PACEP NEWS WINTER 2019
It’s cold outside and PACEP Is heating up!!! As we turn the page on 2018 and welcome 2019, we know the work of Emergency Physicians is never done. During the good times (holidays) and the bad times (tragedies and natural disasters), Emergency Physicians are the backbone of our health care system, 24.7.365. At PACEP, we are committed to helping our members complete their mission of taking care of the people of the Commonwealth anytime. For 2019, in order to advance our mission, PACEP has set the following legislative and regulatory goals. These include: fighting for fair reimbursement for emergency services, drafting and implementing common sense opioid regulations, and ensuring that the PA State Health and Safety regulations (Title 28) rewrite acknowledges the roles that Ankur A. Doshi, Emergency Physicians play in EDs and hospitals. Our EMS/Disaster committee is also MD, FACEP assisting in the EMS regulation rewrite. Finally, we are working with our health care PACEP President partners to combat rollbacks against physicians in the PA medical malpractice climate (more info here: https://www.pamedsoc.org/venue-rule-change/comment). Our members have been involved in many meetings locally and in Harrisburg to advance this agenda. And, there’s way more to go! Stay tuned! Our Board of Directors approved the 4 newest leaders in our College this month – 2 new Resident Board Members and 2 new Leadership Fellows. Welcome to Drs. Khammahavong, Tannenholtz, Olaf and Walls! Additionally, our Nominating Committee and Board of Directors have approved the slate for 2019 BOD Elections (www.pacep.net/governance.html). Please take some time to learn about the candidates and their visions for PACEP and then vote. The BOD serves as your advocate for EM in the state. Please vote! Finally, our PACEP SA 2019 is just around the corner! We will be gathering from April 10-12 in King of Prussia to learn, network and enjoy each other’s’ company. Some highlights include a top-notch slate of speakers on the theme: Providing Evidence-based Medicine at your Doorstep, our 2nd Annual Ultrasound-Guided Procedural Course (https://www.pacep.net/pacep-ultrasound-guided-procedural-course.html), and (for the first time in many years) AOA Credits for those needing them! Go here to register: http://www.cvent.com/events/pacep19-scientific-assembly/ event-summary-b10551cb8569424aaefc663962b7a3ae.aspx. At PACEP we are heating up for 2019! I hope you will join us in protecting EM for ourselves and our patients! I hope your 2019 is safe and prosperous and to see everyone soon in King of Prussia!
PACEP19 SCIENTIFIC ASSEMBLY
APRIL 10-12, 2019 CROWNE PLAZA, KING OF PRUSSIA
www.pacep.net
{ Job Opportunities } Division Chief, Pediatric Emergency Medicine EMS Fellowship Director/EMS Medical Director Assistant Medical Director PEM/EM Core Faculty Vice Chair Research Emergency Medicine
What We’re Offering: • We’ll foster your passion for patient care and cultivate a collaborative environment rich with diversity • Salaries commensurate with qualifications • Sign-on bonus • Relocation assistance • Retirement options • Penn State University Tuition Discount • On-campus fitness center, daycare, credit union, and so much more! What We’re Seeking: • Experienced leaders with a passion to inspire a team • Ability to work collaboratively within diverse academic and clinical environments • Demonstrate a spark for innovation and research opportunities for Department • Completion of an accredited Emergency Medicine Residency Program • BE/BC by ABEM or ABOEM • Observation experience is a plus
What the Area Offers: We welcome you to a community that emulates the values Milton Hershey instilled in a town that holds his name. Located in a safe family-friendly setting, Hershey, PA, our local neighborhoods boast a reasonable cost of living whether you prefer a more suburban setting or thriving city rich in theater, arts, and culture. Known as the home of the Hershey chocolate bar, Hershey’s community is rich in history and offers an abundant range of outdoor activities, arts, and diverse experiences. We’re conveniently located within a short distance to major cities such as Philadelphia, Pittsburgh, NYC, Baltimore, and Washington DC.
FOR ADDITIONAL INFORMATION PLEASE CONTACT: Susan B. Promes, Professor and Chair, Department of Emergency Medicine c/o Heather Peffley, Physician Recruiter, Penn State Health Milton S. Hershey Medical Center 500 University Drive, MC A595, P O Box 855, Hershey PA 17033 Email: hpeffley@pennstatehealth.psu.edu or apply online at: hmc.pennstatehealth.org/careers/physicians Penn State Health is committed to affirmative action, equal opportunity and the diversity of its workforce. Equal Opportunity Employer – Minorities/Women/Protected Veterans/Disabled.
Social Determinants of Health – A “Healthy Opportunity” for Emergency Medicine Emergency medicine has a long history of adopting the mantra, “anyone, anything, anytime” to describe our social compact of Chadd K. Kraus, DO, serving as healthcare’s DrPH, MPH, FACEP safety net. As healthcare costs and value-based care continue to dominate health policy, legislative, and regulatory discussions, the social determinants of health have taken center stage. Social determinants of health are defined by the World Health Organization (WHO) as “the conditions in which people are born, grow, live, work, and age.”(1) Some examples of social determinants include availability of stable housing, reliable transportation options, exposure to crime and violence, access to education, and food.(2) On the national level, there is a strong interest in addressing the social determinants of health, primarily as a way to control costs and manage utilization of health care services. As an example, for the past several years, some state Medicaid programs have used funding to assist individuals in finding and maintaining permanent housing. In a speech in late 2018, HHS Secretary Alex Azar said that that CMS through the Center for Medicare and Medicaid Innovations (CMMI) is exploring new initiatives that would allow hospitals and health systems to pursue additional partnerships with social service groups and other organizations to directly pay to address social determinants of health such as housing.(3) I recently attended a lecture that outlined state and federal health policy and solutions that states are undertaking. The speaker, Len M. Nichols, PhD, a health economist and policy expert, discussed re-thinking the social determinants of health as “healthy opportunities” rather than “determinants.” With my own interests in the intersection of clinical emergency medicine and public health, I was inspired by the concept of changing the focus from “determinants” to “opportunities” particularly because opportunities are something that we can all work together to create. We as emergency physicians and as the specialty of emergency medicine have a clear role to play as leaders in creating those “healthy opportunities” by defining and addressing the social determinants of health that impact our patients and their presentations to the ED. So how is emergency medicine creating “healthy opportunities” for our patients and our communities?
