, residency?

AISHA LIFERIDGE:  My parents ensured that I had ample opportunities to lead even as a small child through my activities at church and in the community. In medical school, which was at UNC Chapel Hill, Dr. Jane Brice introduced me to leading through emergency medicine and research efforts. She planted the true seeds of leadership.

During residency at the University of Maryland, I became interested in advocacy work and became involved with EMRA because I longed to contribute from a larger platform, and I knew that I had something to offer. Ultimately, I was elected president of EMRA as I was wrapping up my residency training.  While I was an attending, I went back and got my Master’s in Public Health degree from Columbia, which focused on health policy.


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I knew that I wanted to play a larger role in helping lead and shape our specialty at the national level, and I realized that policy and advocacy are key ways to create meaningful change in perpetuity, on a large scale. Optimizing patients’ access to the care was what initially motivated me to lead.

GILLIAN SCHMITZ: Prior to medical school, I worked for a government contractor in Washington, D.C., and was involved with a NATO working group. I did a lot of work and presentations in different countries that exposed me early to different leadership experiences and medicine.

When I started medical school, I missed being part of something bigger. I trained at the University of North Carolina and one of the greatest things about our program was our faculty. There were a number of mentors I had early on in my career that exposed me to organized medicine.

In my intern year, I ran for the SAEM Board, but didn’t get it. I was disappointed, but figured there would be other opportunities. I then ran for the EMRA Board of Directors my second year and did get elected. I subsequently got involved with CORD, because I really wanted to get involved in resident education. That early exposure as a resident, and particularly having mentors like Abhi Mehrotra and Cherri Hobgood, helped open a number of doors and really planted the seed of how to get involved, how to network, and how to do something beyond just my day job in the ER.


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TINTINALLI:  If someone isn’t sure about their potential for leadership, how do you excite them to get involved?

LIFERIDGE:  People are motivated by relevance and degree of impact. We have to do a better job of determining what is most relevant, not just to residents, but to younger physicians in general. If we are intentional about explaining with clarity and modeling through our own actions how getting involved can result in concrete, impactful outcomes, then it’s easier to hook someone’s interest.

Without a doubt, I think that we’ll find that there is overlap between what’s relevant to young physicians and what’s relevant to our specialty as a whole. We must seek out and focus on finding those areas of commonality and exploiting them in order to align incentives and satisfy all needs.

Leadership has a lot to offer, but it’s not always intuitive especially if one is less familiar with the culture of leadership. We have to be able to clearly articulate and demonstrate why every single voice matters, and how that voice can really create meaningful change — not just for our specialty as a whole.

SCHMITZ:  One of my ambitions from early on was drawing in young physician leaders. I was the chair of our Young Physicians Section for ACEP and I found engaging young physicians was often a challenge.

How do we get people to understand the value of organized medicine, of getting involved and taking a leadership position and really reaching those at high levels who make decisions? There are a couple of things that I think have been impactful or meaningful.

Many of our state chapters have developed a leadership/mentorship track, with board positions and graduated leadership responsibilities. One starts by sitting in on a few meetings. Leadership starts with just showing up and expressing an interest. Many of our chapter and national board meetings are open; anyone can attend. We encourage young physician input and involvement.

As residents and young physicians, many people are intimidated by the process. They don’t really understand it. They don’t know how to get involved. They’re not sure if that’s really where they want to invest their time because they’re drawn in so many different directions. But making it easier for them to get involved, reaching out to them rather than waiting for them to call us, I think is a great way to start to initiate that process.

Another way we are trying to reach out is through residency visits. A lot of what is happening in emergency medicine is not in our core curriculum or residency training. Communicating the importance of advocacy and the impact we can have as physicians is essential.

TINTINALLI:  We’re seeing so many starting out after residency with a locums group, which leads in some ways to isolation from the hospital, institutional and leadership environment. How do you attract these young physicians into leadership?

LIFERIDGE:  The key is to determine what their needs are, what their interests are and what they value. It’s about offering something that they find valuable and convincing them that they are valuable to organizations.

A new ACEP section for locum tenens EM physicians is on the horizon, for example. Given how many emergency physicians practice locums, you would think that this formalized group would have already existed by now. It’s so important to give individuals a standing and official home wherein they feel supported and able to express their unique interests and concerns.  Having a locum tenens section will therefore hopefully allow that group to have a voice and enable us to learn more about what it is that does and doesn’t motivate them, to make sure that they remain engaged.

