A Newsletter for the Members of the District of Columbia Chapter - Winter 2021
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President's Message
Dear Colleagues,
I hope this New Year finds you and your families well. The last year was one of the most difficult years many of us have experienced and in the face of these challenges we have persevered and found ways to make meaningful contributions to our communities and the practice of emergency medicine at the local and national levels.
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I would like to thank you for your continued commitment to the American College of Emergency Physicians, would like to share with you some of the activities that have taken place in our local chapter and national organization over the last year as well as our plans for the year ahead.
In the last year, national ACEP has delivered in a big way:
- Online COVID discussion forum.
- COVID Field Guide.
- Free hotel rooms for frontline workers.
- Free Grub Hub meals for frontline workers.
- Advocacy efforts to protect our pay.
- Advocacy for ABEM Maintenance of Certification Changes.
- Protection of our scope of practice relative to that of APPs.
Your local DC ACEP Chapter has been active too!
- Yearly LLSA Review Conference which makes MOC a breeze.
- Weekly COVID Townhall Series in Spring 2020 that kept us up to date on rapidly changing circumstances.
- Collaborated with Medical Society of DC to advocate for DC patients and physicians, with goals to: expand telemedicine site of care to permit telemedicine appointments outside of medical facilities. Permit existing relationships between patients and providers to continue across District state lines.Support equitable reimbursement for telemedicine with in-person medical care. Waive civil and medical liability for treatment decisions made in good faith during the public health emergency.
- Highlighted our local extraordinary EM training programs through regional Program Directors Panel with representatives from GW, Georgetown, Hopkins, and the University of Maryland. Over 130 medical students were engaged during this highly unusual recruitment season.
- Submission and successful adoption of council resolutions speaking to the intersections of social and racial justice and health care to help amplify voices of EPs advocating for health equity for our patients and communities.
In this upcoming year, DC ACEP will continue to prioritize activities that continue to address the concerns of our members, advance the practice of emergency medicine, and provide educational programming that is relevant to our specialty. Just to name a few:
DC ACEP Chapter Annual Meeting
In April 2021, our chapter annual meeting will be held virtually and elections for our Chapter Board will take place during this session. There will be several open positions, including Secretary/Treasurer, President-Elect, Director, Resident & Alternate Resident Director (Georgetown), and Resident & Alternate Resident Director (George Washington). If you are interested in running for an open position on the DC ACEP Chapter Board, send an email to Adriana Alvarez, our Chapter Executive. Adriana will be able to share with you more information about the role and responsibility of the position you are interested in.
DC ACEP Townhall Series
We are planning for a townhall series on the Intersection of Race, Police and Medicine for Spring 2021. If there are additional topics you would like for us to explore, please send an email to Adriana Alvarez, our Chapter Executive. More details to follow.
DC ACEP Annual LLSA Review Conference
On Monday, May 17th, we will be hosting our Virtual 2021 LLSA Review Conference from 7:30AM EST - 12Noon EST. The annual LLSA Review Conference is a FREE benefit to members of the DC, Virginia, and Maryland Chapters and $100 for non-members. If you have any questions about the conference and/or would like to participate as a presenter, please reach out to Adriana Alvarez, our Chapter Executive.
Again, thank you for all you do for our patients and our emergency medicine community. Please be well and stay safe.
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EM MAT Waiver Training Course
Leah Steckler, MD
President-Elect
As part of DC ACEP’s commitment to providing high quality Continuing Medical Education (CME), the chapter recently hosted the X-waiver Training Course for local members. The X-waiver, a designation added to a practitioner’s DEA license, is needed to write outpatient prescriptions for buprenorphine. The course, which took place on Monday, February 1, 2021, will certify nearly 20 local physicians and advanced practice providers (APP).
The X-waiver requirement was enacted as part of the Drug Addiction Treatment Act of 2000. Interestingly, one of the goals of this legislation was to decrease reliance on methadone, which can only be administered in federally approved clinics (1). Recently, the Trump administration had planned to decrease barriers to prescribing buprenorphine by eliminating the need for the X-waiver. However, the Biden administration has recently canceled this plan with further practice guidelines forthcoming (2).
