Part of ACEP’s power as an advocate for emergency medicine comes from the passion and innovation of its leaders. Recently, Paul Kivela, MD, MBA, FACEP, who took over as ACEP President in October 2017, shared some of his goals for his presidential year and a few of the surprising challenges so far with ACEP Now Medical Editor-in-Chief Kevin Klauer, DO, EJD, FACEP. Here are some highlights from their conversation.
KK: What were your goals prior to starting this presidential year?
PK: I’m a single hospital guy, and I’m pretty pragmatic. My approach was really to make the emergency physicians’ lives better. I’ve seen emergency medicine become more regulated and controlled by others; I’ve been focused on trying to help the organization take back our specialty.
I think we’ve been hit with a lot of regulations. A lot of things that we’re doing that don’t add value to the patient. We’ve seen epidemic levels of burnout, and a lot of this is lack of control over our specialty and the care we provide.
My goal was really to improve communication and transparency. I think there are a lot of people who feel as though ACEP is controlled by large groups. I am in a single hospital group, and ACEP brings tremendous value to me.
KK: Pragmatically speaking, what were some of the things you thought you could do, some of the dials you could turn, or the switches you could flip to help ACEP serve its members better?
PK: The first thing that I’ve learned in my time on the Board is that there are a lot of things that ACEP does that our members don’t even realize we do, so I’ve really worked hard on trying to establish transparency and communication back to the members on the value that ACEP provides to them.
I’ve worked for over a year and a half with staff on developing a new website that will be coming out at the end of this month. Rather than force something that wasn’t ready, we took the necessary time to offer something that will be of great value with much improved function.
I think medical-legal concerns have always been among the biggest frustrations for our members. We’re really going to come forward this year with some ideas that will provide some more support for our members so that they can practice with less discomfort and less fear, while doing the right thing.
I think a lot of our members have been frustrated by mental health boarding. This is very close to my heart. We need to make sure that the emergency department is a safe environment for both our members and also the patients.
We’re moving some issues forward that should decrease boarding and improve the care to patients that see us in the emergency department. I know future presidents will continue these initiatives.
KK: Every ACEP president has important goals. However, when you get into your presidency, the issues of the day, the circumstances you encounter, are what identify some of your day-to-day priorities. What are some of the things that have come up that you never expected would be Paul Kivela’s to solve?
PK: An issue that has popped up that I never expected is communication. A great number of our members communicate via social media. I‘ve really taken on the role of trying to make sure that we communicate and address issues via social media in real time. The organization has moved in the right direction. We’re going to help bring the information to you, as opposed to you looking for it.
KK: What’s one example of one of those topics that has really been very timely in social media?
PK: The issue of REBOA [resuscitative endovascular balloon occlusion of the aorta] is a great example. We had previously come up with a consensus statement with a number of other organizations that talked about some issues on REBOA that were not consistent with some of our members’ views.
Via social media, that was brought to our attention, and we quickly responded. I think that shows how our organization can respond in a very quick and efficient manner.
KK: Something you said was really an important point: meeting the members where they are. As people start to consume information differently and they go to different modalities of communicating, we have to be nimble.
You’ve done an outstanding job of leading the organization to make sure that we are available and present on the platforms where our members want to communicate. You’ve significantly advanced ACEP’s communications in that regard.
We’re almost midway through the year. What do you hope to accomplish by the end of your term?
PK: We are reviewing every committee objective, nearly 300, making sure each benefits the members. Many are ongoing from year to year. We want to ensure that this work is productive and meaningful.
We’re also moving forward on some issues for medical-legal reform and in psychiatric care that will hopefully translate, in a very short period of time, to improved care and make the lives of emergency physicians better.
I’ve spent time working to unify the specialty. There’s some, unfortunately, duplication within our specialty and there are many challenges that we face. I’ve reached out to work with organizations where our missions either overlap or sometimes conflict. I‘ve reached out to NAEMSP [National Association of EMS Physicians], AAEM [American Academy of Emergency Medicine], SAEM [Society for Academic Emergency Medicine], and ACOEP [American College of Osteopathic Emergency Physicians]. I’m really working to coordinate the issues that we can agree on so that we are not reinventing the wheel on each one of these issues. I think I want to try and make things less competitive between the organizations and more collaborative. I think that‘s hopefully moving the specialty in a better direction in the end.
ACEP dues are not an inconsequential amount of money. I hope when people look at their dues statement that every emergency physician will be able to say, “I received my value from my ACEP membership.”
KK: Every good president makes certain they have really done their very best to show the value of membership and dues dollars spent. You are certainly making good on that promise. Paul, thank you for your service and for your time. I know that you will have left ACEP in a better place following your presidency.