SCHMITZ: There’s been a change into the types of job opportunities that are opening and what really drives emergency physicians. Resident graduates are looking to pay back their loans. We know the cost of medical care is escalating and the ability to pay back those loans is a burden for many of our younger physicians. Locums do present opportunities for high salaries, and they draw EPs to certain environments. One of the things that I’m proud of within ACEP is we are actually looking at developing a locums section because that interest has piqued so much. These are physicians who want to be involved.

TINTINALLI: How can we get EPs of every type involved in leadership?

LIFERIDGE:  Before we can engage young minds and younger docs around leadership, current leadership must prioritize creating a cohesive and unified collaborative healthcare system that is intentionally inclusive and mission-focused. We then, must bring all of our diverse talent together to get a handle on how to more effectively approach and solve the complexities that we now face in health care.

We as leaders must also do a better of job of consistently keeping our members informed of all the hard work that is done on their behalf every day, because they do matter! ACEP spends a tremendous amount of energy and resources on advocating for emergency physician wellness, fair payment, clinical privilege, and the like, by interacting with government agencies, organizations, and other specialty societies every day. We have to make it clear that those efforts do trickle down to make the day-to-day lives of emergency patients and physicians better.

SCHMITZ:  Millennials prioritize their free time. They don’t always understand the importance of advocacy and of getting involved. For many people who go into emergency medicine, there’s a mentality of when I’m off, I’m off.

When we look at that young physician demographic, many people when they graduate from residency are in their early 30s and that happens to coincide when people are starting families. Many people in my generation are now raising both their children and now caring for their elderly parents. People feel stretched in so many directions that getting involved on an advocacy level or getting involved in organized medicine simply becomes less of a priority, even if they understand the value of what it brings. It’s going to be up to us to really light that fire and inspire them and help them understand why getting involved is so critically important.

TINTINALLI:  What have been your own personal benefits that you see from your very rich involvement in leadership?

LIFERIDGE:  It’s challenging to be intentional about making sure that your life is well-rounded and balanced. For me, being a leader actually helps maintain my stamina as a professional because it provides me with a wider view of my purpose and influence, rather than just taking care of patients in a clinical setting.

There are people that I mentor who are watching me, and I want to set a really good example. But I also want to last. I want to finish this work. I want to finish what I’ve started of contributing what I can to make the world better, and that takes years of commitment.

It’s important to maintain your humility and know that leaders must continue to listen. They must continue to grow and know that we all are really just an ongoing work in progress. There is still work to be done within myself, and I know that listening is a really key skill that will allow me to continue to grow as a leader and individual.

SCHMITZ:  We’re part of a community. Emergency medicine can be very isolating. Other people don’t necessarily understand what we do and understand the challenges of night shifts. You have to have a sense of EM community that fosters relationships, and helps us to commiserate and laugh about our common experiences and shared interest in emergency medicine.

I choose to get involved because I can influence change that has a direct impact on my practice. Last week, our hospital went through its policy on procedural sedation: who can and who cannot give ketamine or propofol in the ED, NPO status and restrictions on the number of providers required to provide procedural sedation. I was able to respond: No, EM has a policy on this that has been approved by CMS. We can absolutely use ketamine and propofol and this is well within our scope of practice and is evidence based.

It’s that kind of stuff that I can do at a national level and take it back to the local level and see change in my own practice and clinical environment. And that to me is very rewarding.

ABOUT THE AUTHOR

EDITOR-IN-CHIEF Dr. Tintinalli is currently a professor and Chair Emeritus of Emergency Medicine at the University of North Carolina. In addition to teaching in the emergency medicine department, she is an adjunct professor at the UNC Gillings School of Global Public, and a frequent lecturer in the School of Journalism and Mass Communication. Dr. Tintinalli is double boarded in emergency medicine and internal medicine. She was the founder and first president of the Council of Emergency Medicine Residency Directors. She is a former president of ABEM as well as the Association of Academic Chairs in Emergency Medicine. She is a past winner of ACEP's James Mills award as well as ACEP's National Education Award. And of course, she is the Editor-in-Chief of 7 editions of her eponymous textbook, which is arguably the best-known EM text in the world.

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