A Newsletter for the Members of the North Dakota College of Emergency Physicians

Spring 2019

Kevin S. Mickelson, MD, FACEP

President

Adriana Alvarez

Executive Director

Phone: 800.798.1822 | Website

Table of Contents

President's Letter

Medical Student Scholarships

Adriana's Corner

NEWS FROM ACEP -

States Find Tool for Quick Legislative Response

New Policy Statements, PREP and Information Paper

Two New Clinical Policy Courses from ACEP eCME

Free Annals of EM ACEP eCME Course

Point of Care Tools

Articles of Interest in Annals of Emergency Medicine - Spring 2019

Registration open for the ACEP/CORD Resident's Teaching Fellowship

EMBRS - Emergency Medicine Basic Reserach Skills

President's Letter

Kevin S. Mickelson, MD, FACEP

This year North Dakota legislature passed a law allowing PA’s to practice independently in North Dakota, the only state in the union to support this. Given the recent consolidation by large hospital groups, the urgency to control costs is centering on providing cheaper providers with less training. There are few well controlled studies comparing outcomes of Board Certified, Residency Trained Emergency Physicians and PA’s with different patient acuities. ACEP’s current policy recommends AP’s evaluate ESI level III patients and below. From my experience, this recommendation is not being followed. This is a recommendation only, and no tracking\registry is currently in place to measure and record patient outcomes prospectively. There have been little efforts by organized medicine to educate the public on the difference in training of Board Certified, Residency trained Emergency Physicians vs Advanced Providers.

ACEP, AAEM and EMRA, all have varying policies\views on the practice and supervision of AP’s in the ED. As medicine becomes more “check the box, get the CT scan,” more information is being substituted for clinical judgement and training.

The North Dakota Medical Association and the North Dakota Board of Medical Examiners supported the North Dakota legislation. The North Dakota Chapter did not.

It would behoove younger North Dakota Emergency Medicine physicians to become more involved in the political process and national organizations (ACEP, AAEM). Check the box medicine is right around the corner, and it doesn’t require 4-years of medical school and 3-4 years of emergency room training. Less and less time is being allowed for a good history and physical exam.

Medical Student Scholarships

Every year the North Dakota Chapter Board voted to support one medical student who has worked diligiently throughout the years by awarding him/her a scholarship. This year there were many students to choose from. For this reason, the North Dakota Chapter Board voted to award scholarships to three-(3) medical students. They are the following:

Sean Johnson

Jacy O'Keefe

Zachary Elliott

Keep reading below so that you can hear how they felt about being medical students and emergency medicine.

My experiences as a medical student at the University of North Dakota were wonderful. I found all four years of medical school very rewarding as I was able to learn a lot from working with several physicians and faculty members throughout the state of North Dakota. I especially will always cherish the experiences I was able to have working with multiple emergency medicine physicians during a fourth year emergency medicine rotation in North Dakota, as it helped reinforce my desire to pursue residency in emergency medicine, which I will begin in the near future. I will forever remain thankful for those that have helped me along the way and plan to definitely remain in touch with all of the great emergency medicine physicians in North Dakota who I was fortunate to meet during medical school. - Zachary Elliott

Medical school was one of the most difficult yet rewarding experiences of my life. I am so grateful for the professors and mentors I met during my four years at the University of North Dakota School of Medicine. Not only was I able to work in rural communities, but I was also able to work in larger urban areas, which really gave me a multiple perspectives on the medical field. I can’t wait to continue my education in the field of emergency medicine in St Paul, Minnesota. - Jacy O'Keefe

As a student at the University of North Dakota, I learned an immense amount during my 4 years of education. In the first two years, I enjoyed learning the foundational elements of human systems and pathology. In years 3 and 4 I enjoyed being able to apply the clinical knowledge I learned in years 1 and 2 and applying it to direct patient care. The variety of patients I had the opportunity to be part of their care, helped confirm my desire to work as an emergency medicine physician. Along these years, balancing my life of a family of a wife and 3 boys was challenging but allowed me to be balanced in my studies and personal life. I am excited for my opportunity to complete my residency at Beaumont Health in Royal Oak, Michigan! - Sean Johnson

Join us in congratulating Zachary, Jacy and Sean for being awarded a scholarship and for their hard work!

From Left to Right: Joshua Wynne, UND Interim President, Vice President of Health Affairs and Dean School of Medicine and Health Sciences; Zachary Elliott, Sean Johnson; Jacy O'Keefe; Joycelyn Dorscher, Associate Dean for Student Affairs and Admissions.

