The Pulse - Fall 2021

FALL 2021

THE JOURNEY BEGINS PG 7

THE JOY OF SHOWING UP PG 8

ETHICS IN EMERGENCY MEDICINE: WHAT WOULD YOU DO? PG 11

SAVE THE DATE!

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APRIL 10-13, 2022

#ACOEP22

The Pulse VOLUME XLIX No. 4

EDITORIAL STAFF Timothy Cheslock, DO, FACOEP, Editor Wayne Jones, DO, FACOEP-D, Assistant Editor Tanner Gronowski, DO, Associate Editor Justin Grill, DO, FACOEP John C. Prestosh, DO, FACOEP-D Christine F. Giesa, DO, FACOEP-D Meagan Comerford, Director of Communications Donald Rolfe, Senior Marketing Communications Manager

TABLE OF CONTENTS

EDITORIAL COMMITTEE Timothy Cheslock, DO, FACOEP, Chair Justin Grill, DO, FACOEP Christine Giesa, DO, FACOEP-D

The Pulse is a copyrighted quarterly publication distributed at no cost by ACOEP to its Members, Colleges of Osteopathic Medicine, sponsors, exhibitors, and liaison associations recognized by the national offices of ACOEP. The Pulse and ACOEP accept no responsibility for the statements made by authors, contributors, and/ or advertisers in this publication; nor do they accept responsibility 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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PRESIDENT’S REPORT Robert E. Suter, DO, MHA, FACOEP-D, FIFEM

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EXECUTIVE DIRECTOR’S DESK Katie Geraghty Executive Director

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THE ON-DECK CIRCLE G. Joseph Beirne, DO, FACOEP-D

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WOMEN’S COMMITTEE UPDATE Christina Hornack, DO

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RSO AWARDS

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WHAT WOULD YOU DO? ETHICS IN EMERGENCY MEDICINE Bernard Heilicser, DO, MS, FACEP, FACOEP-D

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Deadlines for the submission of articles are as follows: January issue due date is November 15; April issue due date is February 15; July issue due date is May 15; October issue due date is August 15. Advertisement due dates can be found by downloading ACOEP's media kit at www.acoep.org/advertising. ACOEP and the Editorial Board of The Pulse reserve the right to decline advertising and articles for any issue. ©ACOEP 2021 – All rights reserved. Articles may not be reproduced without the expressed, written approval of ACOEP and the author.

ACOEP is a registered trademark of the American College of Osteopathic Emergency Physicians.

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PRESIDENT’S REPORT

Robert E. Suter, DO, MHA, FACOEP-D, FIFEM

OUR BEST DAYS ARE AHEAD OF US

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he textbook on an outgoing President’s message is that, among other things, it summarizes the term and provides the foundation for how the organization is positioned for success going forward. While reflecting on these things it is impossible to ignore the cloud that COVID-19 has draped over us individually, on ACOEP and our community. Never could I have imagined when elected four years ago that the focus of my President-Elect term would be stabilizing our financial future, and the focus of my term as President would be our surviving the impacts of COVID-19 on our meetings and governance.

Just a few short weeks ago we thought that we would be able to gather in Washington, DC to celebrate surviving the pandemic. But with the surge in the Delta variant among the unvaccinated, your Board made the very painful decision to go virtual with our 2021 Scientific Assembly and cancelled the in-person portion of the meeting. Our decision was based on projections and recommendations of experts. We also realized that even those willing to risk attending an in-person gathering would not have enough control over their clinical schedules to make last-minute decisions about attending when working under employer prohibitions that prevent us from traveling and require us to work extra hours during

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SOME DAYS YOU WIN, SOME DAYS YOU LOSE, SOME DAYS IT RAINS.” Tim Robbins as “Nuke” Laloosh in the movie Bull Durham

COVID peaks.

Though we wanted to provide the opportunity for any sub-group that might have been able to gather in spite of these obstacles, the hotel was not interested in providing us with that option.

Cancellation of the in-person Scientific Assembly is only the most recent of the litany of challenges that we must overcome with your loyalty and support. During the past two years we have been challenged by significant financial issues and devastated by the loss of friends, family and colleagues who were close to us.

So, what are the positives and what have we accomplished over the past two years?

