The ACEP Odyssey

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The Unauthorized Guide to the ACEP Scientific Assembly

“Urbs in horto” City in a Garden -The Motto of Chicago

Hog Butcher for the World,
Stacker of Wheat,
Player With Railroads . . .
City of the Big Shoulders.
from “Chicago”
by Carl Sandberg, 1914

Twenty fourteen is the centennial of the first publication of Carl Sandburg’s love letter to Chicago, a city of life with all its good and bad; a place of vitality, energy, excitement and yes, the 2014 ACEP Scientific Assembly. The Committee could not have picked a better place. Despite having a Mayor named Rahm (I liked the city better when it had a Daley) and traffic that rivals DC and New York, the sites of this urban majesty are legendary. When my children were little, Chicago was a common weekend getaways. I introduced them to the Art Institute of Chicago which is home to the second best collection of impressionist and early 20th century American painters, rivaled only by New York’s Metropolitan.


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I had a trick back then, which was to limit their time at the Art Institute to 30 minutes. Why? Simple. Never bore your children with culture. I was emphatic that it would be a half-hour only. After the mandatory visit to the Grant Wood and the Seurat, they were free to explore. Upon rounding them up, they always begged for more time. I had won. Always leave them wanting more. I wonder if they will use this ploy with their own children? I hope not. Because I want to pull this one off on my grandchildren and see if lightning strikes twice.

They tell me you are crooked and I say: Yes…

Back to the business at hand: my personal guide to the ACEP Scientific Assembly, what to see and do at our specialty’s largest national meeting. I shall be Virgil to your Dante, Boswell to your Johnson as we proceed. I have spoken at the principle Scientific Assemblies in 17 countries and without being chauvinistic, ours is still the best. It’s emergency medicine’s Broadway. It’s where the action is. But you need to look over the meeting’s vast offerings and choose your path wisely. The story is often told of the young scholar who not only attended every course possible but went to all 35 commercially-sponsored off-site programs. Sad to say, his head exploded. Why? Too much information. Relax. Anything really important appears in print multiple times. It’s unlikely you’ve killed a patient by not attending any single talk at ACEP. So go for the great speakers, not the subject. I would suggest that if you haven’t heard Amal Mattu, you should. But then again, everyone has. The Jerry Hoffman/Rick Bukata show, which is a review of the literature, is like no other. It’s a classic in its own time.


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Come and show me another city with lifted head singing…

Let’s get something straight. We go to the meeting for much more than knowledge. We go to be entertained, infuriated, energized, and mostly to be in the company of people who understand us. People who can hear the term “terminal fibromyalgia” and not require any further explanation. People who understand that med school and residency only partially prepared us for what really happens on the night shift. You go to hear, and then question, the lecturers. Is what they’re saying true? Are your colleagues nodding their heads in agreement or shaking them in disbelief?

I admit that I am an ACEP junkie. This will be my 35th consecutive year presenting at the Scientific Assembly. In 1980 for the Assembly in Las Vegas, Ron Krome asked me to do some of the neurologic emergency talks I’d been doing at the Wayne State Residency since 1976. The national meeting in those days had less than 2,000 attendees (about the number Amal, Jerry and Rick will address by themselves this year). But there was as much excitement then as today. It renews my spirit every year. It will truly be a sad day when they no longer invite me back to lecture. The thought brings tears to my eyes.

Under the terrible burden of destiny, laughing as a young man laughs…


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Do me a favor: talk to people. We are a wonderful collection of people with lives as varied as they come and accomplishments which never cease to amaze me. The glow from the power and strength of your colleagues – dare I say comrades – will stay with you for months to come. Please say hello. You have opinions. Let’s hear them. We all read emails and rarely converse. What a loss. Many of my best friends are people I have met at ACEP meetings.

In ACEP as with most professional societies, about five percent of the membership does everything. Be it noted that every committee of the College meets at Scientific Assembly and every one of them is open. So if you want to stop complaining and start doing something, just show up. They are all listed in the on-site brochure and they are held at the headquarters hotel or the convention center.

If you do choose to get more involved, here are my picks. The finance committee. Sounds dull, right? Wrong. This is where you find out where the $40–$50,000 you will send the organization over your career actually goes and how it’s spent. I’m a conservative. I don’t want people wasting my money. Ask a question. Say something.