Adriana's Corner

Have you ever traveled to another country to provide emergency care? If you have, please share your experience. We'd love to hear about it!

FROM NATIONAL ACEP

States Find Tool for Quick Legislative Response

Harry J. Monroe, Jr. Director, ACEP State and Chapter Relations

Those of us that work on state legislation often struggle with the pace of activity, particularly as deadlines approach for bills to get out of committee or as the end of the session nears. When ACEP rolled out engagED as a new social media platform for member communication and collaboration, I am not sure that it was really thought of as a new tool for advocacy efforts, but its value has been shown by at least a couple of chapters. READ MORE

New Policy Statements, PREP and Information Paper

During their April 2019 meeting, the ACEP Board of Directors approved the following new or revised policy statements/PREP/information paper:

New Policy Statements:

Salary and Benefits Considerations for Emergency Medical Services Professionals

Small Motorized Recreational Vehicles

Violence Prevention and Intervention in Emergency Medical Services Systems

Revised Policy Statements:

Crowding

Domestic Family Violence

Patient Support Services

Violence-Free Society

Revised Policy Resource and Education Papers (PREPs):

Resource Utilization in the Emergency Department: The Duty of Stewardship

New Information Paper:

Influenza Emergency Department Best Practices

Articles of Interest in Annals of Emergency Medicine - Spring 2019

Sam Shahid, MBBS, MPHPractice Management Manager, ACEP

ACEP would like to provide you with very brief synopses of the latest articles and articles coming soon to Annals of Emergency Medicine. Some of these have not appeared in print. These synopses are not meant to be thorough analyses of the articles, simply brief introductions. Before incorporating into your practice, you should read the entire articles and interpret them for your specific patient population. View synopses here.

Point of Care Tools

ACEP's point-of-care tools are transforming care at the bedside. We've recruited the field's top experts and thought-leaders to develop tools our members can trust and deploy in the clinical setting. The evidence-based, clinical content provided in these tools ensures that you are providing the best possible care to the patients in your emergency department. Tools can be found on topics:

AFIB – Management of Atrial Fibrillation
ADEPT – Confusion and Agitation in the Elderly
BUPE – Use of Buprenorphine in the ED
DART – Recognition and Treatment of Sepsis
ICAR2E – Identification of Suicidal patients
And more..

Check out all of ACEP's point of care tools!

Free eCME Courses

Two New Clinical Policy Courses from ACEP eCME

These two new courses give you the tools to better evaluate, diagnose, and treat patients presenting in the ED with Suspected Acute Venous Thromboembolic Disease or Suspected Non-ST-Elevation Acute Coronary Syndrome. Earn CME and stay up-to-date on the latest policy and techniques to provide the very best care for your patients. Free to ACEP Members, including Resident and International Members. $15 for Nonmembers. Click the links below to learn more.

Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Suspected Acute Venous Thromboembolic Disease

Clinical Policy: Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes

Approved for AMA PRA Category 1 Credit^TM.

FREE Annals of EM ACEP eCME Course

ACEPs FREE eCME course Managing Opioid Withdrawal in the Emergency Department with Buprenorphine will help you to identify opioid withdrawal symptoms and determine if medication-assisted therapy (MAT) for opioid use disorder (OUD) should be considered. This Annals of Emergency Medicine course is designed for emergency physicians who want to increase their knowledge in the latest emergency medicine advances and their applications as well as fill in gaps in knowledge where additional education and training may be necessary. Go to the course.

Registration open for the ACEP/CORD Resident’s Teaching Fellowship

Do you have a resident aspiring to an academic career? Want to give them the jump start they need? Spots still open for the ACEP/CORD Residents Teaching Fellowship this fall (Aug. 6-8 2019) – sign up soon as these seats go fast! Register here.

Registration Open for the EMBRS Course

Emergency Medicine Basic Research Skills (EMBRS) is a 9-day, 2-session program where participants learn how to identify clinical research opportunities and become familiar with clinical research and outcomes. Participants are also eligible to receive an EMF/EMBRS grant based on their research grant application. Click here to learn more or email ACEP's Academic Affairs to register. The next course will take place Dec. 2-7th, 2019 (session 1) and April 14-16, 2020 (session 2) in Dallas, Texas.

North Dakota Chapter

c/o National ACEP

4950 West Royal Lane

Irving, Texas 75063-2524

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