1. We saved our house and kept our Family together. By making some very difficult decisions we markedly reduced expenses and

insured the viability of ACOEP going forward. There were disagreements and frustrations along the way, but ultimately we found a path that allowed us to do so while keeping our Family intact. Over a period of just a few days we also executed a world class pivot to virtual meetings that enabled us to not cancel a scheduled meeting. Few other associations or societies can make this claim.

2. We published an enduring Strategic Plan for ACOEP. After struggling with the second and third order effects of the decisions made by the AOA concerning residency training, certification and membership we definitively and for all time defined ourselves as a Family and Community of like-minded emergency physicians who share

AS I TURN THE GAVEL OVER TO JOE, I KNOW THAT THROUGH THE HEROIC EFFORTS OF OUR ENTIRE LEADERSHIP TEAM WE KNOW THAT IT RAINED A LOT AND THAT WE DID NOT LOSE. ”

a respect for, or dedication to, the core philosophy of Osteopathic Medicine and who identify themselves as our brothers and sisters.

3. We facilitated inclusion and opportunity for more of our members. We made and continue to make Bylaws adjustments to facilitate inclusion and opportunity for more members of our Family to serve in leadership roles that will benefit both themselves and ACOEP. While the final impact of this accomplishment will only be realized through your enhanced participation in our community, we have unquestionably put the mechanisms in place to do so.

As emergency physicians we know that in any critical situation there are priorities and that the “nice to dos” sometimes must wait. As much as we have, and continue to, dream big about what ACOEP can do for our community this is where we found ourselves over the past two years. We

hope and pray that the cancellation of the in-person portion of our Scientific Assembly is the last active damage control measure that we need to do and that we can get back full-time to the “nice to dos.”

Anticipating that, I look forward to serving as your Past President and working with you to make sure that we go fast and far during Dr. Beirne’s presidency. I will reach out to former Board members and Presidents to help him, and us, rebuild and re-populate our structures and to re-seed them by bringing in younger members to take over the reins of leadership at every level as quickly as possible.

Jesus communicated the wisdom of human history when he concluded, “Truly I tell you no prophet is accepted in his hometown.” (Luke 4:24). While I am no prophet (let alone Jesus!) I have always been keenly aware of the fact that the ACOEP community is my natural hometown, and that my selection to be your President was

unique due to my prior success in non-Osteopathic venues. Frankly, this gave me a bit of anxiety. So, that you give me the opportunity to serve as the leader of our hometown for the past two years was an incredible honor, and more meaningful to me emotionally than you could ever know.

Thank you.

As I turn the gavel over to Joe, I know that through the heroic efforts of our entire leadership team we know that it rained a lot and that we did not lose. Whether we scraped out an ugly victory or merely got to the beginning of the fifth inning ahead by a run in a rain delayed and then postponed game is yours to decide.

Regardless of the call, I am very proud of what our Team, our Family, our ACOEP Community has done and continues to do. I hope to see you all in person very soon…. –•– Robert E. Suter, DO, MHA, FACOEP-D, FIFEM Outgoing ACOEP President

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EXECUTIVE DIRECTOR’S DESK

Katie Geraghty Executive Director

STRENGTH IN NUMBERS

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ear ACOEP Community, More than ever, we turn to our communities to lift us up.

That is why it was so difficult making the decision to move this year’s Scientific Assembly from an in-person gathering to a virtual event.

The human connection is powerful, and the ACOEP community is a refuge for so many. That said, I look forward to connecting with the EM community virtually for the conference, and in person again just as soon as possible.

I am also heartened to learn that there are “viewing parties” for the event being held around the country so that those essential connections are still being made. The ACOEP community is strong and resilient, and it shows.

I was happy to join ACOEP as Interim Executive Director this summer and was warmly welcomed by the ACOEP Finance Committee in Dallas and by the full Board via Zoom.

I cannot wait to meet more of you to better understand your priorities and how ACOEP can support you. I want

I CANNOT WAIT TO MEET MORE OF YOU TO BETTER UNDERSTAND YOUR PRIORITIES AND HOW ACOEP CAN SUPPORT YOU.”

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you to know that can reach out to me at any time.

I hope to “see” many of you at the Scientific Assembly, and hope to meet with you face-to-face at our 2022 Spring Seminar in Fort Lauderdale, Florida (April 10-13). Oh, and while you have your calendar open, be sure to save the date for ACOEP’s 2022 Scientific Assembly too, scheduled for October 24-28, in Las Vegas, Nevada!

