A Newsletter for the Members of the Hawaii Chapter - Winter 2021

Will Scruggs, MD, RDMS, MBA, FACEP

President

 

Tiffany Ligthfoot, RN, MS

Executive Director

Website | hi.chapter@acep.org

 

In this edition: 

Hawaii ACEP President’s Message

How can you assist the state in vaccine administration?

Physician Wellness: Into the Woods

UH JABSOM Emergency Medicine Interest Group (EMIG)

Physician Finance 101: When Can I Retire?

Hawaii ACEP Board Meetings

2020 Hawaii ACEP Emergency Department Leadership Summit  

Welcome New Hawaii ACEP Members

News from ACEP:

ACEP Quick List: Upcoming Events and Deadlines

COVID-19 Resources

Physician Wellness Tools

Regulatory News: Answering Your Questions About the New Medicare Add-on for MAT in the ED

ACEP Member Resources

Save the Dates: Virtual PEM21 and LAC21

Save the Date: ‘Virtually Unstoppable’ CORD Academic Assembly

EMF and AFFIRM have announced a new $40,000 grant in honor of Dr. Tamara O'Neal

ABEM Issues Statement on its Commitment to Maintaining Certification Standards

 

Hawaii ACEP President’s Message

Will Scruggs, MD, RDMS, MBA, FACEP

 

I’m going to start 2021 by asking that you consider becoming involved in another medical association. Your involvement in Hawaii ACEP is incredibly important and, among other things, has allowed us to successfully fend off one-sided balance billing legislation and shape opioid addiction legislation over the last several years.

We’ve been able to support ongoing efforts to bring an ED residency to the state and are helping to develop strategies to tackle methamphetamine abuse in the state. We’ve succeeded because of your excellent care, the hard work of the Board of Hawaii ACEP, and because of the partnerships we’ve developed across the state.

 

The Hawaii Medical Association (HMA) is the leading physician voice in the state. Legislators and other policy makers in Hawaii look to the organization to answer questions only physicians can answer. They’ve been an important partner in our advocacy efforts over the last decade and there is a real opportunity for emergency physicians to take a greater role in the organization. To be blunt, the specialties at the table direct the conversation. There is a need for emergency physicians and primary physicians to direct the organization’s resources to improvement of the larger health care system. I don’t mean this as a criticism of the physicians dedicating their time currently. We advocate for what we know. We need more physicians who know how to find appropriate care for the appropriate patient and the appropriate time. We need ED docs at the table. 

 

I’m optimistic about what we can accomplish to improve care in Hawaii over the next several years. Across the state, you’ve all seen the importance of emergency physicians taking high level positions in hospitals and health systems. Moving forward, we need to expand our presence in health policy and legislation. We can do that by becoming part of organizations that have greater influence than our own. The HMA is the perfect example of where we can have a tremendous impact. Please consider joining: https://hawaiimedicalassociation.org. 

  

Will Scruggs, MD, RDMS, MBA, FACEP

Chief of Staff, Adventist Health Castle

 

How can you assist the state in vaccine administration?  

The best way is to sign up for Hawaii Medical Reserve Corps: 

https://health.hawaii.gov/prepare/mrc/

 

Physician Wellness: Into the Woods

by Grace O’Neil, MD, FACEP

 

With the onslaught of COVID still raging ahead for an unknown period of time, we need to take care of ourselves so we can take care of others. One of the ways that we can do this is to go into the woods, or more specifically "forest bathing". In Japan, a forest bathing trip, called “Shinrinyoku” in Japanese, is a short, leisurely visit to a forest.

 

Spending time in a forest reduces stress, anxiety, and depression. It strengthens the immune system and improves cardiovascular health, boosting overall well-being. A study was done by the Forest Agency of Japan from 2004-2006 to research the therapeutic effects of "forest bathing" on human health. Forest bathing trips reduced the concentration of cortisol in the saliva and the concentration of urine adrenaline and noradrenaline. Forest bathing trips also reduced prefrontal cerebral activity and blood pressure, stabilizing the autonomic nervous system. After a forest bathing trip, participants had increased natural killer activity and increased expression of anti-cancer proteins (which lasted more than 30 days after the trip). Forest walkers had decreases in the stress hormone cortisol, sympathetic nerve activity, blood pressure, and heart rate. Urban walkers did not obtain the same benefits.  

 

Forest bathing is not about bringing your heart rate up or getting the best exercise. Forest bathing is retreating to nature to immerse in the forest atmosphere. Make it a point to spend more time in nature this month!

 

Aloha, Grace Chen O’Neil, MD, FACEP

Secretary-Treasurer, Hawaii Chapter ACEP

 

UH JABSOM Emergency Medicine Interest Group (EMIG)

by Gregory Suares, MD, FACEP

 

With medical students having resumed clinical activities after COVID-19 disrupted clinical education, two students still made time to join the January 27, 2021 Hawaii ACEP Board Meeting. It’s encouraging to see medical student participation in leadership activities early in their academic career.

We still have three students interested in Emergency Medicine with an additional student planning on an Emergency Medicine/Internal Medicine track. 