The course, led by experts on opioid use disorders, was engaging and informative. The instructors emphasized clinical pearls in recognizing, managing, and treating those who are affected by the opioid crisis. While buprenorphine is not a panacea, this medication can offer symptomatic relief to patients, as well as give them an opportunity to resume life as usual more quickly without worrying about pain and opioid withdrawal. Importantly, while in the hospital, any physician or APP with prescribing privileges can give a patient a first dose of buprenorphine.
If you are interested and have not already received X-waiver training, please contact ACEP for available future courses. We hope to be able to provide buprenorphine to our patients and to improve access to timely treatment for opioid use disorders. We are looking forward to more CME events in the future!
(1) Heath Affairs
(2) Washington Post
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Moral Injury: The Newest Pandemic in Emergency Medicine
Rita A. Manfredi, MD, FACEP - Councillor
Breanne M. Jacobs, MD - DC Chapter Member
It is amazing how resilient emergency physicians can be. But there is a limit.
Since the COVID-19 pandemic started, emergency physicians (EP’s) gown-up not only in personal protective equipment, but they also safeguard themselves with a protective emotional barrier so they can carry on in times of extreme stress. This is parallel to soldiers in battle who arm themselves psychologically and try not to think about the carnage and death that surrounds them. Moral injury occurs everyday in emergency medicine. It is the constant conundrum of being confined in a double bind when every choice we make results in a compromised outcome and when each of our decisions disregards the reason, we have been making sacrifices for years.
Every day in the ED we are confronted with multiple episodes of moral injury. These episodes accumulate and blossom and balloon into what we know as “burnout.” Moral injury can range from a blatant episode where a consultant recommends antibiotics for acute cholecystitis with outpatient follow up in someone without health insurance to more subtle examples of emails requiring additional online mandatory training or adjusting your practice to enhance patient satisfaction scores and provider ratings.
Long before the Covid-19, almost 50% of EP’s were burned out and many considered leaving the specialty at increasingly high rates. Moral injury was lurking in emergency medicine prior to the pandemic and Covid-19 has uncovered this plague of moral injury which threatens us all. The problem with moral injury is its subtlety---you do not realize it is there unless you are looking for it. Emergency Physicians are programmed to act in the moment, work through the problem, and forge ahead. We feel fine in the moment, and process only sips of moral injury when we are working in the ED. It is when there is down time and we pause, that we START experiencing all those locked away feelings. Emergency physicians intensively caring for patients may not process the misery surrounding them until they have downtime and that is where danger lurks. Emergency Physicians would rather vanish than ever appear to be weak or vulnerable and we know there is little space in our EM organizations to be helpless.
So, what is the solution? The key may be to normalize the processing of these emotions. No one can be a hero 100% of the time. You cannot meditate or “yoga” your way to wellness! Organizations and departments must provide humane solutions: consider staffing above 100%, offer backup so that emergency physicians can decompress when they need (not when the organization says they should decompress), provide the opportunity to process the grief and trauma, and offer resources for EP’s who may be faltering. The solution must be a coordinated plan with input from “in-the-trenches” EP’s communicated to C-suite leaders so there is a trickledown effect where everyone in the department feels empowered to contribute to joy in work---a proven method to beat back moral injury and burnout.
REFERENCES
Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017. (ihi.org)
Stat News
Dean W, Jacobs B, Manfredi R .: Moral Injury: The Invisible Epidemic in COVID Healthcare Workers Annals of Emergency Medicine May 20, 2020.
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News from the Social Media Ambassador
Kavita S. Jackson, MD
Follow DC ACEP on Facebook & Twitter!
Stay up to date on upcoming events, relevant policy and regulatory updates, the latest FOAM, and highlights of national ACEP’s content.
Also, tag us in any Facebook posts (@DCACEP) or tweets (@DC_ACEP) that you want to share with other DC ACEP Chapter members.
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Adriana's Corner
Would you like to contribute an article for the chapter newsletter? Although any article and topic are welcomed by any chapter member, we are particularly looking for articles from Residents and Medical Students.