Emergency medicine has throughout it’s history, created these opportunities through coordination of care and taking care of all patients. However, more recently, developments such as mobile integrated healthcare (MIH) and community paramedicine (CP) are examples of how EM is “creating opportunities” from “determinants.” MIH and CP use the skills and expertise of EMS personnel to deliver integrated care outside of traditional hospitalbased settings. MIH and CP programs can impact social determinants of health by aiding patients in chronic disease management and education and post-discharge follow-up and can provide telephone or telemedicinebased services to non-urgent 911 dispatches in lieu of sending an ambulance. The informal subspecialty of “social emergency medicine” has blossomed in the past several years.(4) Many academic departments of emergency medicine have established divisions of social emergency medicine and some EM residency and fellowship programs have started to focus on specialized training in social emergency medicine. Other EM groups and departments have undertaken research and community health assessments to better define the social needs of the patients in the communities they serve, from homelessness and housing insecurity to food availability and economic opportunities. So how can you work with patients and other stakeholders to create healthy opportunities out of the social determinants of health impacting them? There are multiple ways. First, work to understand the unique needs of individual patients whom you encounter during clinical shifts by answering the following questions: How or why do the complex social needs of the patient influence his or her ED visit; and, how do those needs impact disposition and transitions across the continuum of care? How is the community you serve impacted by housing, jobs, and food insecurity? What are the available resources to effectively care for a patient beyond the ED visit? Secondly, work to promote efforts in your local hospital ED or health system to implement programs such as warm handoffs for patients with opioid use disorders and participate in programs that allow emergency medicine to use our expertise in care transitions that help our patients to receive care in the most appropriate clinical setting such as telemedicine for MIH/CP. Third, seek to foster the interdisciplinary teams (e.g. case managers) that we as emergency physicians have always worked with to address the non-clinical needs of our patients. Finally, get involved. PACEP News | WINTER 2019
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Many emergency medicine organizations now have opportunities to learn more about and engage in social emergency medicine. One great resource is the recently organized ACEP Social Emergency Medicine Section open to ACEP members with an interest in the topic. Social determinants of health offer an opportunity for us as emergency physicians, and our specialty as a whole, to engage our patients and our communities toward the realization of ‘healthy opportunities.’ REFERENCES 1. WHO. About social determinants of health. Available online at: https://www.who.int/social_determinants/ sdh_definition/en/
2. Office of Disease Prevention and Health Promotion. Healthy People 2020. “Social Determinants of Health” Available online at: https://www.healthypeople.gov/2020/ topics-objectives/topic/social-determinants-of-health 3. Barr P, Dickson V. CMS may allow hospitals to pay for housing through Medicaid. Available online at: https://www.modernhealthcare.com/article/20181114/ NEWS/181119981 4. Klauer K. Can Social Emergency Medicine Give a Different Perspective on Community Health. ACEPNow. Available online at: https://www.acepnow.com/cansocial-emergency-medicine-give-different-perspectivecommunity-health/
Curious about getting involved in policy-setting at the national level? The PACEP Board of Directors is seeking interested members to join our Delegation to the 2019 ACEP Council to be held Friday and Saturday, October 25 and 26, 2019 in Denver, CO. This year, PACEP is allotted 18 councillors, as well as alternates. Any active PACEP member is eligible. We want to know your opinions and thoughts! A councillor/alternate councillor is a key participant in the leadership and development of ACEP policy and has the responsibility to voice the concerns of their (Pennsylvania) constituents on the floor of the Council meeting and in reference committees. Councillors can also express the will of their constituents by voting for or against resolutions and electing board members and Council officers. Councillors and alternates will be a part of PACEP’s resolution planning and writing efforts, discussion of and response to all other resolutions selected for review at the Council meeting, and onsite Pennsylvania Delegation events. Interested in serving on the 2019 PACEP Delegation? Have an idea for a 2019 Council resolution? Email a brief statement of interest to info@pacep.net by April 26, 2019. To learn more, visit the ACEP Council page. If you have any questions, contact Barbara Husic, Executive Director, at bhusic@pamedsoc.org.
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PACEP News | WINTER 2019
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Join USACS!
Own your future in Pennsylvania
Unique Opportunity in Pittsburgh, PA! In late 2019, Allegheny Health Network Emergency Medicine Management (AHNEMM) will begin managing the emergency medicine and hospitalist services at four brand-new Neighborhood Hospitals in the Pittsburgh area communities of Brentwood, Harmar Township, Hempfield Township and McCandless Township: ■ Beautiful new facilities will have fully-equipped, 8- to 10-room EDs and 10-12 inpatient beds ■ Anticipated ED patient volumes of 10,000 - 20,000 per year ■ EDs will be staffed by board-certified emergency medicine physicians ■ Hospitalists will be partners of the emergency physicians via AHNEMM, and will manage the inpatients ■ Lab services and diagnostic radiology including CT and ultrasound available on-site ■ Efficient referral and transfer protocols in place along with the AHN one-call program run by AHNEMM emergency physicians
when you become an owner in one of the largest, fastest-growing physician-owned groups in the nation. Get the support you need with the culture and benefits you want. • Highly competitive financial/benefits package • Physician equity ownership for all full-time physicians
• Industry-leading and company funded 401(k) (an additional 10%) • Yearly CME/BEA (Business Expense Account) • Student loan refinancing as low as 2.99%
• Groundbreaking Paid Parental Leave • Pioneering Paid Military Leave
• Short- and long-term disability (own occupation)
• Comprehensive medical, dental, vision and Rx coverage
• The best medical malpractice including tail coverage • Outstanding Professional development programs
• Location flexibility and career stability of a national group
exceptional hourly pay Ownership Matters
Allegheny Health Network Emergency Medicine Management (AHNEMM) is a joint venture formed by USACS and the Allegheny Health Network (AHN) to provide for the emergency medicine needs for hospitals that are part of AHN and others who partnered with the organization. It aligns physician, hospital and payor to do what’s right for patients and deliver high-quality, innovative and efficient models of care. Partnership in AHNEMM includes partnership in US Acute Care Solutions and access to both organizations’ resources.
