The Pulse - April 2013

The PULSE APRIL 2013 1

role models at all levels of our profession are the leaders we look up to. These leaders demonstrate the values of service, dedication and ingenuity. In discovering these great leaders it might be interesting to trace where they came from. Our success can be traced back to our training and our willingness to boldly go down the road less traveled. But what do you know of physicians who boldly stepped forward so that society would be served lofty values of patient independence, freedom and truth. Let me offer a brief review of physician leaders who set the example by their character to do what is best for our patients and the society we serve. You may know the story of Paul Revere’s ride made legend by famed write Henry Wadsworth Longfellow in Tales of a Wayside Inn. But do you know the real story? It’s a story that, at a veiled level, may be more important than the actual story itself, for it highlights the character and characteristics of real leaders. These attributes of our patriotic forefathers over 200 years ago are the same attributes we can find among our physician ranks today. The story, in a nut shell, begins with Paul Revere and William Dawes. They were tasked by Joseph Warren with warning the colonists of an impending attack upon the village of Concorde as the King of England attempted to impose his tyrannical rule. Revere’s story was fabled by the poem which eloquently captured the daring midnight ride. But did you know Paul Revere did not get to complete continued on page 6

Presidential ViewpointsGregory M. Christiansen, D.O., M.Ed., FACOEP

the mythical ride? Only an hour into the foray, Revere was captured and later killed by the British military. The success of that ride was actually due in no small part to a patriot named Samuel Prescott. It was this physician, Dr. Samuel Prescott, who took up the task and skillfully evaded the pursuing British troops from Lexington all the way to Concord. He alerted the Minutemen and Militia of an impending attack and saved the revolution’s precious military depot. Prescott went on to work as a surgeon for the revolution before being captured later in the war. The planning and foresight of the ride was the work of another doctor, Dr. Joseph Warren. You may already be familiar with Dr. Warren. 14 states have named a county after him in his honor. Additionally, 30 towns, five naval warships and one fort have borne his name. To give you some background, Dr. Warren was appointed to the Boston Committee of Correspondence and later the President of the Massachusetts Provisional Congress – the highest position in the revolutionary government. In the build-up to the revolution, he and Dr. Benjamin Church were the last two officials to stay in Boston during the British occupation. From here Dr. Warren drafted the Suffolk Resolve and supported the resistance to Parliament’s Coercive Acts – documents considered by most historians as major factors in the development of the Declaration of

April 2013VOLUME XXXVII NO. 6

Almost 100 years ago, Robert Frost remarked upon the road less traveled. The poem’s simplicity conveys a powerful message of inspiration, discovery and leadership. It timelessly resonates with those bold enough to ponder the possibilities. As osteopathic physicians, you already know the value of a road less traveled. The path we chose was arduous, but it gave us the ability to uniquely better serve our patients. It is in this vein that ACOEP has promoted leadership development. Leadership has been a priority for our college as we offer our members opportunities to take us to the future. It is with great pride that I reflect on our members’ success. Their service to their patients and profession has put osteopathic medicine at the forefront and now the world wants to learn more. We are not a secret anymore and the path we have chosen is leading others to seek our view of the future. I am sure you personally know outstanding physician leaders who we would all want to emulate. These

The History of Our Future

The PULSE APRIL 20132

2013 SCIENTIFIC ASSEMBLYThe Leader in Osteopathic Emergency Medicine

SAVE THE DATE

OCTOBER 6–9, 2013

Hilton San Diego Bayfront

San Diego, California


The Pulse Editorial Staff:Drew A. Koch, DO, FACOEP-D, EditorWayne Jones, DO, FACOEP, Assist. EditorGregory M. Christiansen, DO, M.Ed., FACOEPMark A. Mitchell, DO, FACOEPErin Sernoffsky, Communication ManagerJanice Wachtler, Executive Director

Editorial Committee:Drew A. Koch, DO, FACOEP-D, ChairWayne Jones, DO, FACOEP, Vice ChairJulia Alpin, DODavid Bohorquez, DO Gregory M. Christiansen, DO, M.Ed., FACOEPJoseph Dougherty, DO, FACOEPAnthony Jennings, DO, FACOEPWilliam Kokx, DO, FACOEPAnnette Mann, DO, FACOEPMark A. Mitchell, DO, FACOEPErin SernoffskyBrian Thommen

The PULSE is a copyrighted quarterly publication distributed at no cost by the ACOEP to its Members, library of Colleges of Osteopathic Medicine, sponsors, exhibi-tors and liaison associations recognized by the national offices of the ACOEP.

The PULSE and ACOEP accepts no respon-sibility for the statements made by authors, contributors and/ or advertisers in this pub-lication; nor do they accept responsibil-ity for consequences or response to an advertisement. All articles and artwork remain the property of the PULSE and will not be returned.

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Deadlines for the submission of articles and advertisements are the first day of the month preceding the date of publication, i.e., December 1; March 1, June 1, and September 1. The ACOEP and the Editorial Board of the PULSE reserve the right to decline advertising and articles for any issue.

©ACOEP 2012 – All rights reserved. Articles may not be reproduced without the expressed, written approval of the ACOEP and the author.

Table of ContentsPresidential Viewpoints . . . . . . . . . . . . . . . . . . . . . . . . . . . .1Gregory M. Christiansen, D.O., M.Ed., FACOEP

The Editors's Desk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 Drew A. Koch, DO, FACEOP-D

Executive Director's Desk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Janice Wachtler, BA, CBA

ACOEP Represents Our Membership with EDPMA . . . . . . . . .7Hurricane Sandy: An EMS Physician's Perspective . . . . . . . . . . .9Stephen J. Vertrano, D.O., FACOEP, FACEP, EMT (I)

Thoughts From an Aspiring Leader. . . . . . . . . . . . . . . . . . . . . .11Andy Little, D.O.

What Would You Do?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12Bernard Heilicser, D.O., MS, FACEP, FACOEP

FOEM: Foundation Focus . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 FOEM: 2013 Lifetime Contributors. . . . . . . . . . . . . . . . . . . . .19 Residency Spotlight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25Resident Chapter Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

PULSEO S t E O P a t h i c E m E r g E n c y m E d i c i n E Q U a r t E r L y

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It has been over a year since we started using scribes services in our Emergency Department and the transition has been a very positive e x p e r i e n c e , e s p e c i a l l y considering the

hurdles that had to be jumped in order to implement the program. I cannot imagine how I survived without a scribe for the first 26 years of my Emergency Medicine career. Who are scribes and what is their background? Typically they could be anyone with a health care background or a desire to pursue a career in medicine. Our scribe corps is comprised of individuals who are interested in going to medical or physician assistant school. They are typically college students or college graduates who are taking time off before they apply to medical school. Once we bought in to the scribe program and everyone was on board, it has taken off. We do not have every physician shift covered with scribes, nor did every physician want a scribe, however the benefits are noticeable with the physicians who utilize their services. The scribe program should be cost neutral. In other words, the program must pay for itself. This is evident with

The Editor's DeskDrew A. Koch, DO, FACEOP-D

Scribes

the increased productivity of the physicians and the number of incomplete charts has decreased. Both of these measures improve the bottom line. Customer satisfaction scores are improved because more time is spent with the patient and less time is spent documenting and reviewing the patient’s past medical history. Scribes cannot have direct patient contact, however they can provide the patient with comfort measures such as warm blankets, food and drink if approved by the physicians. Did you ever want to do a pelvic exam or rectal exam and cannot find a witness? Scribes can chaperone these exams as long as they do not have any direct patient care. Scribes can also initiate phone consults for the physicians. They not only record the results of the diagnostic studies on the chart, but they are able to call the lab or radiology to find out the status of a given test. While the physician is obtains the history and physical, the scribe records everything. When the physician exams the patient they describes the examination to not only the scribe but to the patient and their family and friends. This improves customer satisfaction and allows the patient the opportunity to ask questions during the examination. Many patient complaints come down to a he-said-she-said situation. The scribes are witnesses to the interaction between the physician and patient and the patient’s families and are able to provide an objective account of what actually transpired.

Conversely, they are witnesses to physician-physician conversations and able to record what transpired in the medical record. Scribes can also be utilized to write the patient’s discharge. If you have canned discharge instruction, the scribes can print the instructions along with prescriptions and work, school and gym notes. The Emergency Department charts that the medical staff despises because they are not legible or unable to follow have become legible with the scribes. The charts still all sound the same, but at least they are legible and complete when they are sent out to the medical staff. Of course, their work has to be reviewed. You must sign an attestation statement confirming that their work is accurate. The real benefit to our scribe program has yet to be fulfilled. This will be realized when the Emergency Department goes to an electronic medical record (EMR) later this year. This will hopefully make the transition from paper charts to EMR go smoother and not cause a significant decrease in provider productivity. Our scribe program is now embraced by all of our full time docs. It is an excellent recruitment tool when bringing on new full time physicians. Hopefully, we will be able to provide full time scribe coverage to all of the full time docs. The last edition of The Pulse was supposed to be my last as the Editor and my last article; however, until a new editor is confirmed, I will continue to serve ACOEP.

We Want to Hear from You!

ER Physicians do incredible things every day and we want your stories! From Dr. Vetrano’s experience with Hurricane Sandy, to Dr. Heilicser’ s What Would You Do column, we know that our members have thoughts to share. Send your story ideas to [email protected], we would love to share your experience with our members.We also encourage you to email [email protected] to share your thoughts on specific articles that you read here. We want to keep the conversation rolling, whether you agree or disagree with a point of view represented in our articles, we want to highlight various perspectives from our diverse membership.