 

The future still offers many unknowns but we all hope that our educational community is well prepared for the challenges to come. And in the true spirit of Aloha, we will face those challenges together!

 

Please feel free to visit the EMIG Website. 

 

Mahalo, Gregory Suares, MD, FACEP

Director, Hawaii Chapter ACEP

 

Physician Finance 101: When Can I Retire?

by Nathan Chin, MD, FACEP

 

Despite all the education we go through, doctors are notorious for being bad with personal finances. I hope this column promotes discussion about personal finance among us and provides some learning to those new to the topic. I’m looking for next quarter’s topic... reach out if you have any good ideas or questions!     

 

This Quarter’s Topic: How much money do I need to retire?

 

A quick calculation to determine how much you need to retire is the “25x rule”. To use the rule, you need to calculate your yearly expenses in retirement. While it may be difficult to calculate many of the unknowns/variables of retirement, it is a good exercise to go through. Once you find your yearly expenses in retirement multiply by 25. The product of those two numbers will be the total retirement investments needed. 

 

For example: If you plan on spending 80k/year in retirement, you should have $2.0 million in your retirement investments per the “25x rule”. Based on historical stock returns and inflation data, research has determined that if you have 25x your yearly retirement expenses, you are guaranteed to not run out of money in a 30-year retirement.

 

Yearly Expenses in Retirement  *  25  =  Total Retirement Investments Needed

 

Things to Consider:

  • Total retirement investments need to be invested (50% stocks & 50% bonds)

  • Yearly withdrawal amounts adjust for inflation

  • Rule is based on historical data and cannot predict future returns

  • Healthcare costs may rise significantly and increase retirement expenses

This article is not meant to be personalized financial advice, but rather a starting point to promote discussion about finances.  

 

Hawaii ACEP Board Meetings

The Hawaii ACEP Board meetings are held every other month. Hawaii ACEP members are welcome to attend the Board meetings – please contact us in advance if you are interested. For more information on the meetings, contact Tiffany Lightfoot at hi.chapter@acep.org. The next Board meeting will be Wednesday, March 24, 2021 from 11:00 AM - 1:00 PM virtually via google meet.

 

Visit our Hawaii ACEP website where you can view past issues of our Hawaii ACEP e-newsletter.

 

2021 Hawaii ACEP Emergency Department Leadership Summit    

The 7th annual Hawaii ACEP Emergency Department Leadership Summit has been POSTPONED until 2021. This is a forum to discuss critical issues impacting Emergency Physicians, ED Nurse Leadership, Trauma Coordinators, and Emergency Departments state-wide. Our goal is to make this summit interactive, allowing participants to discuss challenges and potential solutions for all counties. We are hopeful that there will be an opportunity to meet with some of our legislators, either during or after the conference. We are all leaders, and you are all invited. Contact Tiffany Lightfoot at hi.chapter@acep.org for more information. 

 

Welcome New Members

Kagen Ikaika Aeby

Samuel Jameson Bell

Benjamin T Brown, MD

Chi Nga Chan, MD

Oliver Dutczak, MD

Elizabeth England

Kevin Patrick Guyton, MD

Thomas Larson, DO

Patrick Leaf, MD

Weston McCue

Luke Metzker, DO

Nicholas Enoka Siulepa Simon

Maiya Smith

Spencer D Smith

Heidi Solberg Shankle, MD

Grace Sousa, MD

 

FROM NATIONAL ACEP

 

ACEP Quick List: Upcoming Events and Deadlines

Feb. 24: (new date) Free webinar: The EMTALA Complaint Process (2 p.m. CT)

Feb. 24: Virtual Grand Rounds – "Simulation: OB Emergencies with EMRA"

March 1: Nominations due for ACEP Leadership Awards and Wellness Center of Excellence Award

March 14: Applications due for EM Innovators of the Year competition

March 22: Nominations due for ACEP Board of Directors, Council Office

April 15: Nominations due for ACEP Teaching Awards and ACEP/EMRA Medical Student Professionalism and Service Award

April 19-21: Virtual Advanced Pediatric Emergency Medical Assembly

July 25-27:  Leadership & Advocacy Conference (Washington, DC)

 

Stay current with the COVID-19 Center. It's your one-stop-shop for clinical and legislative updates.  

 

New Resource: COVID-19 Data Visualizations

ACEP's newest resource provides visualizations of U.S. emergency department data across three categories: total visits, COVID-like illness visits, and influenza-like illness visits. The data are available at both national and Health and Human Services (HHS) regional resolutions and across several timescales (e.g., 7-day, 30-day, 90-day). It's sortable by time and region. Data is updated weekly. View the visualizations. 

 

The February 10 edition of the Capital (30) Minutes webinar provided updates on COVID relief, physician mental health and more.

 

Quick Links: COVID-19 Field Guide | COVID-19 Vaccination Toolkit | COVID-19 Microlearning Education

The COVID-19 Crisis is Uniquely Exhausting - ACEP Can Help

It’s vital to prioritize your own mental health and this is an especially vulnerable time of year in an extremely stressful environment. Take advantage of these resources whenever you need them: 

 

  • Did you know your ACEP membership comes with three free counseling or coaching sessions available through phone, text or online chat? And for a small extra fee, you can add on financial and/or legal assistance.