This year, I would like to highlight a chapter leader or member in at least two-2 quarterly newsletters. Please reach out if you would like to highlight one of your colleagues and/or are interested in this new section for your chapter newsletter.
Please note a few potential, additional topics for your chapter newsletter: an interesting case and an inspiring COVID-19 story.
Articles do not have to be a particular length (usually 2-paragraphs) and can include images, links, or any references. Please refer to your chapter website under the About Us tab and click on the Newsletters tab to see examples of past articles. For more detailed information, please reach out to me via email.
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Welcome New Members!
A special welcome to the new members of the District of Columbia Chapter and to those that renewed their membership with the chapter. We are excited to have you.
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Abdulla Alhmoudi
Damali N Nakitende, MD
Daniel Berhanu, MD
Daniel J Patenaude, MD
Katherine A Douglass, MD, FACEP
Kathleen Ogle, MD
Kevin Davey, M
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Ksenya K Badashova, MD
Marcus Dean
Michael T Gillam, MD
Nour Rifai, MD
Praneeth Reddy, MD
Thomas Bartenstein
Warren Earl Tripp, MD, FACEP
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You may wonder if you should get involved with District of Columbia ACEP or EMRA or at the national level? We encourage you to please get involved!
If you are unsure about how to get involved, feel free to contact the chapter directly.
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CME Opportunities
Do you need CME? The Maryland & Virginia ACEP Chapters are extending an invitation to all DC Chapter members to register for their 2021 educational conference. Get your CME early in the year!
Maryland ACEP Chapter - Read more here.
Virginia ACEP Chapter - Read more here.
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FROM NATIONAL ACEP
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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.
Vaccine Hesitancy Webinar: Register for “This is Our Shot: How EM Docs Empower Patients to End the Pandemic,” a free webinar hosted by ACEP's Diversity, Inclusion and Health Equity Section at 3 p.m. CT on Feb 17. Speakers: Pilar Ortega, MD; Ugo Ezenkwele, MD, MPH, FACEP and Robert Rodriguez, MD. Moderated by: Tracy MacIntosh, MD, MPH, FACEP.
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 at work and at home. ACEP’s Physician Wellness Hub can help you find the right support.
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Breaking Down President Biden's Executive Order on Strengthening Medicaid and the Affordable Care Act
Since taking office, President Biden has issued a plethora of executive orders, mostly related to tackling the COVID-19 pandemic and reversing or adjusting policies implemented by the last administration. As a reminder, executive orders themselves do not effectuate new policies. Rather, in most cases, they call on federal agencies to examine or institute new policies—usually through regulations. On January 28, President Biden issued a broad sweeping Executive Order on "Strengthening Medicaid and the Affordable Care Act." READ MORE
Catch up on the latest federal regulatory news with ACEP's Regs and Eggs blog:
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ACEP Wellness & Assistance Program: 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. Learn more about this free member benefit.
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 launching soon!
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Peer Support Resource: Theater of War
Have you heard of Theater of War? The format includes presenting dramatic readings of seminal plays—from classical Greek tragedies to modern and contemporary works—followed by town hall-style discussions designed to confront social issues by drawing out raw and personal reactions to themes highlighted in the plays. 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.
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ACEP's Latest Pain Management and Opioid-Related Resources:
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ACEP Virtual Grand Rounds (free online series)
February Topic: Simulation: OB Emergencies with EMRA
February 24, 2021 | 10:00 am - 3:15 pm CT | Must be registered by 8:00 am CT
Topics include newborn resuscitation, precipitous delivery, postpartum hemorrhage and more. Sign up today.
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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.
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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.
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From the Emergency Medicine Foundation:
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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.
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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.
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District of Columbia Chapter
Natasha N. Powell, MD, MPH, FACEP - Pesident
Adriana Alvarez - Chapter Executive Director
800.798.1822 Ext. 3312 | Website
c/o National ACEP
4950 West Royal Lane
Irving, Texas 75063-2524
© 2021 District of Columbia Chapter ACEP. All rights reserved.
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