To learn more about our PA locations: Jim Nicholas | Physician Recruiter jnicholas@usacs.com or 844-863-6797. or visit usacs.com/locations
COMMITTEES WELLNESS COMMITTEE Before you know it, we will be gathering in King of Prussia for Scientific Assembly 2019 and the PACEP Wellness Committee has a variety of activities planned again this year for your enjoyment. Join us for Yoga with instructor Lisa McBride early mornings on Thursday April 11 and Friday April 12 in the Devon Room. Stretch and stimulate your mind and body before sitting in the lecture hall all day. Visit the Recharge Room where you can unwind from the day in our relaxing environment. Stop by the Wellness Booth in the exhibit hall. We will be giving out some much wanted wellness swag. We will also have the Wellness inspiration board again. Post what you do for wellness or get some ideas posted by others on the board. If you are interested in joining the Wellness Committee, sign-ups will be available at the booth. Adult coloring seems to be one of the latest trends. Much like mediation, when you color, your brain switches off from your other thoughts and focuses on the task in the moment. You reach a state of calm that relieves you from the daily stresses and nonstop thinking. A study published in the Art Therapy: Journal of the American Art Therapy Association 22(2) pp. 81-85 provides support that coloring mandalas or geometric patterns actually does help lower stress and anxiety levels. Because coloring requires repetition and attention to detail, you can focus on the activity instead of your other worries. Mindfulness keeps us committed to the present which occurs with coloring.
Here are the top benefits of coloring for adults: 1. Your brain experiences relief by entering a meditative state 2. Stress and anxiety levels have the potential to be lowered 3. Negative thoughts are expelled as you take in positivity 4. Focusing on the present helps you achieve mindfulness 5. Unplugging from technology promotes creation over consumption 6. Coloring can be done by anyone, not just artists or creative types 7. It’s a hobby that can be taken with you wherever you go Coloring brings out our inner child. We are reminded of the days when life was much simpler and our biggest worries were not a life or death matter. No need to be an artist. Anyone can do it. Dr. Katy Hanson will be creating a LARGE adult coloring page which will be available at the Wellness Booth in the exhibit hall and in the Recharge Room when the exhibit hall is closed. Check out her other drawings on Instagram hansonsanatomy. Please give us feedback on the wellness activities on the survey at the end of the conference. Let us know what you liked or what you would like to see in the future. See you there! Katherine Lund, DO, Chair Jennifer Savino, DO, FACEP, Chair Hannah Mishkin, MD, Co-Chair
PACEP’s Wellness Committee promotes the health and wellness of emergency physicians through education and initiatives that encourage habits of wellness, increase awareness of factors and resources contributing to well-being, inspire and empower individuals to take responsibility for their own health and support a sense of community. If you are interested in becoming a Wellness Committee member, please email info@pacep.net.
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PACEP News | WINTER 2019
PEP-PAC 2018 Year in Review PACEP and myself want to thank the 73 donors who raised $20,105 for the PAC this year. We used this money to make 58 donations, totaling $26,650.00 in 2018. 54 donations went directly to State Senators and Representatives and 4 donations went to Democratic and Republican Campaign Committees. PEP-PAC donations were used to support campaigns of past friends and future leaders of the legislature. We donate to build relationships by attending a fundraiser, a luncheon, or making a campaign contribution. PEP-PAC is non-partisan and supports both Republicans and Democrats. Todd Fijewski, MD, FACEP
2017-2018 PEP-PAC Chair
PEP-PAC gives us a chance to support legislators, many of whom have supported emergency medicine in the past. We certainly will be asking for their support for the next two years. After any election, there are new freshman legislators to educate. Most elected officials don’t have a medical background and don’t understand complex issues like out of network billing, tort reform, the opioid crisis, scope of practice, psychiatric boarding and bed availability to name just a few.
We have many opponents in the Capitol. These include the trial lawyers, insurance lobbyists, sometimes the Hospital Association of Pennsylvania, possibly other specialties, special interest groups, etc. It is imperative that we continue to raise money to advance meaningful legislation in our State. There is so much misinformation that we have to address. Thank you for your past, present and future support. When we work together, there is nothing, we can’t accomplish.
Thank you to our 2018 PEP-PAC Contributors! Harris Baderak, DO, FACEP Donna Balewick, MD Smeet Bhimani, DO Shaun Black, DO, FACEP Ralph Bledsoe, MD, FACEP Erik Blutinger, MD Michael Bohrn, MD, FACEP Michael Boyd, MD Deborah Brooks, MD, FACEP Joesph Clark, DO Robert Cooney, MD Lawrence Crochier, MD Evan Crowe, MD Ankur Doshi, MD, FACEP Joseph English, MD Marcus Eubanks, MD, FACEP Mark L. Fennema, MD, FACEP Charles Feronti, DO, FACEP Todd Fijewski, MD, FACEP Steven Frei, MD, FACEP Laurence Gavin, MD, FACEP Daniel Geary, MD, FACEP Lawrence Goldhahn, MD, FACEP Stuart Greene, MD, MBA Roderick Groomes, MD, FACEP
Anthony Guarracino, MD, FACEP Maria Guyette, MD, MPPM, FACEP Francis Guyette, MD, FACEP Steven Guyton, MD, FACEP Ronald Hall, MD, FACEP F. Richard Heath, MD, FACEP Marilyn Heine, MD, FACEP Jerry Jamison, MD, FACEP Thompson Kehrl, MD, FACEP Kristen Kish, DO Jacob Kleinman, MD, FACEP Erik Kochert, MD, FACEP Scott Korvek, MD, FACEP Mitchell Kosanovich, MD Chadd K. Kraus, DO, DrPH, MPH, FACEP Douglas Kupas, MD, FACEP Priyanka Lauber, DO Bruce Macleod, MD, FACEP Lewis March, MD Jennifer Marin, MD, MSc, FACEP Ferdinando Mirarchi, DO, FACEP Dhimitri Nikolla, DO Rika O’Malley, MD Gary E. Penner, MD, FACEP Gary Pollock, MD, FACEP
Shawn M. Quinn, DO, FACEP Jon Rittenberger, MD, FACEP Alexander Rosenau, DO, FACEP David Rottinghaus, MD T Douglas Sallade, DO Albert Saloom, MD Jennifer Savino, DO, FACEP Steven Schirk, MD, FACEP Anna Schwartz, MD, FACEP Jose Serrano, MD David Shellenbarger, MD, FACEP Samuel C. Slimmer, Jr, MD, FACEP Daniel Snediker, MD, FACEP Richard Sullivan, MD Owen Traynor, MD Michael Turturro, MD, FACEP Unidentified Contribution Arvind Venkat, MD, FACEP Richard Wadas, MD, FACEP Brian Wieczorek, MD, FACEP Adam Yates, MD, FACEP Theodore Ziff, MD, FACEP Gary Zimmer, MD, FACEP
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LEGISLATIVE UPDATE Milliron & Goodman Government Relations On Tuesday, January 1st, the Pennsylvania General Assembly met to convene the 203rd legislative session. The 2019-2020 session brings 50 new members to the House and Senate. Below are the lists of the new committee chairs. Relevant committees are highlighted.
