They were each on duty for 5 straight days in a 450-square-foot basement ED with four stretchers, working 12-hour shifts that went from noon to midnight or the reverse. They then had 5 straight days without shifts, which was unheard of for a 1960s physician. By charging $5 per visit and collecting a hospital subsidy for indigent care, they were able to be as financially successful as they had been in their private practices. As Dr. McDade noted, the Alexandria emergency physicians had three main constituencies they wanted to “take care of – patients, the hospital, and the medical staff. We were going to give them all the same top-door service. That was the whole purpose when we went into it.”3
Explore This IssueACEP News: Vol 30 – No 08 – August 2011
It was a fabulous success. All three constituencies came to embrace the new emergency practice – ED visits at Alexandria Hospital doubled in the next 5 years. The Alexandria Plan garnered a great deal of attention from the world of medicine, the public, the media, and physicians who wanted to replicate what the Alexandria team had done.
Within 5 years, Alexandria-type plans had sprung up across the country. By 1968, emergency physicians had organized to create the American College of Emergency Physicians with the Alexandria physicians playing a key role. Dr. Mills became the second ACEP President and a founding member of the American Board of Emergency Medicine. Dr. McDade was an early ACEP leader and a strong advocate and organizer for the development of emergency medical services (EMS).
On June 24, 2011, a diverse group commemorated the Alexandria Plan’s golden anniversary at the “new” Inova Alexandria Hospital. Representatives from the hospital, ACEP, Society for Academic Emergency Medicine, Association of Academic Chairs of Emergency Medicine, Council of Residency Directors in Emergency Medicine, American Board of Emergency Medicine, Emergency Medicine Residents’ Association, and Emergency Nurses Association organized and funded the event.
The program featured a historical review of the Alexandria Plan, and speeches and commentary from elected officials, emergency physician and nurse leaders, and the presentation of certificates from the state of Virginia and the city of Alexandria.
A video featuring Jane Pinkus, a nurse who worked in the ED with the Alexandria pioneers, and Vince Whitmore, a paramedic, provided first-hand accounts of what it was like to usher in a new model of emergency practice. Perhaps the most special moment was the introduction of C.A. (Babe) Loughridge, M.D., one of the founding four physicians, who was in attendance. Although he came in a wheelchair due to recent illness, Dr. Loughridge stood and acknowledged the applause with a broad smile.