About ten years ago ACOEP proposed that the AOA create an agency and a c c r e d i t a t i o n system similar to that of the A c c r e d i t a t i o n Council on

Graduate Medical Education (ACGME). The system would remove the Department of Education, Division of Postdoctoral Training from the political appointment process and bring the standards and evaluation processes in line with the larger national system. It was not meant to criticize AOA or its staff, but to look at the educational processes and align them with those of the allopathic group. The outcome of that resolution was a reinvigoration of the Education Policy and Procedures Review Committee (EPPRC) which changes more of the procedural function of graduate medical education, but did not change its political process or bring it in alignment with ACGME. In 2011, ACGME produced an edict that threatens the AOA’s GME accreditation process and will probably result in the

Executive Director's DeskJanice Wachtler, BA, CBA

Changing the Paradigm for Graduate Medical Education

incorporation of the accreditation processes of both systems into a single, unified system of national accreditation. As we begin the process of amalgamation into this unified system of accreditation we wonder what else awaits us as we start down the road of having one training model for emergency medicine? Training in emergency medicine has several different faces in the U.S. Allopathic medicine allows for both three and four year programs; osteopathic medicine is solely a four-year curriculum. So what is the best format? Opinions vary from person-to-person, physician-to-physician. Many feel that the four year graduates are more mature and able to ‘run a room’ than those with a lesser amount of training. Others feel exactly the opposite. What should be the template for success of these young physicians? I truly don’t know. The Committee on Graduate Medical Education and the ACOEP Board of Directors have considered this question for at least ten years and we’ve taken the stance that the four-year curriculum is best and produces the best emergency medicine physician, regardless of the initials after their name or the pathway that will ultimately credential their training program. But what do you, the member of

Committed Physicians Interested in Serving on College Committees

The annual appointment for physicians seeking committee positions on ACOEP Committees will begin during the last quarter of 2013. Physicians seeking appointment to any committee should send his or her CV with a letter naming the committee they would like to be appointed to and why. All applications must be

received by December 1st and will be assigned based on availability. Terms are 3 years beginning January 1 and ending on December 31st.

Committees are open to any physician and we encourage interested physicians to sit in on meetings of Committees that you are interested in being appointed to. Appointees must attend 66% of all meetings, conference calls and must participate in the activities of the Committee. Failure to do so will cause the appointee to be removed from the committee.Send your information to: Jan Wachtler, Executive Director, ACOEP, 142 E. Ontario St., Suite 1500, Chicago, IL 60611

ACOEP, think?The four-year curriculum currently is made up of the following component rotations: 24 months of emergency medicine (a minimum of 4 months per year of training); 2 months of critical care; 2 months of general medicine/medical subspecialties; 2 months of surgery/surgical subspecialties; 1 month of obstetrics/gynecology; 1 month of orthopedics; 2 months of pediatrics/pediatric emergency medicine/ pediatric ICU; 1 month of trauma; 1 month of EMS; 1 months of administrative and administrative activities (research, medical legal, QA); 6 months of selective rotations to strengthen competence; 2 months of electives, and the remaining 3 months are devoted to vacation and selective rotations.What does a practicing emergency physician think is extraneous to the program? Do you think any rotation should be cut from the curriculum? Do you think additional training is needed? Now is your chance to have input in the curriculum, let us know by June and we will consider your comments in September when we again look at the standards for training. You may contact me at [email protected] with your suggestions.


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Independence. Warren’s tenacity led a group of militia to successfully engage the British in Concord and Lexington. His actions are credited for saving the lives of John Hancock and Samuel Adams who were targeted by the British. After being wounded in battle, Warren’s mother pleaded for his withdraw from the fight. To that Dr. Warren remarked, “Now is not the time for any of America’s children to shrink from any hazard. I will set her free or die.” Warren went to fight at Breed’s Hill where he inspired his fellow troops. After running out of ammunition he stayed on to fight the last wave of the British assault, thereby giving his militia a chance to escape. British General Thomas Gage lamented that the death of Dr. Warren was equivalent to 500 men, owing to the influence he had among the colonialists. As you can see, as a leader your standing in the community is supremely important. Your actions, words and deeds often act as multipliers to benefit, not just yourself, but the people whose lives you touch. Let me tell you the compelling story of an unwitting patriot whose character led him to become a physician. His dedication to his patients and political circumstances led him to become embroiled in one of America’s most influential events. This is the abridged story of Dr. Beanes. In his younger days he supported Boston’s position on the resistance of Coercive Acts. It set him on his path to leadership. He must have been among America’s earliest emergency doctors, shown in his determination to step in and fill the void when our country needed him most. He volunteered his medical services at the General Hospital of Philadelphia after the battles of Concord and Lexington. He was a key figure in tending the wounded in prominent battles like Brandywine and Valley Forge. But it was in his later years, during the war of 1812, in which he made history. Beanes was considered to be among the most respectable and humane members of his Maryland community. Even after the burning of Washington, Beanes tended to both American and British soldiers. Deserting British soldiers were plundering the Maryland farmhouses including the

home owned by former Governor Robert Bowie. Bowie asked Dr. Beanes, who in turn brought Dr. Hill and Mr. Weems, to capture the British deserters and put them in the county jail. One prisoner escaped and reported the incident to the British Vice Admiral. Beanes was arrested and transferred to brig of a British ship. Friends of Beanes went to the Georgetown lawyer, Francis Scott Key, to negotiate Beanes release. Once Keys presented the Vice Admiral with the collection of letters from the British soldiers attesting to the good medical treatment from Dr. Beanes, his release was placed in advisement. However, since being aboard the British warship, Keys and Beanes had seen the battle plans to the eminent attack on Baltimore. Since the British were not willing to lose the advantage of surprise, both Keys and Beanes were detained until the battle was done. Despite the apparent hopelessness of the situation, some good would eventually come from the action that would help define the nation. It was from the prison cell aboard ship that Francis Scott Key penned the poem, The Defense of Fort McHenry. This poem was put to song and later became known as The Star Spangled Banner. Then there was a quiet physician leader who grew up in abject poverty in Detroit. He tells the story of his mother making him read and then write book reports not knowing she could not read herself. From his reading he learned to explore the world and develop his imagination. He went on to become an inspiring man who developed the Carson Scholarship and Reading Project. These nonprofit projects were designed to battle what he hates most – poverty. The leader willing to put his energies into action is Dr. Benjamin Carson. He is the pediatric neurosurgeon who at the National Prayer Breakfast was bold enough to refute the President and the prevailing media on policies that he sees as threatening to the country. He focused on the causes of poverty which rob our patients the most basic defenses to good health, namely good nutrition and oddly enough – education. He spoke from his experiences that developed into the wisdom to do what he could to help change the lives of others who would be

burdened with similar circumstances. He eloquent spoke of the need for sound monetary policies and the dismantling of burdensome regulations which failed to follow the letter and intent of the Constitution. Without opportunity, hope is robbed from the human spirit. He noted the lack of critical thinking in our education is causing our nation to fail in its duties to ensure our country’s future. He noted the special skills and abilities of physicians to use empirical data, define metrics and analyze factual information. These key skill sets enable doctors to be excellent choices in leading public policy. He also railed against the politically correct because it quashed the ability to test ideas. It is the individual who needs the freedom from oppression to develop the expression of ideas and imagination. He used the analogy of the bald eagle to describe the importance of this expression of ideas. The bald eagle is majestic because it knows how fly high. It must use its left wing and its right wing to be successful in moving forward. We live in very tumultuous times and there is a need for leaders to test ideas, investigate hypothesis and analyze concepts. We need to use our skills to validate or reject public policy designs to give our patients the opportunities to make their own decisions. We should also be mindful of history to avoid repeating failures. For example, policies that impugn the entrepreneurial spirit by imposing forced business models discourage innovation and adaptation. This insidious policy paradoxically weakens our medical advancement over time. Symptoms already evident give validity to the alarm and concern. Just look to the chronic drug shortages which are now a fact of life and serve as an example of how these policies slowly degrade the care for all. Let face it, it’s a bold statement to take the road less traveled. You have already demonstrated your fortitude by choosing a career – not a job – in emergency medicine. It’s a bolder statement for you to stand up for your patients when your patients need you most. Choose to take a road less traveled and be sure to give us all a glimpse of your point of view.


actual patient attitudes about their care.2. ED Patients Surveyed: Current surveys do not evaluate emergency department care forthe sickest patients, including patients that are admitted to the hospital. Since a largeproportion of resources, focus, and effort are spent on this important group, we recommend including them in the population of patients surveyed.3. Survey Method: There are many methods of obtaining patient feedback and input. Each has strengths and weaknesses with respect to accurately reflecting overall satisfaction with emergency department care. Of particular concern, using written surveys (versus calling patients and interacting with them personally) can encourage a negative selection bias, which skews results toward the most unsatisfied population. Whatever the feedback mechanism, comparisons between facilities (or providers) must only be made if the same method is used in a similar timeframe (irrespective of the questions asked). Failure to do so often results in inaccurate conclusions and misdirected actions.4. Attributing Results to Individual Providers: In the emergency department environment, health care is delivered by teams, including nurses, technicians, physicians, and other professionals. Since emergency care is delivered 24/7 and shift changes are required, a patient may experience multiple individuals and multiple teams appropriately participating in their care. These realities emphasize the importance of evaluating the communication between providers (addressed below). However, patients may have considerable difficulty attributing and evaluating their satisfaction with individual care providers. This is especially true if the survey is delayed for weeks or months after the care is rendered. If satisfaction surveys are intended to evaluate and compare individual providers, we recommend that

efforts to evaluate and compare patient experiences in a variety of settings. In addition, our membership has experience with hospitals, health systems, and physicians that utilize survey results to inform financial incentives and penalties. The current systems that are utilized for evaluation of patient satisfaction in the emergency department setting are not geared to our unique environment. We do not have the ability to control many of the factors we are faced with including volume surges, acuity, or breadth of services provided by the facility. EDPMA and ACOEP agreed with CMS that existing instruments, which are often designed for either outpatient or inpatient care, are not sufficient to reflect the patient’s experience of care in the emergency department setting, and therefore hamper effective efforts to improve this essential component of the health care delivery system. We support efforts to develop a survey that will enable objective, evidence based, methodologically sound comparisons of patient experiences in various emergency settings across the United States. We urged CMS to ensure that any survey instruments reflect the unique nature of the emergency department environment. Importantly, we also urge CMS to ensure that survey methodologies and deployment mechanisms (including the timing and manner in which the survey is conducted) are valid, reproducible, statistically sound, and that each survey’s conclusions and implications will meaningfully drive appropriate changes that support cost-effective, quality patient care. Shortcoming of Instruments, Measures, and Methods Currently in Use1. Sample Size: Current patient satisfaction survey tools frequently utilize response rates that are too low to produce accurate, reliable results. Frequently, standard rules of probability and statistical significance are not utilized. Therefore, survey results may not reasonably reflect