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House Committee
Republican Chair
Democratic Chair
Aging and Older Adult Services Agriculture and Rural Affairs Children and Youth Commerce Consumer Affairs Education Environmental Resources and Energy Finance Game and Fisheries Gaming Oversight Health Human Services Insurance Judiciary Labor and Industry Liquor Control Local Government Professional Licensure State Government Tourism and Recreational Development Transportation Urban Affairs Veterans Affairs and Emergency Preparedness
Rep. Thomas Murt Rep. Martin Causer Rep. Karen Boback Rep. Mark Keller Rep. Brian Ellis Rep. Curt Sonney Rep. Daryl Metcalfe Rep. Michael Peifer Rep. Keith Gillespie Rep. Jim Marshall Rep. Kathy Rapp Rep. Gene DiGirolamo Rep. Tina Pickett Rep. Rob Kauffman Rep. Jim Cox Rep. Jeff Pyle Rep. Dan Moul Rep. Dave Hickernell (New Chair) Rep. Garth Everett Rep. David Millard Rep. Tim Hennessey Rep. Sue Helm Rep. Stephen E. Barrar
Rep. Steve Samuelson Rep. Eddie Day Pashinski Rep. Joseph Petrarca Rep. John Galloway Rep. Rob Matzie Rep. James Roebuck Rep. Greg Vitali Rep. Jake Wheatley Rep. William Kortz Rep. Scott Conklin Rep. Dan Frankel (New Chair) Rep. Angel Cruz Rep. Tony DeLuca Rep. Tim Briggs Rep. Patrick Harkins Rep. Dan Deasy Rep. Bob Freeman Rep. Harry Readshaw Rep. Kevin Boyle Rep. Mark Longietti Rep. Mike Carroll Rep. Thomas Caltagirone Rep. Christopher Sainato
Senate Committee
Republican Chair
Democratic Chair
Aging & Youth Agriculture & Rural Affairs Appropriations Banking & Insurance
Sen. John DiSanto Sen. Elder Vogel, Jr. Sen. Pat Browne Sen. Don White
Sen. Maria Collett Sen. Judy Schwank Sen. Vincent Hughes Sen. Sharif Street
PACEP News | WINTER 2019
Senate Committee
Republican Chair
Democratic Chair
Communications & Technology Community, Economic & Recreational Development Consumer Protection & Professional Licensure Education Environmental Resources & Energy Finance Game & Fisheries Health & Human Services Intergovernmental Operations Judiciary Labor & Industry Law & Justice Local Government Rules & Executive Nominations State Government Transportation Urban Affairs & Housing Veterans Affairs & Emergency Preparedness
Sen. Wayne Langerholc, Jr. Sen. Mario Scavello
Sen. Steve Santarsiero Sen. Larry Farnese
Sen. Tommy Tomlinson Sen. Ryan Aument Sen. Gene Yaw Sen. Scott Hutchinson Sen. Dan Laughlin Sen. Michele Brooks (New Chair) Sen. Judy Ward Sen. Lisa Baker Sen. Camera Bartolotta Sen. Pat Stefano Sen. Scott Martin Sen. Jake Corman Sen. Mike Folmer Sen. Kim Ward Sen. Tom Killion Sen. Mike Regan
Sen. Lisa Boscola Sen. Andrew Dinniman Sen. John Yudichak Sen. John Blake Sen. Jim Brewster Sen. Art Haywood (New Chair) Sen. Wayne Fontana Sen. Daylin Leach Sen. Christine Tartaglione Sen. Jim Brewster Sen. Tim Kearney Sen. Jay Costa Sen. Anthony Williams Sen. John Sabatina, Jr. Sen. Katie Muth Sen. Lindsey Williams
The House and Senate both return next week and will begin preparing for the Governor’s budget address which is scheduled for Tuesday, Feb. 5th, 2019. A complete list of session days is as follows:
2019 SENATE SESSION SCHEDULE January
1, 15, 16, 28, 29, 30
February
4, 5, 6
March
18, 19, 20, 25, 26, 27
April
8, 9, 10, 29, 30
May
1, 6, 7, 8
June
3, 4, 5, 10, 11, 12, 17, 18, 19, 24, 25, 26, 27, 28
2019 HOUSE SESSION SCHEDULE January
1, 15, 16, 28, 29, 30
February
4, 5, 6, 19, 20, 21
March
11, 12, 13, 18, 19, 20, 25, 26, 27
April
8, 9, 10, 15, 16, 17, 29, 30
May
1, 6, 7, 8, 13, 14, 15, 22, 23 (Cancelled)
June
3, 4, 5, 10, 11, 12, 17, 18, 19, 20, 24, 25, 26, 27, 28
HOSPITAL REGULATIONS
In mid-December, MG set up a conference call with the available PACEP board members and the individuals at the Department of Health who are drafting the hospital regulation changes. During that call, PACEP was able to
voice some concerns over some of the changes in the regulations, particularly those pertaining to victims of sexual assault and micro-hospitals. PACEP also offered to come to the Department of Health in person to review the regulations and provide further comment and feedback on the draft, which did happen on Wednesday January 3. It’s important to remember, while we are working on these regulations, the regulatory process is much longer and very different than the legislative process and we are still in the very early stages of the process. The hospital regulations have not yet been made public. It is our expectation that these regulations will be available to the public for a comment period sometime this spring. The publishing of the proposed regulations signals the official start of the regulatory process, which can take well over two years to complete.
OPIOIDS
While it is still very early in the session and most bills have not yet been introduced, we anticipate that many of the same bills from last session will return for the 2019-2020 session. We are already tracking cosponsorship memos for things like involuntary commitment, regulation of fentanyl, and taxation on opioids.
