Impact of Supreme Court ruling on emergency medicine | Are you ready for your Written Board Review? Prepare with us! | New study on ED use debunks Medicaid myth

Michael D. Smith, MD, FACEP
President, Ohio ACEP

Laura Tiberi, CAE
Executive Director

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In this Issue:

From the Ohio ACEP Bookstore:

Can't attend a board review course? Supplement your review with Dr. Carol Rivers Board Review products!

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Welcome New Members!

Matthew Armstrong, MD
Taylor A. Baldwin, MD
Jared Bayless, MD
Derek L. Broering, MD
Charles C. Burtis, MD
Alexandra Leigh Bush, MD
Andrew Campbell, DO, FACEP
Amanda F. Collins, DO
Bentley Woods Curry, MD
Joshua Adam Denney, MD
Robert Cullen Doerning, MD, MBA
Alex Charles Fox, MD
Leigh Ann Giano, MD
Bruce B. Graham
James Hall, DO
Tyler Hill, DO
Joseph S. Jones, DO
Anthon J. Lemon, MD
Christi M. Makas, DO
Nathaniel Ronald Mann, MD
Jessica Lauren Nelson, MD
Kyle Christopher Niziolek, MD
Cory Lee Norman, MD
Benjamin Michael Ostro, MD
Michael C. Pearson, MD
Jason Thomas Pedrick, MD
Sundeep Punia, MD
Christopher Cody Reynolds, DO
Christopher L. Smelley, DO
Ryan T. Smith
Carly D. Snipes, MD
Jessica Lynn Vinyard-Davis, DO

President's Message

As you have no doubt heard by now, the US Supreme Court has upheld nearly all provisions of the Affordable Care Act (ACA). Regardless of your political leanings, the high court’s decision affects each of us and—for good or ill—will impact the care we provide to our patients. For a good breakdown of what this impact could be here in Ohio, you may find it helpful to review this publication released by the non-partisan Health Policy Institute of Ohio.

There are policies in the ACA that emergency doctors can get behind. In fact, some of the provisions specifically related to emergency medicine are reforms we have championed before. Importantly, the law includes emergency care as an essential part of any health plan and also recognizes the prudent layperson standard, which ensures coverage based on patients’ presenting symptoms rather than their final diagnoses.
One of the most significant components of the ACA is its expansion of Medicaid. And while the idea of broadening coverage is commendable, insurance coverage does not equal access to care. Until more physicians willing to treat Medicaid patients are available, these patients will continue to have little choice but to seek care at our emergency departments, many of which are already strained and over capacity. 
The ACA also lacks meaningful cost containment, which will become even more important if coverage and access are expanded. We simply cannot provide the American “expectation” of health care—with its relatively poor outcomes per dollar spent—while costs continue to balloon out of control. With the inherent risks associated with emergency medicine, it is not feasible for us to provide federally mandated care without liability protection while at the same time facing reimbursement cuts. As emergency physicians, we pride ourselves on doing more with less, but in the end, something’s got to give.
The Supreme Court ruling has effectively resolved the legal debate over the ACA. As the political phase of the debate continues, I hope the volume is turned down so that we may substantively address significant gaps in the law. 
As our nation’s medical safety net, we have an important role to play in this debate, but no matter what happens with the ACA—or any health care policy—our mission is constant: ensuring the best possible care for each and every one of our patients in the State of Ohio.
Mike Smith, MD, FACEP

Letter from EMRO Representative to EM Residents

Dear Ohio Emergency Medicine Residents,

My name is Alicia Shelby, and I was recently elected as your Resident Representative to the Ohio ACEP Board of Directors. I am thrilled with this opportunity, and I look forward to working hard on behalf of each of you!

For those of you who don’t know me, I am a 2nd year resident at Akron General Medical Center in Akron, Ohio. I was born and raised in Detroit, Michigan. I also completed my undergraduate and med school training at Wayne State University in Detroit, but I hope my new Buckeye colleagues won’t hold that against me! 
As a resident preparing for my career, I understand that Ohio ACEP’s three core areas of focus—advocacy, education and physician leadership—are just as important to medical students and residents as they are to the grizzled veterans of emergency medicine!
  • Advocacy: Ohio ACEP fights for us on the issues that will affect tomorrow’s EM physicians most: medical liability reform, ED overcrowding and ensuring patient access to quality emergency care.
  • Education: the Chapter offers several outstanding courses and educational materials right here in Ohio, which many residents find especially helpful when preparing for the Qualifying exam.
  • Leadership: Ohio ACEP is also committed to developing the future leaders of emergency medicine through its Leadership Development Academy—because every emergency physician that learns to be an effective advocate is a potential leader and activist for advancing emergency care. 
It’s important to me that you know about available resources to help you advance your careers and the specialty of emergency medicine. During my term as EMRO Representative, I plan to engage with you, my fellow residents, to help you find the best ways to take advantage of those benefits and get involved in Ohio ACEP. 
For Ohio ACEP to stay viable into the future, the Chapter’s priorities need to reflect the needs of its resident members. That’s why I urge each of you to get involved and take ownership of Ohio ACEP activities. After all, this is your organization, and I want each of you to be proud to say “We are Ohio ACEP!”
Best wishes,
Alicia Shelby, MD

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Advocacy Update

On June 28, the Ohio ACEP Government Affairs Committee gathered for the first time under the leadership of newly-elected Chair Dr. Matt Sanders. In the meeting, the committee reaffirmed its commitment to pursuing the objectives of the Chapter through legislative advocacy, health policy and regulatory issues. The highest policy priorities for the Chapter were identified as:
  • Pursue limited liability for EMTALA care
  • Advocate for fair payment/promote funding for EMTALA care
  • Protect access to emergency care
  • Preserve ability to serve individual patients in a time-critical environment
  • Guard against administrative burdens that may impede physicians’ ability to provide the best possible care
The Government Affairs Committee will continue to strategize during the legislature’s summer recess. 
As always, Ohio ACEP wants to engage members in its advocacy activities. If you are interested in becoming involved in Ohio ACEP’s advocacy efforts, we invite you to attend a future Board of Directors meeting or contact us to inquire about other ways to make your voice heard.