ACOEP was invited to have a representative serve on the Federal Health Policy Committee of the Emergency Department Practice Management Association (EDPMA). EDPMA is one of the nation’s largest trade associations that support the delivery of emergency medical care to all Americans. Together, EDPMA’s members deliver (or directly support) health care for over half of the 136 million patients that visit US emergency departments each year. Its members represent one of the most important and necessary elements of American’s healthcare system. EDPMA’s membership includes emergency department physician groups of all sizes, as well as organizations that support health care providers in the delivery of high quality care in the nation’s emergency departments. In February the Federal Health Policy Committee worked diligently to provide a response to CMS on CMS-4169-NC: Medicare Program Request for Information To Aid in the Design and Development of a Survey Regarding Patient Experiences with Emergency Department Care. The response was based upon the feedback and frustration that many Emergency Physicians have voiced over the years based upon the current patient satisfaction survey tools that are being utilized. We obviously all support the delivery of high quality, compassionate care in an environment that can hopefully result in a positive experience. We also realize that we are faced with every growing challenge in meeting the needs of every patient all the time. Our response focused on the major areas noted below. Need for a Unique Survey to Reflect the Emergency Department ExperienceJointly the membership of ACOEP and EDPMA provides services in hospitals in multiple states and in hospitals of various sizes and capacities. Therefore, our members have broad-scale, first-hand experience with current and historical

ACOEP Represents Our Membership with EDPMAMark A. Mitchell, D.O., FACOEP, FACEPPresident - Elect

ACOEP Represents (continued on page 8)


ACOEP Represents (continued from page 7)

considerable efforts be expended to insure that there is precise matching of patient feedback to the individual provider. This is most effectively accomplished by point-of-care surveys. In the correspondence we also addressed the following areas of concern and made recommendations as well.• Delays in obtaining results from patients.• Unintended consequences of patient satisfaction surveys including the most satisfied generally have high health care cost.• Concern over the use of patient satisfaction surveys for reimbursement, incentives, penalties, or other financial purposes.• Utilization of raw scores in addition to percentile rankings.• Recommendation that any survey tool should include the

following substantive areas: o Communication o Pain Control/Management o Waiting Times o Communications within the ED Team o Emergency Department Environment• Characteristics of an effective survey tool: o Survey access for all emergency patients regardless of disposition o Standardization of measurable. o High response rates o Judicious cost to support effective data gathering ACOEP and EDPMA support and encourage CMS ongoing quality improvement efforts for Medicare beneficiaries. With respect to measuring patient satisfaction, we agree that there is a need to tailor a specific approach for the patient experience in the emergency department. We are concerned that

there are significant shortcomings and unintended consequences of current approaches. ACOEP and EDPMA stand in commitment to working toward effective solutions. We also made the offer to assist CMS in development of the tools and processes needed for a successful program. I am representing ACOEP in this role and am very pleased with the opportunity this affords our membership to have yet another avenue to be heard and have an impact on the ever-changing environment we are facing. EDPMA has their annual Solutions Summit XVI to be held April 28 – 30 at the Cosmopolitan in Las Vegas. I will be representing the membership of ACOEP in two (2) of the sessions that will be held during that conference. If you are interested in attending please visit the EDPMA website for more information.

EM Physician opportunity within EM ResidencyCHARLESTON, WEST VIRGINIABP/BC EM physician opportunity within EM Residency. Ideal for a physician who enjoys teaching, this three-hospital system has 100,000 annual ED visits and includes a Level 1 facility. In addition to Emergency Medicine, there are numerous allopathic & osteopathic residencies; as well as rotating medical and allied health students. Equity-ownership group provides outstanding package including family medical, employer-funded pension, CME, malpractice, plus shareholder status at one year with no buy-in. As West Virginia’s largest city, Charleston offers both metropolitan amenities and easy access to outstanding outdoor recreation.

For additional information, contact Rachel Klockow, Premier Physician Services [email protected], (800) 406-8118, fax (954) 986-8820.

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Stephen J. Vertrano, D.O., FACOEP, FACEP, EMT (I)

Hurricane Sandy: An EMS Physician's Persepctive

As everyone knows, Hurricane Sandy made landfall in the Mid-Atlantic region on Oct. 29, 2012, causing billions of dollars in damage. Principal areas affected were the Jersey Shore, New York City and Long Island. The actual landfall was just south of Atlantic City, but that landfall is the eye of the storm. The clouds surrounding the eye battered the areas north of Atlantic City, as the storm circled counterclockwise around the eye. These are areas I call home. I grew up in a small town called Neptune. Its principal neighbor is Asbury Park, home of Bruce Springsteen and the legendary bar The Stone Pony. I went to high school in neighboring Belmar, and hung out with friends many a night at the Point Pleasant or Seaside Heights boardwalks.Much of that is gone, as the pictures have shown time and again. What role did I play in all this? Where do I, as an ED and EMS physician, fit into the response? Much of my role was in preplanning. Our principal enemy in this storm was wind. I live 30 miles from the shore, and in my area, tides were right so the Delaware River would not flood, as it had during Irene. Our main problem with wind was infrastructure damage: wires and utility poles down, streets blocked, power loss. Our other problem was in response: the higher the wind speed, the more dangerous it is for public safety apparatus (ambulance, fire trucks) to respond. NJ is fortunate to have a quasi-state agency known as the EMS Task Force. Born out of the response to 9/11 and counterterrorism funding, this group has become the principal authority in large scale response, incident support and operation planning for EMS. They have many dedicated response plans, including one for tropical storms. The NJ Office of EMS adapted their plan and made its use statewide for all agencies. Part of this plan is the cessation of EMS operations when

sustained winds reach 50mph or gusts reach 60mph. While great on paper, this plan raised many questions: if the ambulances aren’t running, what do we tell people who call 911? Does the dispatch centers do telephone triage, providing advanced instructions approved by a medical director? Do dispatchers still dispatch the ambulances, but leave it to the providers to follow or not follow the state plan? Do dispatchers forward the callers to EMS agencies for medical advice? The ERs? And who is calculating the wind speed? If I get it from internet sources, where are they getting it from? Are conditions at one place indicative of an entire region? These were discussions I was having with county officials and agency leaders for the area in which I live, and serve as medical director for most of the EMS agencies. In short, we had no real guidance for handling these issues, and it was still handled differently, from agency to agency, with some agencies ignoring wind speed, others using lower speeds, having the agency talk to patients if they could not respond, and other agencies just getting lucky with no calls for service. We had these discussions in the days before the storm and during the height of the storm itself. We seemed to get lucky in that it wasn’t a big problem, but we were also lucky not to have the heavy rain with Sandy that we had with Hurricane Irene. If we had Irene’s rain with Sandy’s wind, my area would have much more heavily affected and some of these questions would have had become more problematic. As it were, we are left to deal with them in the aftermath, in preparation for the next storm. On the day of the storm, I was off from work in the ED, and spent the day with the family at home, getting things taken care of home, conference

calls, and seeing what the day would bring. I basically sat in my home office, doing my usual routine, with weather.gov up on the computer and my portable radios on with one set to NOAA weather radio, keeping tabs on what was going on. I was supposed to be on shift at my ER from 9-5 the next day, about an hour from where I live. At about 3:45 pm, the power went out. We always talk about preparing your family, keeping them safe and secure, before you respond to an incident. Now it was time to put my plan into action. We gathered the flashlights, filled the tubs with water, and I set up my home generator. I had a strategic location near the garage where I could secure it just outside, run the wires into the garage, thru the doggie door and into the house to get to the kitchen and to the basement. Plan worked: my fridge, deep freezer were up and running, and I still had some free space on the extension cords to run a light, charge a lap top, run a microwave, whatever was needed at the time. Then came the problem. My middle brother, the more mechanically inclined of us, had recently done some preventive maintenance on the generator and did not refill the tank, and burned down a lot of fuel, including what was in my gas cans. I had a two and one half gallon and a one gallon gas can, and the generator holds five. I had half in all those tanks. While I had enough for the night, I didn’t think I would have enough for the next day. But by the time I realized this, it was after 5pm, dark, and Gov. Christie had ordered a complete shutdown. I called several stations, but all were closed. I still kept up on the news and the response, but mostly with a battery operated radio. My kids found new entertainment with board games, playing with the

continued on page 10


flashlights, lighting candles throughout the house, and even getting back into the electronic age with fully charged ipads and portable DVD players. They were amazed that we could listen to Radio Disney with my battery radio! I had called my ED director, letting him know I was already without power, and the height of the storm was yet to come. He graciously volunteered to cover my shift, as he lived closer; conditions were not as bad further south and inland. I checked in with him at 7:00 am, and we made the right call as all the roads leading to my shop were still shut down in my area. I went out in my neighborhood and surveyed the damage: only minor property damage had one tree starting to lean over. Behind my house, an entire block of power lines was down. PSE and G was hard at work working on a utility pole still upright that had wires knocked off by a tree branch, still hung up in the wires. While many agencies were now gearing up for the response and damage assessment, I had to secure my family: I needed more fuel. I stopped at the fire house where I serve as Fire Commissioner and checked in with my firefighters. They had been running all night keeping up with reports of wires down, trees down, alarm activations from loss of power, and were getting ready for the today’s run of the same. They helped me by telling me where they saw open gas stations. I made several fuel runs, to fill up my generator, and then fill up the tanks; stopping at a Home Depot to pick up more extension cords and gas cans. By the time I was home to stay, my daughter leaned out the door and said the power was back on! I got the house off generator, and went back to my home office monitoring the situation. Mercer County, where I live, was doing okay. I check in with my shore agencies that I work with. Asbury Park was more fortunate than most shore communities, some boardwalk damage. Neptune was hit hard in the Ocean Grove sections, losing the fishing pier and much of the boardwalk; and storm surge came up the Shark River, flooding the Shark River Hills community. Our own Office of Emergency Management Coordinator had 4ft of water in his first floor. I happened to be off for the next