BALANCE BILLING
Protecting consumers from surprise balance bills from medical providers remains a priority for lawmakers this session. State House Insurance Committee Chair PACEP News | WINTER 2019
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Tina Pickett (R-Bradford) has filed a cosponsorship memo on her intent to introduce legislation. PACEP is actively engaged in the discussions with lawmakers and is working with other hospital-based specialties. Pennsylvanians should be able to use the closest and most appropriate emergency department when they have an acute need. No patient at a time of medical crisis should have to worry about insurance network coverage. At the same time, insurance companies should be required to pay fair and reasonable reimbursement rates to emergency care providers, regardless of whether they are considered in- or out-of-network. PACEP continues to advocate for transparent and objective reimbursement criteria (e.g. Fair Health). The good news – lawmakers are interested in learning more about the solutions proposed and concerns raised by the provider community. The state House Insurance Committee, chaired by Pickett, is planning an informational meeting with Fair Health in February. In addition, the Committee is scheduling an informational meeting with stakeholders, including PACEP and other medical specialties, on surprise balance billing. There is also discussion on an informational meeting with the state Department of Health to talk about network adequacy and their standards for determining network adequacy. PACEP agrees that patients should not receive surprise bills when care is provided unknowingly by an out-of-network provider. Emergency physicians want to be part of the solution and work with the Legislature to avoid unintended consequences. Please stay alert for updates. In the interim, we encourage you to continue your discussions with your local legislators on this important issue.
CONTACT If you have any questions regarding this legislative update or would like to get involved, please do not hesitate to contact us at 717.232.5322. We have an open door policy.
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Do you get a little anxious at the mention of MOC? Look, you have other things to worry about #ACEP4U will help you stay organized and ontrack for your #ABEM #MOC. MOC Center: https://www.acep.org/moc ABEM: https://www.abem.org/public/ ConCert: https://bit.ly/2BUBwlT
“
Here’s to You, Dr. Robinson…”
It’s safe to say that PACEP’s volunteer leaders bring the passion, experience, and energy of the profession to the board and committees. Thank you to the following emergency physicians who tirelessly worked in 2018 to advance the mission and goals of the Pennsylvania College: 2018-2019 Officers and Board of Directors Officers: President: Ankur A. Doshi, MD, FACEP President-Elect: Arvind Venkat, MD, FACEP Vice President: Shawn M. Quinn, DO, FACEP Treasurer: Ronald V. Hall, MD, FACEP Secretary: F. Richard Heath, MD, FACEP Immediate Past President: Maria K. Guyette, MD, MPPM, FACEP
Board Members: Deborah M. Brooks, MD, FACEP Todd Fijewski, MD, FACEP Thompson Kehrl, MD, FACEP Chadd K. Kraus, DO, DrPH, MPH, FACEP Jennifer Marin, MD, MSc, FACEP Ferdinando L. Mirarchi, DO, FACEP Anna Schwartz, MD, FACEP Robert J. Strony, DO, FACEP
Resident Representatives to the Board of Directors: Smeet Bhimani, DO Val Bratinov, MD Priyanka Lauber, DO Dhimitri Nikolla, DO
Committee Chairs: Bylaws F. Richard Heath, MD, FACEP Communications/Membership Scott Korvek, MD, FACEP Stuart Greene, MD, MBA Education Rika O’Malley, MD Elizabeth Werley, MD, FACEP EMS & Terrorism and Disaster Preparedness Scott Goldstein, DO, FACEP Gregory Hellier, DO, FACEP Benjamin Lawner, DO, EMT-P, FACEP Governmental Affairs Michael Boyd, MD Marcus Eubanks, MD, FACEP Medical Economics Glenn Geeting, MD, FACEP Heather Walker, MD, FACEP PEP-PAC Todd Fijewski, MD, FACEP Wellness Katherine Lund, DO Jennifer Savino, DO, FACEP Young Physicians Vishnu Patel, MD PACEP News | WINTER 2019 11
PACEP Members of National ACEP Committees October 2018 to October 2019
ACADEMIC AFFAIRS COMMITTEE Ankur A. Doshi, MD, FACEP Lillian Liang Emlet, MD, FACEP Shawn M. Quinn, DO, FACEP
Member Member Member
CEDR - CLINICAL EMERGENCY DATA REGISTRY COMMITTEE Chadd K. Kraus, DO, DrPH, MPH, FACEP Member Lillian Liang Emlet, MD, FACEP Member CLINICAL POLICIES COMMITTEE Susan B. Promes, MD, MBA, FACEP
Member
CODING & NOMENCLATURE ADVISORY COMMITTEE Daria M. Starosta, DO Member COMPENSATION COMMITTEE John Skiendzielewski, MD, FACEP
Member
DISASTER PREPAREDNESS & RESPONSE COMMITTEE Bryan Wexler, MD, FACEP Member EDUCATION COMMITTEE Frank Guyette, MD, FACEP Cecil James Holliman, MD, FACEP Allan B. Wolfson, MD, FACEP
Member Member Member
EMERGENCY MEDICAL SERVICES (EMS) COMMITTEE Scott Goldstein, DO, FACEP Member Frank Guyette, MD, FACEP Member
MEMBERSHIP COMMITTEE Lillian Liang Emlet, MD, FACEP David C. Lee, MD, FACEP
Member Member
NATIONAL CHAPTER RELATIONS COMMITTEE Ralph James Riviello, MD, FACEP Member PUBLIC HEALTH AND INJURY PREVENTION COMMITTEE Ralph James Riviello, MD, FACEP Member PUBLIC RELATIONS COMMITTEE Sean C. McGann, MD Member Jose R. Torradas, MD, FACEP Member Rade B. Vukmir, MD, JD, FACEP Committee Chair Gary David Zimmer, MD, FACEP Member QUALITY AND PATIENT SAFETY COMMITTEE Joshua J. Davis, MD Member Marilyn Joan Heine, MD, FACEP Member Judd E. Hollander, MD, FACEP Member Scott Jason Korvek, MD, FACEP Member Anthony S. Mazzeo, MD, FACEP Member REIMBURSEMENT COMMITTEE Anthony S. Mazzeo, MD, FACEP Daria M. Starosta, DO
