Medical Degree: MD, Centro de Estudios Universitarios Xochicalco, School of Medicine, Ensenada, Baja California, Mexico

Response

The College needs to help simplify and streamline our practice to eliminate nuance and pointless frustration in our practice to ensure practice sustainability and fair compensation. Specifically, addressing misuse of ICD diagnosis codes by payers to deny reimbursement. Payers need to be held accountable for their “proprietary” diagnosis lists that inappropriately downcode. EHR vendors must make their diagnosis calculators more physician friendly so that the proper terminology can be easily found.

The College needs to work with state and federal authorities and support state chapters in resolving these issues that can adversely affect patient care.

Are there too many resident programs? In 2020 there were 265 EM resident programs with 2,665 available positions. In this last match there were 277 programs offering 2,921 positions. This represents an increase of 4.5 percent in the number of EM residencies but an almost 10 percent increase in the number of positions.

The report coming from the ED Accreditation Task Force will help provide direction for the College to meet its workplace strategic goal. We also need to work with our partner groups to help ensure that residencies are not just being developed as a source of inexpensive labor, but that they are providing high quality training preparing their trainees to provide care in a range of environments. We must take care that the expansion of programs does not risk dilution in the quality of training. While, through supply and demand, there is a potential that their influx could drive down reimbursement in competitive markets, this could be countered by ACEP supporting programs that could help reduce graduate medical school debt.

Kristin Bond McCabe-Kline, MD, FACEP

Current Professional Positions: vice president/chief medical information officer, AdventHealth Central Florida Division; EMS medical director, Flagler County/City of Palm Coast/City of Flagler Beach; chief medical officer, WaterSafe, medical director, Flagler Technical College EMT Training Program; medical director, AllCare Medical Transport

Internships and Residency: residency, Advocate Christ Medical Center (IL)

Medical Degree: MD, University of Texas Medical School, San Antonio

Response

The ACEP strategic plan is key to serving our members and specialty. Rather than selecting two issues, I prefer to distill the strategic plan into two top priorities to be addressed: 1) the future of emergency medicine and 2) the culture of emergency medicine.