few days as our Statewide Conference on EMS was to start November 1, but it was cancelled as it was to be held in Atlantic City. I covered a shift for my boss, to pay him back for his kindness and give him some rest. As part of my monitoring, the NJ EMS Task Force was in full operation, with deployments running throughout the state. There was a request for staff for the Mobile Satellite ER, so I signed up for a 12 hour deployment with the MSED in Brick, NJ on the grounds of Ocean Medical Center. Originally set up there as the hospital lost power and generators couldn’t be used, the MSED was now acting as an overflow ED/walk in center. I arrived early in the morning of November 2, to find many of the streets blocked off, power out, street lights off. After checking in, I got a brief orientation to how the operation was going to work that day, followed by an orientation to the MSED itself, and by 9am we were up and running. We would see patients in triage and if they needed full ED capabilities we would send them to the main ED via NJEMS Task Force Alternate Support Apparatus (ASAPs). These are golf cart sized, gas or diesel powered mini-ambulances designed for off road or short distance transports. We probably saw close to 100 patients that day, with some in my area, the fast track area (which we as staff dubbed the 4077th, a tribute to the MASH tents of the day, as we were in a modular tent system) and some in the Mobile ER itself, an 18 wheeler with expandable sides housing six beds, cardiac monitors, mini-lab, pharmacy and portable x-ray machine. That shift was one of my most rewarding shifts ever. These people were truly appreciative for what we were doing. I did a lot of prescription refills for patients who were displaced from other areas of the state, handled many minor issues of cough and colds for people who would have normally gone to their doctor’s office, but they were either displaced from their home areas, or offices were closed because of power outages. I went home after my shift by way of my parents’ house. They were still living on the generator and portable propane heater. They were content to stay where they were. My grandmother, the rock that she is, stayed home, across the street from my parents, with no generator, only a

propane heater and a cell phone she would charge at my parent’s house. She refused to come home with me. I continued to take stock in my agencies and monitor the situation. Sadly, one of my agencies had a storm related death. The Princeton First Aid and Rescue Squad, who lost a member during swift water rescue operations during Hurricane Irene, lost a member of their community advisory board. William Sword was clearing debris from his property when a falling tree branch struck him in the head. He died at the hospital. So, what lessons can we learn from this tale? I have come up with several:

1. Disasters are different from Mass Casualty Events. Most of our hospital disaster drills deal with events that generate patients. We rarely, if ever, deal with issues of loss of infrastructure. We continually learn from our experiences with evacuating hospitals affected by a true disaster (New Orleans, Joplin, Fukujima Japan, e.g.). Keep this in mind for the future. Each event is a lesson learned.

2. Working during a disaster can be stressful enough without having to worry about family. Have a plan to keep your family safe. Prepare before an event, and maintain constant readiness (my mistake with the fuel!). Know what your options are for sheltering in place, where to evacuate to, what to bring. There are plenty of resources out there to help you plan. www.ready.gov is one of them.

3. Keep open lines of communication with your ED and/or your EMS agencies. Knowing that you may have an issue getting in to work, or if you are available to help out, will go a long way in ensuring continuity of coverage.

4. Participate in post event analyses. There will be plenty of questions, concerns, and praise going around. Take the good with the bad, and use every event as an opportunity to improve, find problems and work around them for the next event, because there will be a next event!

Hurricane Sandy (continued from page 9)


Thoughts From an Aspiring LeaderAndy Little, D.O.

At a large meeting of volunteer church leaders held in Philadelphia a regional leader posed the question to a room filled with over 300 men. This room contained men who were national and world-renowned scholars from the finest universities in the United States, it also included men with little or no educational background, but who were valiant in the service for their cause. The gentlemen who oversaw this meeting posed a question the to audience, asking them to each write on a piece of paper their definition of a leader. After giving the audience 10-15 minutes to answer the question he allowed volunteers to offer their answers. Over the next 30 minutes some of the men gave beautiful explanations over what they perceived to be their definition of a true leader. At one point, the man presiding over the group saw one elderly man, who he new very well, a dear friend of his in the back appear frustrated and watched him roll up his piece of paper into a ball in his hands. He made a point to call on this man and ask him to share his definition. Now this man, a high school janitor by trade, stated, "oh, there have been so many beautiful explanations, written and spoken so well, you do not want to hear my answer.” Despite his objections, he unrolled his paper, now a wad and read the following "A leader: someone who gets people to follow him.” Of all the explanations given that night, this one was the true definition of what a true leader is. This story is one of my favorites. Although plain, and simple it is the

hallmark of what it means to be a leader and is something I have used as a rubric when I interact with others. The great leaders of all time, and those in my own life, have been people who could "get people to follow them," while the worst managers I have had are those who despite all of their efforts struggle to find ways to inspire and ways to truly lead. Each of us will sometime be given the task to lead, even if we don't perceive in that way. In fact, as physicians, each of us lead every day. The question is, will we be one who can get people to follow us or not? My answer will be short and sweet, and to some probably too simple, but if you know me, I like to keep things simple. First and foremost, as a leader you are not always right. Boom, I said it, sorry if this bursts your bubble. But being a leader does not mean you always, or even most of the time, have the best idea. I would even argue it means you are the best at getting people to work together for a cause that they are passionate about, rather than trying to convince a group that your cause is best. Second, from my favorite author Dr. Seuss, I'll paraphrase from his children's book Horton Hears a Who, "I meant what I said and I said what I meant and (insert you name here) is faithful a hundred percent.” Be a keeper of your word, a fulfiller of your commitments, this alone will elevate you from mediocre to stellar leader. This will not only serve you individually but your organization in the future as one who is known they get it

done. Third, know when to close your mouth. It is not helpful for you to give the members of your organization history lessons of the "way things have always been," or long diatribes about things not relevant to your goals or objectives. This wastes everyone’s time, even your own. As a leader you should become a great listener, observer, only interjecting small addenda to the working of your organization. Consider your words as valuable and the more you talk the less valuable those words become. Fourth, be open to change, going against the norm and breaks from tradition. I have never seen or heard a phrase do more to kill or stun an organization as "this is how we have always done it.” Remove this from your allowed vocabulary; make it a bad word that you refuse to utter. Also do more than copy your competition, be ingenious, take chances, and go big! Finally, the single best advice I have ever received is this, "failure will become your greatest teacher.” Know that as a leader the majority of what will define your greatness has little or nothing to do with what went right. Of course you'll get an "ata boy,” some public praise for all of your successes, but to those you serve with and over, how you handle failure will be how you are remembered. My hope is that each of us will do what we can to be, as that wise janitor said so simply, leaders who can others to follow us.

Call to Meeting

At the request of the Secretary, John C. Prestosh, D.O., FACOEP, a meeting of the membership of the American College of Osteopathic Emergency Physicians has been arranged for October 6, 2013 at 5:00 p.m. at the Hilton San Diego Bayfront Hotel in San Diego, California. This event will be followed immediately by the Welcome Reception for the College’s 2013 Scientific Assembly.

Voting for Board Members will once again take place online and will be available to Active, Fellow, Distinguished, Retired and Life Membership between August 7th and 4:30 p.m. on October 6th. Please watch for voting keys that will be emailed to any eligible members on August 6th.


What Would You Do?

Nine years ago, I was approached by one of our paramedics requesting permission to wear body armor on EMS calls in a particular area of their town. There had been an increase in violent crime in that area, and he expressed concern for his safety. No specific EMS involved events had occurred. In response to his request, we stated there would need to be a policy delineating the proper equipment and when it would be worn in a manner that precluded any semblance of profiling. His department chose not to pursue this. We have been fortunate enough

Ethics in Emergency MedicineBernarnd Heilicser, D.O., M.S., FACEP, FACOEP

in our EMS System, and have not had any significant assaults on our providers (average 130,000 calls per year). This illusion of safety was broken one month ago when an ambulance transporting a patient to our hospital came under surprise gunfire for no apparent reason. Although the ambulance was hit numerous times, no one was struck. Would this event cause you to reconsider your thought process? If so, how would you approach this? Should a known high-crime area warrant special precautions?

What would you do?

Please send your thoughts and ideas to [email protected]. Every attempt will be made to publish them when we review this dilemma in the next Pulse.

If you have any cases that you would like to present or be reviewed in The Pulse, please email them to us at [email protected]. Thank you.

EPMG understands that some of life’s greatest rewards carry the biggest burdens. That’s why we offer loan management and forgiveness programs*, giving you the peace of mind to focus on the important things in life.

EPMG is currently seeking EM physicians throughout the Midwest and Atlantic coast. Our compensation package is structured to meet your specific needs and includes paid health benefits, employer paid 401(k), partnership program, and so much more. Contact us at 734 686 6335 or [email protected]. Visit us at www.epmgpc.com.

*Loan management and forgiveness programs are subject to facility specifications.

WE CARE ABOUTYOUR PIECE OF MIND.

I LL INOISRiverside Medical CenterKankakee 39,000 volume

IOWAMercy Medical Center – ClintonClinton 21,000 volume

PH

YSI

CIA

N O

PP

OR

TUN

ITIE

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INDIANAFranciscan St. Anthony HealthMichigan City 30,000 volume

MICHIGANLakeland Regional Medical CenterSt. Joseph 43,000 volume

Mercy HospitalCadillac 20,000 volume


2013 Legacy GalaMonday, October 7, 2013VIP Reception 7:00– 7:30 pm Dinner and Awards 7:30–10:00 pm

Hilton San Diego Bayfront HotelSan Diego, California

ACOEP Scientific Assembly

Friends:

Black Tie Optional

For reservations and complete information please contact: Stephanie Whitmer, Event Chair 312.587.1765 or [email protected]


FOR MORE INFORMATION VISIT WWW.FOEM.ORG

The 4 competitions are:

Oral Abstract, Research Paper, Research Poster

and the CPC Competition

DID YOU MISS THE OPPORTUNITY TO

PRESENT AT SPRING CONFERENCE?