Member Member
RESEARCH COMMITTEE Brendan G. Carr, MD, FACEP Joshua J. Davis, MD Marna Rayl Greenberg, DO, FACEP Kristin L. Rising, MD, FACEP
Member Member Member Member
ETHICS COMMITTEE Chadd K. Kraus, DO, DrPH, MPH, FACEP Gregory Luke Larkin, MD, FACEP Laura Vearrier, MD Arvind Venkat, MD, FACEP
Member Member Member Member
FINANCE COMMITTEE Alexander Max Rosenau, DO, FACEP
Member
STATE LEGISLATIVE/REGULATORY COMMITTEE Erik Blutinger, MD ACEP Committee Member EMRA Michael Boyd, MD Member Marilyn Joan Heine, MD, FACEP Member Chadd K. Kraus, DO, DrPH, MPH, FACEP Committee Chair
Member
WELL-BEING COMMITTEE Megan H. Phillips, MD
MEDICAL-LEGAL COMMITTEE Rade B. Vukmir, MD, JD, FACEP 12 PACEP News | WINTER 2019
Member
Dues Revenue Bud Actual vs. Budget Annual Dues Revenue as of 10/31/2018 $267,006 $257,000 Dues Revenue Budgeted Due Actual$263,540 vs. Budget Annual Dues Revenue $285,643 as of 10/31/2018 $250,195 Pennsylvania College of$249,701 Emergency Physicians $280,000 Dues Revenue Budgeted Dues Revenue Actu Actual vs. Budget $285,643
$280,000 $263,678
MEMBERSHIP as of 10/31/2018DASHBOARD REPORT
2018
2017
2016
$285,643 $257,000
$263,678
$280,000
2015
$280,000
(as of 12/31/2018) $267,006 $250,195
$285,643 $257,000
$263,678
Membership Totals By Month andby Year PACEP Membership Totals Month and Year 2016
2017
Annual Dues Revenue Actual vs. Budget 1807 as of 10/31/2018
1762
2018
1847 1852 Dues Revenue Budgeted
1726
$257,000
$250,195
201
$24
2017
1758
$263,540
2017
Dues Revenue Actual YTD
2018
$285,643 2018
$263,678
2018
1772
1722
1706 $280,000 1697
$267,006 $250,195
$257,000
$263,678
2016
Membership Totals By Mon
1769
2017
2016 2016
2017
2015
2017
2018
1847
Membership Totals By Month and Y $267,006 $263,540
2016
Membership Totals By Month and Year $249,701 1807
$250,195
1847 1852 2018 1772 1762 1807 1722 2016 1657 1682 1702 1715 1738 1747 1749 1763 1673 1675 1682 1659 1706 2018 2017 2016 2015 1697 1847 1852 1762 1772 2017 1667 1669 1692 1697 1731 1759 1783 1802 1695 1711 1717 1690 1807 2018 1697 1706 1722 1762 1772 1807 1847 1852 1726 1758 1769 1726 1722 1697 1706 1772 Membership Totals By Month and 1762 Year 1758 1769 1726 1722 2016 2017 2018 Statistics Annual Dues Revenue PACEP Member 1697 1706 Jan
Feb
Mar
Apr
May
Jn
Jl
Aug
Sept
Oct
2016 Nov
Dec
2017
11/30/2018
Dues Revenue Budgeted Dues 1852 Revenue Actual YTDJan Actual vs. Budget Feb CnResiDues Revenue 1 1847 Annual (Actual vs. Budget)
as of 10/31/2018
$280,000
Fellow Intern ACEP Candidate $285,643 MedStu 1722 1697 1706 Resident
1772
1762
180727
2016 1657
1682
1769 2 Jan Feb 1758 Mar 1669 Apr 2017 11667 ACEP Honorary 1726 179 2016 1657 1682 1702 1706 1715 2018 1697 582 $267,006
Mar
Apr
May
Jn
Jl
1702 May 1692
1715 Jn 1697
1738 Jl 1731
1747 Aug 1759
1749 Sept 1783
Annual Dues Revenue 1738 1762 1747 1772 1749 1807 1763 1847 1673 1722 2017 1667 1669 1692 1697 1731 1759 1783 1802 1695 Jan Feb Mar Apr May Jn Jl Aug Sept Oct Nov $257,000 $263,540 TOTAL 791 Dues Revenue Budgeted Dues Reven Actual vs. Budget 2016 165720 RegPPre 2018 1697 1702 1706 1715 1722 1738 1747 1772 1749 1807 1763 1847 1673 1852 1675 1726 1682 1762 Life 1 as1682 of 10/31/2018 $249,701 Annual Dues$250,195 Revenue PACEP Member Sta Life06 17 2017 166730 RegRet 1669 1692 1697 1731 1759 1783 1802 1695 1711 1717 Life09 20 Regular 585 11/30/2018 Revenue Actual1726 YTD 1758 1769 Actual vs.AprBudget 2018 1697 1706 Dues 1722Revenue 1762 Budgeted 1772 $285,643 1807Dues 1847 1852 Jan Feb Mar May $280,000 Jn Jl Aug Sept Oct Nov Dec
$263,678
Life13
as of 10/31/2018
2016 1657 2017 1682 1702 NewMemb ACEP Regular
80 RegYR1
56
PACEP Member Statistics CnResi
1738 1673 167542 1682 1659 RegYR21763 2015 2016174756 1749 $263,678 1731 1759 5 1783 1802 1695 $257,000 171144 1717 1690 RegYR3 $285,643 RetInact1852 1726 1758 7 1769CnResi 1772 1807 6 1847
1715
$267,006 11/30/2018 Fellow $263,5 PACEP Member Statistics 1 Intern NewYR2 2018 1697$280,000 1706 1722 1762 ACEP Candidate $250,195 11/30/2018 Fellow 27 MedStu 7 Wiegnstn 1 $267,006 MembershipNewYR3 Totals By Month and Year $257,000 $263,678 TOTAL Intern 2 $263,540 Resident PACEP Member Statistics CnResi977 1 2016 2017 2018 ACEP H ACEP Candidate PACEP Member Statistics MedStu 179 TOTAL Fellow 27 GRAND TOTAL11/30/2018 1769 $250,195 $249,701 1852 2018 582 Intern 2017 Resident Life 22016 CnResi 1847 ACEP Candidate 1 ACEP Honorary TOTAL 791 1807 MedStu 179 Life06 Fellow 27 1769 2 Life 20 RegPPre Resident 582 1762 1772 Intern Life09 1758 1 ACEP Honorary ACEP Candidate 2018 2017 2016 Life06 2015 MedStu 179 1726 Membership Totals By Month and 1722 TOTAL 791 30Year RegRet Life13 1697 1706 Resident 582 20 Regular Life ACEP 20 RegPPre Regular2017 NewMemb 2016 Life09 2018 TOTAL 791 Life13 80 RegYR1 NewYR1 Life06 30 RegRet Life 20 RegPPre 1 Year Membership Totals By Month and 1852 NewYR2 Life09 20 Regular 56 RegYR2 1847 ACEP Regular NewMemb Life06 30 RegRet 17 2016 5 RegYR3 Life13 2018 NewYR1 80 RegYR1 Life09 20 2017 Regular 585 1807 NewYR3 Life13 80 RegYR1 56 1772 6 RetInact NewMemb 56 RegYR2 Jan Feb Mar Apr May Jn Jl Aug Sept Oct Nov Dec1762 NewYR2 ACEP Regular 1758 1852 42 1847 56 RegYR2 ACEP1715 Regular 2016 1657 1682 1702 1738 NewMemb 1747 1749 1763 1673 1675 1682 1659 NewYR1 5 RegYR3 1726 NewYR3 7 Wiegnst 1722 GRAND TOTAL 51706 RegYR3 44 1807 2017 1667 1669 1692 1697 1731 NewYR1 1697 1711 1759 1783 1802 1695 1717 1690 NewYR2 6 RetInact
2018
2018 1697
2017 1667
1706
1722
1669 1692 NewYR1
1762
1772
1697
NewYR2 1807
1847
NewYR3 1722 1697 1706
6 RetInact