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Member Kudos

Thomas Gavin, MD, FACEP, for being featured in ThisWeek Community News’s article, “New emergency center will open June 20
Richard Hausrod, MD, FACEP, for being quoted in The Chronicle-Telegram article “Hospitalized man possibly on bath salts
Thomas Waters, MD, FACEP, for being quoted in The Cleveland Plain Dealer article “Authorities in Ohio to crack down on intoxicated boaters this weekend
Carol Cunningham, MD, FACEP, for her appointment by Transportation Secretary Ray LaHood as the EMS Medical Directors representative to the National EMS Advisory Council
Joan Kolodzik, MD, FACEP, for being named Director of Clinical Education at Emergency Medicine Physicians
Robert I. Broida, MD, FACEP, for being a contributing author to the American Society of Healthcare Risk Management’s Emergency Department Risk Management Pearls, 2012 Edition
Howard K. Mell, MD, MPH, FACEP, for being featured in The Cleveland Plain Dealer article, “Lake County doctor wants 10,000 people to learn hands-only CPR

If you know of a member that deserves to be congratulated, let us know!

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Emergency Medicine Review Course - Three Course Dates!

Our Emergency Medicine Review course is ideal for physicians preparing for the Qualifying Exam, ConCert Exam, or those looking for a CME resource and a comprehensive EM review.
Course Highlights
  • Over 30 nationally known educators
  • Extensive daily course syllabus 
  • Pre, Post & Daily Tests totaling over 400 questions
  • Access to Ohio ACEP’s online visual stimuli guide with 1,400+ cases
  • Copy of ECGs for the Emergency Physician
EMR Long Track (5-day course)
  • August 20 – 24, 2012
  • October 22 – 26, 2012
EMR Fast Facts and Fundamentals (3-day course)
  • August 25 – 27, 2012
All courses will be held at the Renaissance Columbus Hotel. For information on hotel reservations, visit

For additional information or to register online visit

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Ohio AG, Department of Health and Drug Free Action Alliance Announce Drug Take-Back Program

On July 9, Ohio Attorney General Mike DeWine announced a partnership with the Ohio Department of Health and the Drug Free Action Alliance to give Ohio residents and law enforcement another tool to fight drug abuse in their communities. Through the Ohio Prescription Drug Drop Box Program, the organizations have placed 75 boxes to collect unwanted, expired or unused prescription drugs. The pilot program is initially being rolled out in Southern Ohio, an epicenter for the state’s battle with prescription drug abuse.
"Instead of medication drop off days just being available several times each year, these drop boxes will allow Ohioans to dispose of dangerous prescription drugs as soon as a person decides it is appropriate to do so," said Ohio Department of Health Director, Dr. Ted Wymyslo. "We want to make it convenient to get these unused dangerous drugs out of the home, safeguarding the family and decreasing the possibility of the drugs being diverted or misused."
For more information on the Ohio Prescription Drug Box Program, view the Ohio Attorney General’s news release.

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Oral Board Review Course - Space is Limited!

Oral Board Review Course dates are set for October 17 and 18. This one-day course includes five hours of one-on-one mock oral patient simulations and each participant practices 10+ cases with our experienced faculty. Our 1:1 student/instructor ratio ensures attendees receive individualized feedback and leave prepared to pass the Oral Board exam. 
Due to this course's low faculty to student ratio, space is limited. Early registration is highly recommended. Click here for more information and to register.

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Recent News and Opinion

ACEP releases statement on ACA ruling

Following the release of US Supreme Court’s highly-anticipated ruling on the Affordable Care Act, the American College of Emergency Physicians issued a press release in which ACEP’s President, Dr. David Seaberg, praised several provisions of the law. At the same time, he raised serious concerns about other problems left unaddressed by the law, such as the lack of meaningful liability reform and the unaccountable Independent Payment Advisory Board.

[read the full ACEP press release…]

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Most Medicaid patients visit EDs for urgent or worse symptoms

According to a new report released by the Center for Studying Health System Change (HSC), the majority of adult Medicaid patients who seek emergency care do so for potentially urgent medical needs. The HSC report challenges the widely held assumption that Medicaid patients tend to go to emergency departments for routine or non-urgent care. Unlike some other studies and anecdotal evidence, the HSC report looked at patients’ presenting symptoms instead of their final diagnoses. 

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President Obama signs bill to fight drug shortages

On Monday, July 9, President Obama signed into law S. 3187, the Food and Drug Administration Safety and Innovation Act, which gives the FDA much-needed authority to require manufacturers of drugs to report shortages or potential shortages, especially those used in emergency medicine. The law, which Congress passed with broad bipartisan support, will allow the FDA to work with manufacturers to produce drugs in short supply or to reallocate these drugs to ensure they are available where needed. Among some other provisions, the bill also bans two chemicals frequently used in the production of the designer drugs known as “bath salts.” 
For more information on the law, see the The Hill’s article, “Obama signs bipartisan FDA bill.”

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Career advice for senior EM residents

In his blog post, on Emergency Physicians Monthly’s website, James Hamilton, MD gives helpful advice to senior residents on evaluating job offers.

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