ALL APPLICATIONS DUE JULY 31ST

2013

DON’T WORRY ABOUT ITTHERE ARE 4 GREAT COMPETITIONS

AT FALL CONFERENCE IN SAN DIEGO........


FOR MORE INFORMATION VISIT WWW.FOEM.ORG

The 4 competitions are:

Oral Abstract, Research Paper, Research Poster

and the CPC Competition

DID YOU MISS THE OPPORTUNITY TO

PRESENT AT SPRING CONFERENCE?

ALL APPLICATIONS DUE JULY 31ST

2013

DON’T WORRY ABOUT ITTHERE ARE 4 GREAT COMPETITIONS

AT FALL CONFERENCE IN SAN DIEGO........

RAFFLE - To benefit -

Enter to win one week* in a beautiful two bedroom villa at the Grand Regina Resort in Los Cabos (www.grandregina.com).

OR

One week* in a two bedroom unit at any comparable member resort in The Registry Collection (www.registrycollection.com).

Tickets sales will end on May 31, 2013. Winner will be announced June 3, 2013 *Week selected is subject to availability and must be used before December 31, 2013. Please see official rules and regulation for entry.

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ You may purchase tickets online. To order by check or credit card, fill out this form and returning it in person, by mail or fax with your payment or credit card details to:

Foundation for Osteopathic Emergency Medicine Attn: Stephanie Whitmer 142 E Ontario St, Ste 1500 Chicago, IL 60611

(F) 312-587-9951 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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A copy of your order transaction will be sent via email for your records.


During the last 10 years, ACOEP has seen a dramatic transformation in the development of a resident research culture with increasing interest and productivity through adoption of a mandatory research requirement for residency graduation and demonstration of competency. A competitive spirit among residencies has developed that drives quality research and productivity in the form of the resident annual paper competition, oral presentations, posters, and abstracts presented at the ACOEP Scientific Assembly and Spring Seminar. It is the vision of FOEM that the American College of Osteopathic Emergency Physicians (ACOEP) can, through its residency training programs, achieve the next level of excellence by establishing a growing research presence on a national level. This can be accomplished in two ways. First, by providing opportunities for multi-center studies developed by our resident/core faculty research teams in a single institution and disseminated to one or more residencies for more rapid acquisition of quality data. Secondly, providing a venue for Pharma and CRO’s to conduct multi-center trials within our research network hospital systems. During a time when our healthcare system faces a shrinking financial base, a more cost effective, austere

approach to clinical research has developed within the pharmaceutical and medical device industry. With less research funding available, The FOEM Research Network can be a very attractive cost effective tool for pharmaceutical companies and contract research organizations (CRO’s) to use for the following reasons:• Our50residencyprogramsprovide geographically heterogeneous patient populations avoiding regional bias;• Themajorityofosteopathicemergency medicine residency programs are closely aligned with a medical school or university• Combined, our residency programs treat in excess of 2 million patients annually in different hospital settings, i.e., urban, suburban, and rural.• Segregated totals of types of patients by discharge diagnosis are available by institution and hence by consortium aggregate figures. This is very attractive to research companies to know, for instance, that the network treats 3,000 migraine headaches per year, thereby allowing study data can be accumulated quickly. As a network, we can tabulate patient populations by diagnosis and make this information available to the targeted companies,

Foundation FocusFoundation for Osteopathic Emergency

Medicine Research Network

according to market and area of emphasis in research.• By doing multi-center studies as a network, individual research bias in minimized.• Pharmaceutical, medical device companies and CRO’s who utilize the network would experience significant cost reduction for expenses incurred by contracting directly with individual residencies. Procedure and Process: Residencies would share in the grant revenue based on the number of patients they successfully entered into the study protocols and calculated by a percentage of the total grant. For instance, a CRO might pay $3000 per patient to the network for each subject properly entered in the study and protocol objectives achieved... The network would then pay the participating residency $3000 minus an administrative fee to cover expenses for maintenance of the research network and to expand individual research grants under the current model. Some monetary support could be given to residencies for participation in the network derived from grant seed money when part of the research source’s contract. Research grant revenue would become a new source to fund residency educational enhancements and faculty development.

Victor Scali, D.O., FACOEP


In addition to pharmaceutical company grant procurement, the network concept could potentially stimulate larger NIH grants through its ability to study large numbers of patients. It is consistent with the Graduate Medical Education (GME) approach to overall improvement of “Community Health” rather than the traditional clinic model approach of treating single patients. The “Community Health Integrity Model” is ideal for Emergency Medicine research that involves screening for disease incidence, frequency, and severity. The Hospital Emergency Department (ED) has evolved into the safety net under EMTALA for the insured and uninsured population, and does it cost effectively. The ED also acts like an epidemiologic window to the community because it triages and treats large numbers of patients in a captive setting, and can perform disease incidence screening that potentially could have a long-term effect on overall community health, disease prevention, and health promotion. The NIH is interested in giving grants for translational research involving large population-based studies. In addition, community based integrated education for medical postgraduate trainees as a curriculum model enhancement, could be satisfied by doing community research screening projects sanctioned and funded by the government agencies such as CDC, NIH, and AHRQ. The creation of a viable FOEM Research Network would involve the establishment of:A. Close working relationship between research directors and PD’s from each residency program.B. A computerized patient profile databank segregated by discharge diagnosis compiled from each separate residency’s treatment totals.C. A participating institution

database with detailed demographics and demonstration of research pedigree where it already exists D. Designated pharmaceutical company liaison representatives assigned from groups of interested research directors to contact and / or visit targeted companies to promote the network and solicit studies on behalf of the network. The regional liaison representatives would be chosen on their experience and success in acquiring grants in the past for their own residency and their proximity geographically to areas of high pharmaceutical company density, for instance, Northern New Jersey, Wilmington, Delaware, and the Research Triangle in North Carolina, etc. The concept of a FOEM Research Network, allows small residencies with less capital resources to benefit in several ways by their participation in clinical studies that could not have acquired if they solicited them as a single residency applicant. Their residents would benefit from a structured research program that is enhanced by residents participating in national protocols. Please be assured that the Research Network will not negatively impact residency programs with established research grant pipelines but will only serve to enhance their revenue with additional research opportunities. Based on the success of the Research Network, a portion of the revenue generated will be donated to the grant funds of the Foundation for Osteopathic Emergency Medicine. In order to be a viable entity with sustainability in the future, the FRN will require the expertise of several individuals within the ACOEP Research Committee and the FOEM Board of Trustees. Individuals within the ACOEP membership with research and marketing

skills who are not currently in committee positions are also invited to interview for these positions which will count toward scholarly activity by residency core faculty.It is anticipated that the initial FOEM Research Network Administrative Structure will need to recruit for the following positions within the following organizational diagram that identifies the network’s primary division of labor and responsibility.

FOEM Research Network Structure

FOEM Research Project ----- Coordinator (A)

Residency Research ----- Directors (B)

Bio-statistician(C)

Pharmaceutical Company Liaison (D)from Regions E-W-S-N-MW

Fund Collection & Disbursement

Director (E)

Medical-Legal and Contract Execution (F)

A. FRN Research Project Coordinator- Assures studies at individual institutions are being approved by individual institutions IRBs, works Through Residency Research Directors, compiles statistics on national patient aggregate yearly totals, insures individual residency research profile documentation.B. Residency Research Directors- Facilitates IRB approval at individual institution and; insures study is done in timely fashion.C. Biostatician- Designee of FOEM, reviews official protocols


site selection can be a cumbersome and costly exercise that may delay the start of a study, and prevents potentially valuable treatment regimens from reaching patients in a timely manner. The effect on market timing of the introduction of a new drug or device could also determine the successful return on investment and future funding of new research.” If your residency program is interested in joining the FOEM Research Network, please contact, Ms. Stephanie Whitmer, Assistant Executive Director of FOEM, and a the research site database will be sent to you in a web based format for ease of completion. If you have any further

questions about the FRN or wish to be considered for one of the six administrative positions available within the network, please do not hesitate to contact me at [email protected]. Over twenty EM residencies have already joined the network and the ultimate strength of the organization will best be served by 100% participation. Thank you for your support and interest in FOEM. The FRN has great potential in providing the financial strength needed to fund more resident research projects in the future. Working together, we can make this dream a reality.

for quality of study.D. Pharma/CRO Lia i sons -Visits or contacts pharmaceutical companies, promotes network and procures quality grants. E. Grant Fund Collection and Disbursement Director-Assures grant money is collected from companies at completion of studies. Disburses grant revenue to individual residencies based on patient enrollment.F. Medical/ Legal Counsel and Contract Execution- Responsible for risk management, legal review of contract, insurance indemnification, etc.

In the future, individual residency directors through their interface with local pharmaceutical company sales forces will be able to introduce participation in the FOEM Research Network as an added benefitto their research programs. The elevator speech may go like this:” Pharmaceutical companies and CRO’s spend a lot of time recruiting prospective sites for their phase 4 and post marketing clinical trials nationwide usually relying ultimately on a small cadre of client institutions based on their successful execution of previous studies as well as nationally respected investigators. Repetitive use of the same study institutions runs the risk of introducing selection bias into the data. Through the utilization of the FRN for study site selection, you will have unlimited, easy access to the research databases of 50 hospital sites where our emergency medicine residencies are based in a cost effective matter. This cost effective approach to study site selection will be a valuable asset to Pharma and CRO’s interested in single site or multicenter trials. Study

Fairview Health ServicesEmergency Medicine Opportunity

Fairview Northland Medical Center in Princeton, Minnesota, just 57 miles northwest of Minneapolis, seeks a physician to care for patients in our Emergency Department.

• Provide direct patient care in our state-of-the-art Emergency Department

• Work 10-12 hour shifts

• See an average of 1.5 patients per hour

Work and live in one of the fastest growing areas of the state and in close proximity to the world-class arts, outstanding year -round recreation and education excellence for which Minnesota is known.