1852 1762172617721758
TOTAL
PACEP Member Statistics GRAND TOTAL 11/30/2018
8
CnResi Fellow Intern
7
1769
NewYR3 7 Wiegnstn
Jan 1 2016 1657 27 2 2017 1667
1769
1758 7 Wiegnstn GRAND TOTAL 1 1726
977
GRAND1769 TOTAL Feb
Mar
Apr
May
1682
1702
1715
1738
1669
1692 1
1697
1731
Jn
Jl
Aug
TOTAL Sept
1747 1749 1763 1673 PACEP News | WINTER 2019 1759
1783
1802
1695
1
Oct 1675
13
1711
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Notice of Proposed Bylaw Change One of the duties of the PACEP Secretary is to review our organization’s bylaws as appropriate, and to suggest changes when needed. With that in mind, I reviewed Article VI F. Richard Heath, MD Board of Directors, Section PACEP Secretary 4A - Nomination and Election, of the bylaws. The paragraph is unclear on several points, including: • Is it the Nominating Committee, the Board or Directors, or both that must represent (as far as practical) all geographic sections of the Chapter? • What happens if a designated member of the Nominating Committee is unable/unwilling to serve? • How is “written” to be interpreted? • Which nominees require petitioner signatures? In the interest of clarifying the process, and with specific attention to these points, I proposed to the Board of Directors a revision. The PACEP Board of Directors has reviewed the proposed language and has recommended that it be approved by a vote of the membership. We will hold this vote at the Annual Business Meeting on April 12, 2019, held in conjunction with the Scientific Assembly. Passing the amendment will require an affirmative vote of two-thirds of the members present at that meeting. Should you have questions or concerns about this, please contact me at secretary@pacep.net. CURRENT BY-LAW (2017) ARTICLE VI - Board of Directors Section 4A - Nomination and Election. A Nominating Committee for candidates to the Board of Directors (representing as far as practical, all geographical sections of the Chapter) shall be appointed by the Board of Directors and chaired by the Immediate Past President and shall include but not limited to the President-Elect, current President, and past Presidents and other members at the discretion of the Immediate Past President, and shall present a list of nominees to the Board of Directors at least ninety (90) days prior to the date of the annual meeting. Nominees for the Board of Directors must be regular members in good standing.
Nominations may be made by any other voting member of the Chapter by submitting the proposed candidate’s name in writing to the Secretary no later than ninety (90) days prior to the annual meeting. The nomination must be accompanied by a copy of the proposed candidate’s curriculum vitae, written acceptance of the nomination, and the signatures of fifteen (15) voting member petitioners. Directors shall be elected by a plurality of the members voting. Write-in votes are not allowed. Nominations from the floor at the time of the elections are not allowed. *** PROPOSED BYLAW CHANGE ARTICLE VI - Board of Directors Section 4A – Nomination and Election. A Nominating Committee for candidates to the Board of Directors shall be appointed by the Board of Directors. The committee will be chaired by the Immediate Past President and shall include the President-Elect and current President. Past Presidents and other members may be included at the discretion of the Immediate Past President. If any designated member of the Nominating Committee is unable to serve, the Board of Directors shall appoint a substitute. The committee shall present a list of nominees to the Board of Directors at least ninety (90) days prior to the date of the annual meeting. The nominees shall represent, as far as practical, the diversity of the Chapter. Nominees for the Board of Directors must be active members in good standing. Any active member of the Chapter may submit the names of potential nominees to the Nominating Committee. Nominations may also be made by any other member of the Chapter by submitting the candidate’s name in writing to the Secretary no later than ninety (90) days prior to the annual meeting. Such nominations must be accompanied by a copy of the candidate’s CV, written acceptance of the nomination, and the written signatures of fifteen (15) member petitioners. Candidates must be active members in good standing. All listed requirements for nomination may be transmitted in hard copy or electronic format. Directors shall be elected by a plurality of the members voting. Write-in votes are not allowed. Nominations from the floor at the time of the elections are not allowed.
PACEP News | WINTER 2019
15
MEMBERS in the news Dr. Kraus wore his white coat while attending a press event at the State Capitol Rotunda on Wednesday, January 30, 2019 to show opposition to the proposed rule change to Pennsylvania Rule of Civil Procedure 1006. The Civil Procedural Rules Committee proposed a change that would revise the venue rule: the county in which medical malpractice case may be filed. PACEP joined the Pennsylvania Medical Society’s movement through stakeholder involvement to flood the Committee with comments by the February 22, 2019 deadline date. The Pennsylvania Medical Society set up a portal where you can send your comments to the Committee: https://www.pamedsoc.org/venue-rule-change/comment.
Representative Mike Turzai, Speaker of the House, along with other legislators, physicians, and patients at the State Capitol Rotunda on Wednesday January 30, 2019. Dr. Kraus is standing behind Rep. Turzai to the left.
