RS: One of the questions you asked was about forming a group. In my case, it just sort of happened. My first partner was Nat Rose. We were in the Navy and got out in July 1972. We started working 16-hour nights for the first two years, rotating, Nat and I, and we were getting about $20 an hour. We had an 80 percent contract to start. About four months into it, the hospital CEO said, “This doesn’t work. We think we want to pay 60.” That pushed us into independent billing. Inadequate Medi-Cal payments were a big issue. That made it clear that CAL/ACEP was a vehicle that we absolutely needed to have to make all of this work, and so three of us in my group, Bill O’Riordan, Roland Clark, and I, all became presidents of CAL/ACEP. We just evolved into things we needed to be and developed affiliate organizations, whether it was billing, insurance, or marketing, in order to make it all work. There was no plan. It was serendipity, but it turned out pretty well.
KK: So necessity bred invention. What about John and Harry? Did you feel that the support and development of ACEP helped you and your group?
JS: There was national ACEP, but California was a little ahead of Kentucky. We didn’t even have a state chapter when Harry and I started. In fact, I got together with three other physicians around the state; we actually formed the Kentucky chapter of ACEP. National ACEP was huge because it gave us contact with other physicians who had common problems. There were meetings, and it provided a tremendous educational resource for us.
KK: Zach, from your perspective, what is the reputation of emergency medicine now among students who are deciding what specialty they want to practice?
ZJ: I think, reflecting on a couple of things that were said, that there have always been challenges in emergency medicine, and the challenges 40-plus years ago are a little bit different than the challenges that today’s physicians are facing. It sounds like ACEP and other organizations are crucial in addressing these challenges, and I’m glad that those organizations are still around to help us today. I think a lot of people don’t appreciate the history as much as everyone who was there and fighting these early battles. Nowadays, I think students probably take for granted that emergency medicine is a well-respected specialty with lots of resources within its own department at most every single major academic medical center and that emergency physicians are respected members of the health care team. Emergency medicine gets more and more applicants every year. It’s very popular. I think that it seems on the same level as any medical specialty now, thanks to all the hard work from our pioneers.