We offer a competitive salary, comprehensive benefits and malpractice insurance. We offer relocation assistance, loan forgiveness/repayment options, and residency stipends for eligible candidates.

Join us in providing exceptional care to each patient, every day.

Visit fairview.org/physicians to explore this and other ED opportunities, then apply online, call 800-842-6469 or e-mail [email protected]

H1B Visa status candidates will be considered.

fairview.org/physiciansTTY 612-672-7300EEO/AA Employer


FOEM Thanks Its Lifetime Contributors!The Foundation for Osteopathic Emergency Medicine (FOEM) thanks its lifetime donors for making the

legacy of improving patient care through research and education possible.

*In an effort to conserve space, this list accommodates only one designation (D.O.) per name.

Pinnacle Level - $25,000 and above

ACOEPJoseph Kuchinski, D.O.

President’s Circle Level - $10,000 - $24,999

Juan Acosta, D.O.Paula DeJesus, D.O.Anita Eisenhart, D.O.

*Peter Kaplan – New member of the President’s Circle to be recognized at the 2013 Legacy Gala

Beth Longenecker, D.O.

Pillar Level - $5,000 - $9,999John Becher, D.O.

*Gary Bonfante, D.O. – New member of the Pillar Level to be recognized at the 2013 Legacy Gala

Mark Foppe, D.O.Victor J. Scali, D.O.Robert E. Suter, D.O.Janice WachtlerDouglas Webster, D.O.Bruce Whitman, D.O.

$500 - $4,999Anthony Affatato, D.O.Fahim Shan Ahmed, D.O.Victor Almeida, D.O.AnonymousAOBEMLarry Bachle, D.O.Jerry Balentine, D.O.Peter A. Bell, D.O.Nancy Bellemare, D.O.Sheldon Bender, D.O.Rudolph Bescherer, D.O.Donald Beyer, D.O.

Brian Blaustein, D.O.David Bohorquez, D.O.James M. Bonner, D.O.Thomas Brabson, D.O.Bernadette Brandon, D.O.Wallace Broadbent, D.O.Howard Brown, D.O.Denise Buruse, D.O.Joseph J. Calabro, D.O.Ben H. Chlapek, D.O.Gregory Christiansen, D.O.Mark E. Cichon, D.O.Duane J. Corsi, D.O.Mark A. Cynar, D.O.Mario D'Alessandro, D.O.Mark Damon, D.O. and Shelly Zimmerman-Damon, D.O.Glenn DeLong, D.O.Lisa J. DeWitt, D.O.William DiCindio, D.O.Doctors of EM of ILKenneth Doroski, D.O.Joseph Dougherty, D.O.John Everett, D.O.Mark L. Fennema, D.O.Jack B. Field, D.O.Benjamin A. Field, D.O.Clifford Fields, D.O.Donald Findlay, D.O.Bryan T. Fitzgerald, D.O.Gregory R. Frailey, D.O.J. Gregory Frappier, D.O.William R. Fraser, D.O.Howard Friedland, D.O.Calixto Garcia, D.O.Christine Giesa, D.O.Jeffrey Giese, D.O.Bernadette Gniadecki, D.O.Edward Goetten, D.O.Michael Goodyear, D.O.John W. Graneto, D.O.Greg Gray, D.O.Anthony Guarracino, D.O.E. Rodrigo Guzman, D.O.William Halacoglu, D.O.Regina Hammock, D.O.

Bernard Heilicser, D.O.Douglas Hill, D.O.Susan Horling, D.O.Ira Brady Husky, D.O.Alan R. Janssen, D.O.Michael Jarzabek, D.O.Anthony W. Jennings, D.O.Julie Johns, D.O.Bobby Jr Johnson, D.O.Wayne T. Jones, D.O.B. Bryan Jordan, D.O.George M. Kaiser, D.O.Stephen G. Kaiser, D.O.Risty T. Kalivas, D.O.Dmitry Katkovsky, D.O.Raymond P. Kelly, D.O.Gregg Kling, D.O.Drew A. Koch, D.O.William Kokx, D.O.Anthony Korvas, D.O.Daniel Kowalzyk, D.O.Christ Kyriakedes, D.O.David Lang, D.O.Paula Lange, D.O.Gary LaPolla, D.O.Francis L. Levin, D.O.David Levy, D.O.Brandon Lewis, D.O.George Librandi, D.O.David A. Ligor, D.O.Wesley Lockhart, D.O.Freda Lozanoff, D.O.William LynchNed Magen, D.O.David T. Malicke, D.O.Christopher Martella, D.O.Douglas McGee, D.O.David McKelway, D.O.Robert B. McManus, D.O.James McMullen, D.O.George J., III Miller, D.O.Daniel A. Miller, D.O.David E. Miller, D.O.Mark A. Mitchell, D.O.James Mitchell, D.O.Gary Moorman, D.O.

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Thomas Westenberger, D.O.Michael W. Westfall, D.O.Thomas Wetjen, D.O.Jeffrey Wheeler, D.O.Lisa Wheeler-Lewis, D.O.Susan Whitaker, D.O.Erik White, D.O.Thomas Wigboldy, D.O.Elaine Lombardi Wilk, D.O.Michael Williams, D.O.Adrienne Brooks Williams, D.O.Stacy J. Williams, D.O.John Williamson, D.O.Thomas Wills, D.O.Courtney Wilner, D.O.Cathy Wilson, D.O.Elizabeth Wilson, D.O.Yvette A. Wirta, D.O.Robert J. Wise, D.O.Maury Witkoff, D.O.William Wixom, D.O.Lara Wiziecki, D.O.Thomas Woltanski, D.O.Charles Worrilow, D.O.Jody Wozniak, D.O.Michael Yangouyian, D.O.John Zambito, D.O.Michael E. Zielinski, D.O.Jocko Zifferblatt, D.O.Roger Zionitz, D.O.Carolynn Zonia, D.O.

$99 and BelowMikhael Abourjeily, D.O.Lajon Addison, D.O.David Adinaro, D.O.Andrew Alaimo, D.O.Siddhartha Al-Hashimi, D.O.Andrea Allman, D.O.Richard Anderson, D.O.Daniel Anderson, D.O.Eric Anderson, D.O.Verna Arcedo, D.O.Alwin Arendse, D.O.Cindy Armstead, D.O.Sarah Arzt, D.O.Gerard Ashbeck, D.O.Brian Ault, D.O.Jennifer Axelband, D.O.Allison Ayotte, D.O.R. Scott Baeder, D.O.Jacob Bair, D.O.James F. Baird, D.O.Raj Baman, D.O.Clyde Banner, D.O.Chandler Tracy Barber, D.O.Stacey Barnes, D.O.Jane Barnes, D.O.S.B. Bashor, D.O.Gary Batten, D.O.Robert Beight, D.O.Jason K. Benn, D.O.John Benson, D.O.Elizabeth Berry, D.O.James Berry, D.O.Luke Bertorelli, D.O.

Besrkshire Health SystemGust Bills, D.O.Dennis Blankenship, D.O.Jason Blasenak, D.O.Blessing HospitalWojciech Bober, D.O.Suzana Bogdanovska, D.O.Brian T. Bonner, D.O.James Botti, D.O.Katay Bouttamy, D.O.Matthew Boyer, D.O.Christine Boyko, D.O.Joseph Boyle, D.O.Joshua Bozek, D.O.Alvin Jay Bradford, D.O.Thomas Brandon, D.O.Brentwood Emergency PhysiciansTodd Britt, D.O.Lauren Courtney Brown, D.O.Christopher Bruner, D.O.Steven Brunetti, D.O.Sharla Bryan, D.O.Holly Ann Bryant, D.O.Terry L. Bucan, D.O.Jory Bulkley, D.O.Steven Burkholz, D.O.David Burmeister, D.O.Gregory Burnette, D.O.Kristie Busch, D.O.Joseph Bushek, D.O.Nikolai Butki, D.O.Michelle Butler, D.O.Keith Butvilas, D.O.Richard Buzard, D.O.Kenneth Byerly, D.O.George Sarkis Caleel, D.O.Terrence Callahan, D.O.Bradley Caloia, D.O.John Caltry, D.O.Bradley Campbell, D.O.Nicholas Cardinal, D.O.Craig T. Carter, D.O.Kevin Casey, D.O.Tania Castro, D.O.Maurice Chao, D.O.Stephen Chester, D.O.Dale Chisum, D.O.Tichansky Christine, D.O.Jerfi Cicin, D.O.Gary Clark, D.O.Stephen R. Cluff, D.O.Eric Clymer, D.O.Ryan Coates, D.O.Douglas B. Coffman, D.O.Andrew Cohen, D.O.Jason Coisman, D.O.Elizabeth Colella, D.O.Jonathon Conard, D.O.Patrick Connolly, D.O.Eric Cook, D.O.Elizabeth Cook, D.O.Stephen Corriz, D.O.Lonnie D. Couch, D.O.Brian P Crowley, D.O.Joseph Cruz, D.O.Maryvic Cuison, D.O.