If you’re looking for other ways to connect and learn, check out ACOEP’s online partner – DocMatter.

Your ACOEP membership includes access to this great facilitator of virtual engagement that provides you with tailored content and interaction opportunities.

We appreciate your ongoing support and dedication to the EM profession and ACOEP. Each one of you makes us stronger. –•– Sincerely, Katie Geraghty

THE ON-DECK CIRCLE

G. Joseph Beirne, DO, FACOEP-D

THE JOURNEY BEGINS

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ello to the ACOEP family!

This will be my first official article for The Pulse as president of ACOEP. In my summer article titled “The Path to Success,” I addressed how ACOEP is a family that has made my personal life and career more rewarding. The last line of that article was “The first step on the path to success begins and ends with all of us together. Come along with me and take the journey. I promise you it will be exciting!” As incoming president, my journey begins with you, our ACOEP family.

After much deliberation and discussion, the ACOEP Board of Directors made the difficult decision to move the 2021 Scientific Assembly to an all-virtual format. It was our hope in the spring and early summer that the pandemic numbers would improve. But as we all are aware, the Delta variant has made an in-person conference impossible. The safety of our members and their families is paramount, and we felt that meeting in person was too risky. Furthermore, we recognized that many of our members are subject to travel restrictions in order to maintain safe staffing levels in their emergency departments and precluding them from attending in person. For these reasons, we made the decision to move to a virtual conference.

As I begin my presidency, it is my hope that our ACOEP family expands by bringing in new members. It is my intent to increase our transparency

THE FIRST STEP ON THE PATH TO SUCCESS BEGINS AND ENDS WITH ALL OF US TOGETHER.” with the membership, so that our college functions as a team. When I was elected to the Board of Directors in 2014, I recognized the importance of my role as a Board member. Now as your president, I am responsible for leading this college over the next two years. I look forward to representing our ACOEP family on the national stage and maintaining our high standard as an icon in emergency medicine. However, I cannot do that alone.

Our Board of Directors is a diverse group of dedicated physicians with sincere interests in making our college the best it can be. We represent you, our membership.

However, our entire college is part of this leadership team. All members– attending, residents, students–are a vital part of our team, and our future success depends upon each of you.

As president, and with our Board, I ask for your help in keeping ACOEP at the forefront of emergency medicine.

My vision for the next two years is not just maintaining ACOEP but growing our organization into the best specialty college in the AOA and emergency medicine. That

vision requires you, our members, to be actively involved as part of the team. I want ACOEP to help its members develop their professional and leadership skills in emergency medicine. With so many talented people in our ranks, I am confident that there are members who will step up to become part of our future leadership, and that all members will have opportunities to help steer the growth of our college.

As your president, it is my responsibility to foster and improve this creative environment as we expand into the future. It is a responsibility that I take seriously and will, to the best of my ability, work to achieve. I know everyone is familiar with the acronym “TEAM: Together Everyone Achieves More.” Together, our college will be successful and thrive. That is my pledge to you. As our journey on the path to success begins, we have taken the first step.

Now, let’s make the rest of the journey unforgettable and one for the ages!

–•–

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By Christina Hornack, DO Immediate Past President of ACOEP-RSO AOA TIPS Fellow

WOMEN’S COMMITTEE UPDATE THE JOY OF SHOWING UP

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n a popular musical there is a reference made to “the room where it happens,” but where is this room and how do you get there? It turns out, as an adult, this is usually every room you’ve been avoiding, and you get there by just showing up. Most everyone you know is usually “too busy” to participate in another activity, and so engagement is generally low. But what if we could find time to attend that committee, or go to a class, or volunteer to help?

The first time I showed up for one of these extra activities, it was a membership meeting for the honors society I had just been inducted into.

At the time, I thought I would pursue the law, and my aunt told me that I would need to not only show up, but to be an officer in that group if I wanted to get into law school. I ended up running for an officer position which, after years of participating in one way or another, resulted in me being the speaker for my graduating class. Through my connection with the faculty mentor of that group, I was

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able to nimbly change direction from law to medicine, get connected with all the people who could help me make that happen, and add things to my CV which would catapult me into medical school.

No one wants another task added to their list. If you’re anything like me, you live somewhere between comfortably busy and overwhelmed every single day. But if we shift our focus from classifying things as “tasks” and instead look at them as “opportunities” it becomes easier. And really, that’s what they are.

