C. Ryan Keay, MD, FACEP

(Washington)

Current Professional Positions: Emergency Physician, North Sound Emergency Physicians, Providence Regional Medical Center Everett and Puget Sound Physicians, Snoqualmie Valley Hospital

Internships and Residency: Emergency Medicine Residency, Denver Health Medical Center, University of Colorado (2009); Chief Resident (2008-2009)

Medical Degree: MD, University of Washington School of Medicine (2005)

Response

The answer to this question is simple – it is not an easy fix. It is a multi-phase process, and we have to listen to the voices of our membership. The themes that are evident today are not new or unexpected. Most organizations through history experience a disconnect between older, “seasoned” membership, and the younger, vigorous parts of our organizations. In ACEP, we have not yet ascertained what drives different demographics to join, and stay, a part of a larger organization. Unless you have information to inform strategy, then you are stabbing in the dark. The longest-serving members of the College are rightly proud of the institution that they were part of creating and shaping. The rising generation, however, may be interested in transformative disruption of the status quo, a longer-term vision of the future, and most importantly in having their voices heard. Those in mid-career may simply be trying to prevent drowning in the burden of compliance, decreasing reimbursement, and harmonizing a life with their careers.

So, with this potential paradigm, I would pose the following questions as the framework for three pillars of work. 1. What is essential to ACEP and cannot be changed? 2. What needs to be disrupted and remade? 3. And finally, what needs to be added to make us whole? When we understand those three pillars, then we can begin phase two of the process. Listening sessions with key stakeholders will help us to understand for each demographic within ACEP what falls into those three buckets. Phase three will be to then take the summary of that information to the other teams – to dialogue around the needs and fears, and truly understand the barriers to implementing change. Finally, phase four is implementation – and we have to get this right.

This will be uncomfortable, and the conclusions could be radical. However, to stay static in today’s world is to fade into irrelevance and our country and our membership needs the voice and presence of emergency medicine.

Heidi C. Knowles, MD, FACEP

(Incumbent, Texas)