Czar Medical ServicesAlan Daar, D.O.Michael T. Dalley, D.O.Anne M. Darlington, D.O.Frederick Davis, D.O.John Deagle, D.O.Scott Dellinger, D.O.Janice DeMaray, D.O.Paul DePonte, D.O.Douglas Dero, D.O.John A. DeSalvo, D.O.Francesca DeTrana, D.O.Paul DiModica, D.O.John Ditchman, D.O.Anamika Doma, D.O.Joseph A. Dombroski, D.O.Jennifer Donze, D.O.Arthur Dortort, D.O.Trace Dotson, D.O.G. Phillip Douglass, D.O.William Downs, D.O.Melissa Martens Drake, D.O.Aleksandr Dubrovskiy, D.O.Carla'nne Dukes, D.O.Nana Dwomoh, D.O.Kevin T. Dwyer, D.O.Jacqueline Dziedzic, D.O.Pamela C. Eaton, D.O.Donna M. Eget, D.O.Tiffany Elliott, D.O.Randy Engelman, D.O.Jack D. England, D.O.Warren Entwistle, D.O.Julie Evans, D.O.Kathleen Faccio, D.O.Daniel Fagnant, D.O.James Farinosi, D.O.Larry G. Farmer, D.O.Syrita S. Farrow, D.O.Osama Fashho, D.O.Susan Tartelone Fedewa, D.O.Kurt R. Feighner, D.O.Harold E. Feiler, D.O.Claudio M. Fernandez, D.O.Eric Fete, D.O.Laura Fil, D.O.David R. Fisher, D.O.Jerry Fitzgerald, D.O.Patrick Flaherty, D.O.Andrew Flanagan, D.O.Marc Flores, D.O.Kim Floyd, D.O.Edward Fog, D.O.Albert Ford, D.O.Jeffrey Foster, D.O.J. J. Foutty, D.O.William E. Franklin, D.O.Darryl Lawrence Friedl, D.O.Gregory Fuller, D.O.Jesamyn Fuscardo, D.O.Karen Gaber-Patel, D.O.Frank Gabrin, D.O.Allan Galarneau, D.O.Michael J. Garcia, D.O.Gavin Gardner, D.O.Aaron Garret, D.O.Patrick Garrity, D.O.

Brent Gear, D.O.David M. Gearhart, D.O.Mark Geary, D.O.Marino Gennaro, D.O.Robert J. George, D.O.Cynthia Gessler, D.O.Mary Gessner, D.O.George Gibson, D.O.Elizabeth Gignac, D.O.Chelsey Gilbertson, D.O.Joseph Ginejko, D.O.Evan M. Gleimer, D.O.Natali P. Gleimer, D.O.David Glorius, D.O.David Goldman, D.O.T.S. Goldsborough, D.O.Sodi Goldstein, D.O.Natalie Goran, D.O.Catherine Goss, D.O.Jason Green, D.O.Kristen Green, D.O.Brian Greenberg, D.O.Dwynn Greenfield, D.O.Mark Greenwood, D.O.Kevin Grieb, D.O.Pamela Grigg, D.O.Randy Grinspan, D.O.David Grounds, D.O.Manoj Gupta, D.O.Bradley Gutierrez, D.O.William G. Hadcock, D.O.Tara A. Hallahan, D.O.Robert Jared Halterman, D.O.Janet Eng Hamel, D.O.Hamot Medical CenterWilliam Hampton, D.O.Robert Harper, D.O.Todd Hartgerink, D.O.Laura Harvey, D.O.Jennifer Hauler, D.O.Daniel Hearld, D.O.Jeanine Heitmann, D.O.Lisa C Henning, D.O.Paul K. Hick, D.O.James O., II Hill, D.O.Amy Hoffman, D.O.Eric Hogan, D.O.Michael Hoh, D.O.Michael S. Hohlastos, D.O.Joshua M. Hoien, D.O.Dorene Hojnicki, D.O.Adam Holbrook, D.O.Steven Hollosi, D.O.Robert J. Horn, D.O.Bruce D. Horton, D.O.Andrea Horvath, D.O.Richard Houck, D.O.Evan Houck, D.O.Jamey P. Hourigan, D.O.Roger Howell, D.O.John Hoyle, D.O.Lisa Hrutkay, D.O.Ben Huang, D.O.Shao Huang, D.O.Debby Hudson, D.O.Mary J. Hughes, D.O.Heather Hughes, D.O.

Timothy Huschke, D.O.Joseph Imbesi, D.O.Kimberly Irvin, D.O.Louis Issacson, D.O.Kenneth Jacobs, D.O.Ali Jamehdor, D.O.Kristin James, D.O.Daniel Jarrell, D.O.Tabitha Jeffers, D.O.Edward Jelonek, D.O.Jeanne Johnston, D.O.Heath Jolliff, D.O.Bruce Jones, D.O.Paula Lynn Jones, D.O.Michael J. Jule, D.O.Jennifer Julian, D.O.Travis Kain, D.O.Eb Karkevandian, D.O.Jessica Kasirsky, D.O.Mark Katsaros, D.O.Randy Katz, D.O.Michelle Kearney, D.O.Steven Keehn, D.O.J. David Keitz, D.O.Amy E. Kelleman, D.O.Catherine Kelly, D.O.Shon Kendall, D.O.Adam Kessler, D.O.LaToya Khalil, D.O.Joseph Kidd, D.O.Jessica Kirby, D.O.Kevin Klauer, D.O.Scott Kleiman, D.O.Michael Kleiman, D.O.Harry E. Kleiner, D.O.Patrick Klocek, D.O.Joseph W. Knight, D.O.Timothy Koch, D.O.Scott Kohl, D.O.Joby Kolson, D.O.Joseph Kovacic, D.O.Michael Kovalick, D.O.Daniel J. Kranitz, D.O.Ellen Kroon, D.O.Michael Kupon, D.O.Ellen J. Kurkowski, D.O.Kyla Kutch, D.O.Elizabeth Lacy, D.O.Michael J. Lamers, D.O.David Larkin, D.O.Matthew Larrew, D.O.Marisa Laurosa, D.O.Teddy Lee, D.O.Evan Lee, D.O.Joseph Lee, D.O.Jeremy Lee, D.O.Yvette LeFebvre, D.O.Mark Lekas, D.O.Joseph Lemmons, D.O.Tracie Leonhardt, D.O.Marc Lewbart, D.O.Thomas Licata, D.O.James Lively, D.O.Hollis London, D.O.Catherine Loniewski-Girdler, D.O.Carrie Loterno, D.O.

Aaron Love, D.O.Michael S. Lowry, D.O.G. Edward Mallory, D.O.Andrea Marconi, D.O.Louis Marquet, D.O.Brian Marshall, D.O.Sheffey Massey, D.O.Julie Massoud, D.O.Susan M. Mastellone, D.O.Dennis Mays, D.O.Mary Mazza, D.O.Heather McArthur, D.O.John McCarthy, D.O.James McClay, D.O.Matthew McCormick, D.O.John W. McCracken, D.O.Eric McDowell, D.O.J. R., Jr McKinney, D.O.John McMahon, D.O.Donald Meade, D.O.Ragini Mehta, D.O.Bryan Menges, D.O. MidState Medical, D.O.Leo Jr. Midure, D.O.Ronel B. Millana, D.O.Lewis J. Miller, D.O.Evelyn Moore Mills, D.O.Julie Mills, D.O.Kenneth M. Minett, D.O.Eric Mohr, D.O.Jeffrey Moldovan, D.O.Elizabeth Monnot, D.O.Melissa Lin Monte, D.O.Mary K. Montgomery, D.O.Enash Moodley, D.O.Mary Moore, D.O.Terrall Moore, D.O.Russel E. Mordecai, D.O.Moises Moreno, D.O.Joshua Morrison, D.O.Victoria L. Mossbrook, D.O.Lauren M. Muchorski, D.O.Terrence Mulligan, D.O.Stephan Mussehl, D.O.Joan Naidorf, D.O.Matthew Nerland, D.O.Themy T. Ngo, D.O.Tung Nguyen, D.O.Oanh Clark Nguyen, D.O.Dzung-Young Nguyen, D.O.Jeri Norman, D.O.Gerald O'Malley, D.O.Rory O'Neill, D.O.Frank S. Orth, D.O.Chantel O'Shea, D.O.Nicole Ottens, D.O.Jeannine Owens, D.O.James Owens, D.O.Jeffrey Ozan, D.O.Andrew Pacitti, D.O.Joseph J. Pagano, D.O.Natalie Painter, D.O.Michael Painter, D.O.Hema Pandit, D.O.Brandon Parker, D.O.Cindy Parker, D.O.Kishan B. Patel, D.O.


Punam Patel, D.O.Sandeep Patel, D.O.Frank A. Paul, D.O.David Pawsat, D.O.Amanda Pearce, D.O.Thelma Peery, D.O.Hale T. Peffall, D.O.Ralph Peiris, D.O.Nadia Pellett, D.O.Kimberly Perry, D.O.Narendaralall Persaud, D.O.Joseph Peters, D.O.Bradford Pflaum, D.O.Nicole Phillips, D.O.Deborah Pierce, D.O.Mary Lynn Pitlanish, D.O.David S. Porter, D.O.David E. Porterfield, D.O.Robert Prahl, D.O.Shaila Quazi, D.O.Brian Rader, D.O.Ambreen Rahman, D.O.Vishnuvardhan Rao, D.O.David Kade Rasmussen, D.O.Denis J. Reavis, D.O.Jody Rein, D.O.Dow J. Richards, D.O.William Richardson, D.O.Omer Richman, D.O.Gregory Rimmer, D.O.Holly Ringhauser, D.O.Vincent J. Rizzo, D.O.Ann C. Robenstien, D.O.Ellen B. Rodman, D.O.Gregory Rokosz, D.O.Jaclyn Ronovsky, D.O.Joel Rosenbloom, D.O.Thomas A. Rosier, D.O.Chadwick Ross, D.O.Brian Roy, D.O.Arthur Ruediger, D.O.Herbert E. II Russell, D.O.Scott Russo, D.O.Kelly Salinas, D.O.Yazan Sarsour, D.O.Frank Schell, D.O.Michael Schiesel, D.O.Herbert Schiffer, D.O.Arnold Schiller, D.O.Grant Schmidt, D.O.Robert L, II Schoenen, D.O.Kathleen Schomer, D.O.Marie Schreiber, D.O.Michael Schreiber, D.O.Steven Schwartz, D.O.Eric Schwiger, D.O.Edmund Sciullo, D.O.Jennifer Scott, D.O.Tammy Scott, D.O.Seacost Emergency PhysiciansThomas Seglio, D.O.David Sestak, D.O.Troy Shaffer, D.O.Tara Shapiro, D.O.Daniel Sheesley, D.O.Steven Shepherd, D.O.Jeffrey Shipman, D.O.