Obviously not every opportunity is going to change your life and your future profession. But then how do we determine where to invest our time, and where to decline participation?

It turns out, we get the most out of the things we put the most into. And we put more effort into things that we enjoy. In the beginning of my “showing up” phase, I had no idea what I enjoyed doing. I ended up agreeing to participate in everything, and then had to cull back to just my

most enjoyable activities. That can obviously lead to some uncomfortable conversations, but most people are fairly understanding when you explain that you’re pre-med.

Once you’ve established what you enjoy, you’ll also discover your own personal aptitudes. After we know the things we enjoy AND the things that we are good at, our participation becomes much more seamless. Along my journey, I learned that I enjoy organizing events and writing. I found ways to leverage these activities into most situations, as most groups will need someone to organize things and then write about them.

It was over a decade ago since that first meeting with the honors

society. Since that time, I’ve been president of multiple undergraduate organizations, participated on the national level in graduate school, attended multiple conferences and had my expenses paid for, and met people who could get me into “the room where it happens” to match emergency medicine and then find a job. In addition to all of that, I’ve met some really great people – people whose weddings I’ve attended, whose children I’ve held, whose families I’ve stayed with, and who have undoubtedly enriched my life in immeasurable ways.

GET INVOLVED ACOEP’s Committee for Women in Emergency Medicine is seeking a medical student and a resident representative.

To learn more and get into “the room where it happens,” email Association Manager, Joanne Kubinski at JKubinski@acoep.org.

–•–

Christina Hornack, DO started her undergraduate journey in the fall of 2005 as a nontraditional student with a husband and 8 year old son. After an unexpected job loss in 2010, she decided to pursue medical school and was able to leverage her network to connect with all the right contacts. She started medical school at 36 and would later learn she was the oldest person in her class. She is now a single coverage, critical access nocturnist somewhere in the Midwest with an incredible group. She spends her spare time mentoring medical students, serving as a public relations co-chair of the ACOEP Women’s Committee, and hanging out with her husband and dog.

If you’d like to tell your story, we would love to hear it! We publish in The Pulse quarterly and are always looking for incredible women to share their passions.

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RSO AWARDS ACOEP-RSO STUDENT OF THE YEAR Andrew Hopsodor, Class of 2024, VCOM Carolinas campus has been named 2021 RSO Student of the Year. Andrew has served his community as an EMT, paramedic and member of the North Carolina Crisis Intervention Team. He is student chapter president of ACOEP at VCOM Carolinas campus, is an experienced Field Training Officer, and received the Code Save Award for multiple successful out of hospital arrests. Congratulations, Andrew!

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ACOEP-RSO CLUB OF THE YEAR The 2021 RSO Club of the Year is Texas College of Osteopathic Medicine. This emergency medicine interest group has more than 500 members and hosted many events in the last year, including a cadaver intubation clinic, guest speaker Brandon Lewis, DO, FACOEP from ACOEP’s Board of Directors, Women in EM panel, suture clinic, journal club, and speakers from numerous emergency medicine publications. Congratulations to this outstanding club!

Bernard Heilicser, DO, MS, FACEP, FACOEP-D

What Would You Do? Ethics in Emergency Medicine

The following dilemma was previously presented to us by an emergency department physician.

An 81-year old female was transported to the emergency department by EMS after an attempted strangling. It appeared her husband attempted to euthanize her by strangulation with a belt. The family discovered the situation and called EMS. In the ED, the patient indicated that she had terminal breast cancer and was prepared to die. She refused all labs, IVs or treatment. The ED physician was unsure what his obligations were and what to do. If clinically stable, should the patient be discharged? Is there a need for psychiatric intervention or consultation?

WHAT WOULD YOU DO? This would be rather perplexing. Does the patient have the inherent right to allow for her death, or should a psychiatric evaluation be entertained? If the patient demonstrates clinical psychosis would we not be demonstrating a fair objective evaluation of her clinical status? It would appear after a psychiatric evaluation if she has decision making capacity then discharge could be considered.

There is a thin line between decision making capacity and clinical psychosis, and this case certainly challenges this.

The patient was referred for a psych consult and was ultimately admitted to inpatient hospice.

If you have cases that you would like to present or have reviewed in a future issue of The Pulse, email them to us at drolfe@acoep.org.

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