Doctors Doshi and Venkat met with Mike Turzai, Speaker of the Pennsylvania House of Representatives on Monday February 2, 2019 to discuss legislative healthcare agenda for the upcoming session. They discussed PACEP’s legislative priorities and offered assistance on those issues.
mark your CALENDARS PACEP Board of Directors Meeting PACEP19 Scientific Assembly PACEP Board of Directors Meeting PACEP Committee Meetings PACEP Ultrasound Workshop PACEP YP Reception PACEP Annual Membership Meeting ACEP LAC
Friday, March 8, 2019 Harrisburg Wednesday, April 10 – Friday, April 12, 2019 Crowne Plaza, Valley Forge Wednesday, April 10, 2019 Crowne Plaza, Valley Forge Wednesday, April 10, 2019 Crowne Plaza, Valley Forge Wednesday, April 10, 2019 Crowne Plaza, Valley Forge Thursday, April 11, 2019 TBD, Valley Forge Friday, April 12, 2019 Crowne Plaza, Valley Forge Sunday, May 5 – Wednesday, May 8, 2019 Washington, DC PACEP Board of Director Meetings are open to anyone in membership to attend.
16 PACEP News | WINTER 2019
2019 Warm Hand-off Summits Please check www.pacep.net/events.html for locations.
REGION
COUNTIES
DATE
TIME
Southeast
Hearing in Bucks County: Berks, Chester, Delaware, Montgomery, Schuylkill
March 20, 2019
9:00 AM – 12:00 PM
Philadelphia
Hearing in Philadelphia: Community Behavioral Health Building
March 21, 2019
9:00 AM – 12:00 PM
Southwest
Hearing in Cambria County: Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Somerset, Washington, Westmoreland
March 27, 2019
9:00 AM – 12:00 PM
Allegheny
Hearing in Pittsburgh: Allegheny
March 28, 2019
9:00 AM – 12:00 PM
Southcentral
Hearing in York County: Adams, Bedford, Blair, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, York
April 4, 2019
1:30 PM – 4:30 PM
Northeast
Hearing in Luzerne County: Carbon, Lackawanna, Lehigh, Luzerne, Monroe, Northampton, Pike, Susquehanna, Wayne, Wyoming
April 11, 2019
1:30 PM – 4:30 PM
Northcentral
Hearing in Lycoming County: Bradford, Centre, Clinton, Columbia, Lycoming, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga, Union
April 16, 2019
9:00 AM – 12:00 PM
Northwest
Hearing in Erie County: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, Lawrence, McKean, Mercer, Venango, Warren
April 17, 2019
9:00 AM – 12:00 PM
WELCOME NEW PACEP MEMBERS Emir Ashour, MD Steve Balian, MD Brittney Bunkis, MD Andrew Catherine, MD Anthony Cocciolone, DO Laura Congelio, MD Matthew Fisher, MD Kasondra Hartman, MD Rishi Kalwani, MD Lee McChesney, DO Kelly O’Brien, MD Allison Taylor, DO Charles White, MD David Whitehead, MD
Shane Zeshonski, MD Amir Abdulhay Anis Adnani Jordan Allen Kevin Amuquandoh Kevin Argentieri Ariana Barkley Katelynn Baska Michael Bernett, MBA Jon Bornstein Patrick Boyle Shane Brown Davis Cho
Suhrudh Daaram Elizabeth Davis Daniel Doynow Daniel Forrest Ethan Graham Hilary Gray Majd Helou Brian Hilands Carissa Jeannette Rachael Kern Ivy Le Sean Leary Hannah luu Rebecca Markson
Joseph Piraneo Prachi Priyam Collin Reynolds Connor Rohrback Benjamen Schoenberg Scott Schoenborn Michael Talotta Margaret Vido Emily Walsh Matthew Weirich Sierra Williams Thijs Wolf
PACEP News | WINTER 2019
17
2nd Annual Ultrasound-Guided Procedural Course
APRIL 10, 2019 8:00 AM-3:00 PM
CROWNE PLAZA, KING OF PRUSSIA Limited Spots Available. Visit our website to Register for the event! www.pacep.net,
Ultrasound Compatible Task Trainers Small Group Sessions Hands-On Live Model Scanning State-Of-The-Art Ultrasound Machines Expert instructors from across the state US guided Procedures including: Central and Peripheral Vascular access Paracentesis, Thoracentesis, Lumbar Puncture, Pericardiocentesis Musculoskeletal procedures including arthrocentesis and nerve blocks. HELD IN CONJUNCTION WITH:
PACEP19 SCIENTIFIC ASSEMBLY
18 PACEP News | WINTER 2019
Perfect for Physicians and Advanced Practice Providers in Emergency Medicine, Critical Care, Hospitalist Medicine and Surgery
Program Overview Join us as our expert faculty discusses:
The fundamentals of MAT (Medical Assisted Treatment) for patients with Opioid Use Disorder Buprenorphine prescribing rules, the “72 hour rule”, and DEA license “X-waiver” Indications, algorithms, and potential complications of buprenorphine in the ED The differences between buprenorphine and methadone How the “three day rule” enables physicians to stabilize patients and ensure a warm hand off to an opioid addiction clinic Rationale and evidence for community Naloxone distribution, including a discussion of common misconceptions about this medication The opportunities to make a long term, life saving impact on patients with Opioid Use Disorder
Funding for this initiative was made possible (in part) by grant no. 1H79TI080816 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Emergency Physicians and the Illinois Chapter of Emergency Physicians. The American College of Emergency Physicians is accredited by the ACCME to provide continuing medical education for physicians. The American College of Emergency Physicians designates this live activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
EARN 1.0 CME Credits
April 10, 2019 4:30-5:30 Crowne Plaza 260 Mall Boulevard King of Prussia, PA 19406
Presenter: Dr. Kate Hawk MD, MHS Assistant Professor
Department of Emergency Medicine, Drug use, Addiction, HIV Research Scholar
Yale University
PRSRT STANDARD U.S. POSTAGE PAID
PACEP NEWS
HARRISBURG PA PERMIT NO. 922
777 East Park Drive | PO Box 8820 Harrisburg, PA 17105-8820
We fight the good fight. At USACS we have one mission: to care for patients. Every full-time physician in our group becomes an owner in our group, creating a legendary culture and camaraderie you can feel. That’s true whether you’re working in the ED, or getting clobbered by a snowball on a ski trip with your fellow comrades. Discover why USACS is the fastest growing physician-owned group in the country. Check out career opportunities at USACS.com.
Own your future now. Visit USACS.com or call Darrin Grella at 800-828-0898. dgrella@usacs.com