Stacia Shipman, D.O.Chad Shuff, D.O.Steven Shy, D.O.Iqbal Siddiqui, D.O.Lori Lee Siemon, D.O.Doni Marie Sigarivas, D.O.David E. Sikorski, D.O.Dean Silverberg, D.O.D Simmers-Dabinett, D.O.George R. Jr. Simons, D.O.Kerrilene Sinapi, D.O.Pragyya Singh, D.O.Juan Sinisterra, D.O.Annie Sinnott, D.O.Rita Sivils, D.O.Rebecca J. Smith, D.O.Lawrence Smith, D.O.Thomas M. Smolin, D.O.Niels Erik Snyder, D.O.William Sotack, D.O.Peter Spence, D.O.Jon Spyridakis, D.O.Bruce St. Amour, D.O.Christopher Stark, D.O.Daria Starosta, D.O.Louis Steininger, D.O.Cynthia Stephenson, D.O.Edward Stolyar, D.O.Derek Stout, D.O.Dan Suders, D.O.Carolyn SwallowMichael Systma, D.O.Javier Talamo, D.O.Steven Talbot, D.O.Robert Tam, D.O.Timothy Taylor, D.O.Laurie Taylor, D.O.Linda J. Thomas, D.O.Kevin Tishkowski, D.O.Haley Todsen, D.O.Garrett Tomasino, D.O.Harrison Tong, D.O.Paul Toote, D.O.Paul Traficanti, D.O.Jeremy Tucker, D.O.Barry Turek, D.O.Dawn Marie Turner, D.O.Danielle Turrin, D.O.Lyncean Ung, D.O.Franklin Veer, D.O.Steven Vetrano, D.O.Al Villarin, D.O.Karen Vincent, D.O.Sean Vitale, D.O.Sarah Vitello, D.O.Michael Volpe, D.O.Florence Wachtler, D.O.Brianne Waggoner, D.O.Pierre Wakim, D.O.Arthur G. Wallace, D.O.Aimee Washington, D.O.Travis Washut, D.O.Kenneth Watson, D.O.Kristin WattonvilleJohn Palmer Weddle, D.O.Shannon Weinstein, D.O.Sherry Wells, D.O.

Serge Wenzel, D.O.Douglas Wheeler, D.O.Maureen Whiteley, D.O.Kenneth Scott Whitlow, D.O.Kirk Whyte, D.O.Brian K. Wiboon, D.O.Ernest Williams, D.O.Timothy Scott Wilson, D.O.Melissa Winger, D.O.John Winter, D.O.Warren Wisnoff, D.O.Jared G. Wolfert, D.O.Julianne M. Wysocki, D.O.Travis Yates, D.O.Timothy Ying, D.O.Shabnam Zarrabi, D.O.Jennifer Zernec, D.O.Christina Zhang, D.O.Faizah Zuberia, D.O.

MEMBERS IN THE NEWS

Congratulations to ACOEP Board Member, James Turner, DO, FACOEP, FACOFP! Dr. Turner has been named the Dean of the William Carrey University College of Osteopathic Medicine in Hattiesburg, MS! Congratulations, Dr. Turner, WCUCOM is very lucky to have you!

Resident Chapter President Megan McGrew has recently been named Chief Resident at Midwestern University. Congratulations, Megan, on this well-deserved appointment!

Do you have news to share? We’d love to hear from you! Send your latest news or accomplishments [email protected] to be included in our Members in the News segment!


Residency Spotlight

With all of the changes to residency standard, It is good to know that emerging physicians have incredible options when selecting their programs. We are happy to highlight four more programs with the continued feature, Residency Spotlight.

Program: Henry Ford Wyandotte HospitalAddress: 2333 Biddle AvenueCity/State/Zip: Wyandotte, MI 48192

Hospital Information: Type (Community, rural, urban): CommunityTrauma Level: Number of Hospital Beds: 379Number of ED Beds:

EM Program Information: Phone: 734-287-9029Website: http://www.henryford.com/body_wyandotte.cfm?id=48054 Total Number of EM Residents: 18Residents to Attending Ratio Working Clinically: Accepts Medical Student Rotations? Yes

EM Program Curriculum: Visit website for additional information PGY 1: EM, Peds EM, MICU, Pulmonology/MICU, Orthopedic Surgery, IM, OB/GYN, Trauma/Surgical ICU, Trauma SurgeryPGY 2: EM, MICU, Radiology, Ultrasound, Anesthesia, EMS, Peds EM, Vacation PGY 3: EM, Plastic Surgery, Elective, Trauma/Surgical ICU, Ortho Trauma, Toxicology, Medical Examiner, VacationPGY 4: EM, Research, Ophthamology, Legal, Administration, Elective, Trauma Critical Care (Shock), Vacation

EM Program Application Information:Dates applications are accepted: July 15Prefers COMLEX Scores of: Interview Dates: First Wednesdays of November and DecemberNumber of Letters of Recommendations and who can write the letters: 4__________________________________________________

Program: Botsford HospitalAddress: 28050 Grand River AvenueCity/State/Zip: Farmington Hills, MI 48336

Hospital Information: Type (Community, rural, urban): CommunityTrauma Level: 2Number of Hospital Beds: 336Number of ED Beds:

EM Program Information: Phone: 248-471-8224Website: www.botsford.org/mededTotal Number of EM Residents: 27Residents to Attending Ratio Working Clinically: 2:5Accepts Medical Student Rotations? Yes

EM Program Curriculum: See Hospital Website

EM Program Application Information:Dates applications are accepted: 7/1/2013Prefers COMLEX Scores of:Interview Dates: November 2013Number of Letters of Recommendations and who can write the letters: 3__________________________________________________

Program: Henry Ford Macomb HospitalAddress: 15855 Nineteen mile Rd.City/State/Zip: Clinton Twp, MI 48038

Hospital Information: Type (Community, rural, urban): CommunityTrauma Level: Level IINumber of Hospital Beds: 435Number of ED Beds: 44

EM Program Information: Phone: 586-263-2953Website: HenryFord.comTotal Number of EM Residents: 32Residents to Attending Ratio Working Clinically: VariesAccepts Medical Student Rotations? Yes

EM Program Curriculum: PGY 1: 5 months Emergency Medicine 2 months Internal Medicine 2 months ICU 1 month Pediatrics 1 month General Surgery 1 month OB/GYNPGY 2: 6 months ER 1 month EMS 1 month Trauma 1 month Toxicology (DMC) 1 month PEDS (CHM) 1 month ORTHO/HANDPGY 3: 8 months ER 1 month Elective


1 month Neurology/Optho 1 month ICU 1 month Research/AdministrationPGY 4: 9 months ER 1 month Elective 1 month Trauma (Baltimore or HF-Macomb) 1 month PEDS (CHM)

EM Program Application Information:Dates applications are accepted: As soon as ERAS opensPrefers COMLEX Scores of: PASSEDInterview Dates: Fall-TBD OCT/NOV/DECNumber of Letters of Recommendations and who can write the letters: Prefer 3__________________________________________________

Program: NSCUCOM/Mt Sinai medical center, Miami beach florida Emergency medicine residency (#126254)Address: 4300 Alton RdCity/State/Zip: Miami Beach, FL 33139

Hospital Information: Type (Community, rural, urban): Urban Tertiary Care CenterTrauma Level: Level IINumber of Hospital Beds: 712 bedsNumber of ED Beds: 40 beds

EM Program Information: Phone: (305) 535- 7953Website: www.msmc.com Total Number of EM Residents: Residents to Attending Ratio Working Clinically: 3 to 1Accepts Medical Student Rotations? We have a robust 4 year medical student clerkship experience.

EM Program Curriculum: PGY 1: 5.5 months Emergency Medicine, 1 Month Cardiology, 1 Month ob/gyn. 1 month of Trauma, 1 month Gen surgery, 1 Month MICU, 1 month Peds EM, 2 weeks anesthesia, 2 weeks neurology, 2 weeks nephrology PGY 2: 6 months of EM, 1 Month MICU, 1 month PEDS EM, 1 Month Trauma, 2weeks opthal, 2 weeks infectious disease, 2 weeks admin, 2weeks ultrasoundPGY 3: 7 Months of EM, 1 Toxicology, 1 month EMS, 1 month Orthopedics, 1 Month Trauma, 1 Month Elective,PGY 4: 8 Months of EM, 1 month Trauma ICU, 1 month Peds EM, 1 month Selective, 1 month Elective, 1 Month Research

EM Program Application Information:Dates applications are accepted:Prefers COMLEX Scores of: 500or greaterInterview Dates: August of academic year till Jan 1stNumber of Letters of Recommendations and who can write the letters: 3- 4 letters of recommendation. Preferrably CORD standard letters of recommendation (SLOR) from EM physicians

Megan S. McGrew, DO, MBA, MSACOEP- RC National PresidentACOEP Board of Directors

Greetings from the Resident Chapter,

It is that exciting time of year again, when each of the 47 Osteopathic Emergency Medicine (EM) Programs across the country have completed the annual match and are looking forward to the years ahead with their new list of interns.

Each year EM gets more and more competitive, and of course 2013 was no exception. Of the 233 open positions in the match, all but two were filled (both of which subsequently filled during the scramble).

As a testament to the persistent efforts of the ACOEP and Graduate Medical Education Committee, EM has become one of the largest and more popular fields in the Osteopathic match. Outside of internal medicine and family medicine, EM has the largest number of Osteopathic residency spots available, with a total of 1,089 positions. This doesn’t even include the positions in specialty or combined programs, such as pediatric EM, EMS, EM/IM, EM/FM, etc, which is well in excess of 200 positions.

The popularity and size of Osteopathic EM is expected to continue to grow even more over the coming years. With more medical schools being opened across the country and at least two more residency programs in the pipeline, the future looks promising! The prediction is that there will be 1,129 positions in the 2014 match.

As an EM resident entering her last year of residency, it is very exciting to see this growth and I would like to take this opportunity to express my gratitude to the College for their continued support. Without their incredible leadership we would not be able to report such positive statistics. There is not another specialty college in this country that provides such guidance and support for the medical students and resi-dents going into EM!

RESIDENT CHAPTERREPORT


Documents

The Pulse - April 2013