Second, government affairs. What has the federal government got up its sleeve and what are we doing to proactively improve our position with the “big dog”? Entry into the federal government affairs arena happened under the leadership of then ACEP President Richard Stennes. It was a move of genius. Most members don’t realize we have perhaps the best Washington office in all of medicine and have done better than almost everyone else in terms of reimbursement. Find out how this happened.

Third, there is a big world out there that looks to the United States for leadership in the organization of emergency care. International emergency medicine is booming and deserves your careful consideration. You don’t know what you don’t know, so just show up.

And just so one of my favorite topics gets covered, try the medical-legal committee and see what the College is working on to get the lawyers off our backs and out of our pockets.

I think you are getting the point. Hundreds of events are taking place in rooms you’d never see unless you sought them out. You have a choice. You will make your career at a person-to-person event. Find out who really has the power to change your life. Get to know them. Be with them and the process will energize the rest of the years of your practice. As I page through the brochure for the forthcoming meeting I see that on Monday between 11:00am and 1:00pm, eleven different committees or organizations will meet. Eleven, in the space of two hours. Check it out. Look at the listing. If you can’t find something that excites you, that needs your anger and input, or is at least relevant to your practice, I’d be shocked. It’s your time, your dues money and your life. It’s about a lot more than sitting in a classroom. During that Monday time slot, I’m teaching a session on neurologic case studies. But I’ll forgive you for not showing up if you find a committee meeting to attend that has a long-term impact on your career.

Fierce as a dog with tongue lapping for action…

As your guide, let me make a suggestion. Before you go to ACEP, ask this question: What can my association do for me and my career besides fight for their share of the money in a system so perverse that it will undoubtedly implode? What can I take from this meeting that will make me better able to move with the changing times? What can I take back home which will help me extend my career far beyond the limited lifespan of standard emergency department work?

Start with the end in mind. Where do you want to be in ten years and how can this experience move you toward these future goals? Believe it exists and it will exist. This is the only place where all the potential mentors and role models are to be found. They’re not just on the stage but in the seats next to you. They are the people that you are rubbing elbows with. I literally have dozens of people come up to me and just ask questions about their careers (and unfortunately about their lawsuits). I have never seen this faculty refuse to talk or answer such questions. They want to help. They want you to have a great experience.

Emergency physicians are really interested in four things: remuneration, liability, job security and status. Specifically we want to know (1) how much money will we get to keep, (2) the long-term effects of the legal system on our practice, (3) the aspects of job security which are beyond the individual’s personal control (i.e. the role of mid-levels, staffing, electronic health records and scribes); and (4) the proper status which people doing real frontline medicine deserve.

All of this is waiting for you if you only open the door. Trust me. I was there at the beginning and it’s only been getting better since then. You’ll be amazed at how your inner thoughts on everything from hospital consolidations to end-of-life care to the second half of your career lie unexpressed in the souls of everyone in the room. If you’re thinking of going just for the science, save your money. You can get CME credits cheaper. But if you want the emergency medicine rush, this is the place to the be.

Laughing the strong, husky, brawling laughter of youth…

Which brings me to the social program, which is as good a reason as any to come to this gathering. We hang out with each other. As an honorary EMRA member, I wouldn’t miss their party for the world. It is my annual stress test without wearing the leads – dancing with residents is much tougher than any treadmill. I usually want the entire crowd of children arrested for impersonating doctors – they look so young. My glycemic index and liver enzymes are always tested along with my cardiac output – thank God. I would hate to have a long life with no fun. A prude is someone who’s angry about the fact that somewhere, someone might be having a good time. Well, prudes beware, because in Chicago come the last week in October almost 7,000 people will be growing, talking, debating, complaining and definitely having a good time.

Youth, half-naked, sweating, proud to be Hog Butcher, Tool Maker, Stacker of Wheat, Player with Railroads and Freight Handler to the Nation.

Poem excerpts taken from Carl Sandberg’s “Chicago,” first published in 1914
Photo by Matthewjs007

ABOUT THE AUTHOR

EXECUTIVE EDITOR
Dr. Henry is the founder and CEO of Medical Practice Risk Assessment, Inc.; past president of ACEP.

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