  • The Physician Wellness Hub can help you find the right support, whether you’d like to talk with a peer or a professional counselor. 

It’s a great time to gently check in with your friends, family and colleagues. Worried about saying the wrong thing? Read these peer support basics. 

 

Want to remind your team about on-site support options? Create a mental health care access map. Already have one? Resend the map so your coworkers know how to find support during the challenging weeks ahead. 

 

ACEP hosted two Theater of War performances in 2020 and recently partnered with the Infectious Disease Society of America on a podcast discussing how these performances can help EM physicians process the unprecedented hardships of working in the ED during a pandemic. Learn more.

 

Last but not least: If you’re passionate about peer support in emergency medicine, we invite you to join ACEP’s Peer Support Project.

Regulatory News

Answering Your Questions About the New Medicare Add-on for MAT in the ED

EM physicians can start getting reimbursed by Medicare for MAT services you deliver in the emergency department (ED)! This is a policy that ACEP strongly advocated for and helped secure in the 2021 Medicare physician fee schedule regulation (the major annual reg that impacts Medicare payments for physicians and other health care practitioners). In that reg, the Centers for Medicare & Medicaid Services (CMS) finalized a proposal to create a new add-on code for MAT (G2213) that can be billed in addition to an ED evaluation and management (E/M) code during an ED visit. READ MORE

 

Catch up on the latest federal regulatory news with ACEP's Regs and Eggs blog: 

  • Federal Financial Support for COVID-Related Losses are Still Available—Find Out More About Your Options! - February 18

  • Breaking Down President Biden’s Executive Order on Strengthening Medicaid and the Affordable Care Act - February 4

  • X-ing the X-Waiver: The Fight Continues! - January 28, 2021
  • At the Buzzer! CMS’ Last Minute Regulatory Actions - January 21, 2021
  • Major Crisis Averted (for Now): Rather than Medicare Payment Reductions, a Raise May be Coming Your Way In 2021 - January 7, 2021
 

ACEP Member Resources

Litigation Resources: The majority of physicians will be sued during their career, and the experience – or even just the prospect of being sued – can be very stressful. On top of that reality, COVID-19 presents new concerns that could make it even more complicated. These resources are here to help.

Prepare for your continuous EM board certification with Critical Decision's 2020 LLSA Literature Review issue (free member benefit). Get the highlights from each ABEM article to make your studying faster and more productive. 

Podcast fans: ACEP's podcast family includes Frontline, ACEP Now, Annals of EM, Critical Decisions and JACEP Open + EMergence, a new EM innovation podcast.

Latest Pain Management and Opioid-Related Resources:

  • Latest Frontline podcasts: ACEP Pain and Addiction Care in the ED (PACED) Program with Dr. Alexis La Pietra and Cathlyn Robinson & California Bridge Program with Dr. Alicia (Kurtz) Gonzalez

  • ACEP's Managing Acute Pain (MAP) point-of-care tool was recently updated. It's available on the ACEP website and within the emPOC app (Mac App Store or Google Play).

PEER Can Help You Cram for the ConCert Exam

Getting ready for the spring ConCert Exams? ACEP has tools that can help! PEER is the leading resource for review and self-assessment. You can check your readiness with a free PEER pretest. Learn more.

 

Save the Dates: Virtual PEM21 and LAC21

ACEP's Annual Leadership & Advocacy Conference is now scheduled for July 25-27 in Washington, D.C. This is your chance to advocate for your specialty, engage with new members of Congress and connect with your peers. Join the Interest List for updates.

 

While you're marking your calendars, make plans to join us for this year's Virtual Advanced Pediatric Emergency Medical Assembly April 19-21, 2021. Learn what's new and gain the skills you need to take on your next pediatric emergency.

 

CORD 2021 Academic Assembly

CORD is excited to launch its ‘Virtually Unstoppable’ Academic Assembly on April 12-15, 2021. Registration information coming soon! Visit www.cordem.org for updates.

 

From the Emergency Medicine Foundation:

  • Show your love for EM research this Valentine's Day! For every EM practitioner who watches this video, Vapotherm will donate $10 ($20 per EM resident) to the Emergency Medicine Foundation.

  • EMF and AFFIRM have announced a new $40,000 grant in honor of Dr. Tamara O'Neal. Apply by March 31.

 

News From ABEM

ABEM Issues Statement on its Commitment to Maintaining Certification Standards

Feb 08, 2021

The American Board of Emergency Medicine (ABEM) understands that this past year was particularly challenging for emergency physicians, especially early career physicians. Every physician member of the ABEM Board of Directors is clinically active and understands the disruptions caused by the COVID-19 pandemic. The disruptions affecting our specialty have also affected ABEM certification. Read the full statement here. 

 

Hawaii Chapter ACEP

34 Puukani Pl.

Kailua, 96734

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