In light of ACEP’s approaching golden anniversary, ACEP Now took a look back at the last 50 years of emergency medicine and the people and trends that have shaped the specialty.
ACEP Now Medical Editor-in-Chief Kevin Klauer, DO, EJD, FACEP, recently discussed the history of the specialty with two emergency physicians who have been members of the same EM group for their entire 45-year careers, a past ACEP President, and one of the next generation of EM leaders. The group discussed the origins of emergency medicine, how it has grown and changed over the years, and what the future holds. Here are some highlights from that conversation.
Moderator
Kevin M. Klauer, DO, EJD, FACEP, is an ACEP board member; chief medical officer–emergency medicine, chief risk officer, and executive director–patient safety organization at TeamHealth; ACEP Now medical Editor-in-Chief; and assistant clinical professor, Michigan State University College of Osteopathic Medicine, East Lansing.
Participants
KK: John, what was emergency medicine like when you and Harry started?
JS: Harry and I started at St. Elizabeth’s July 1, 1971. We had no hospital status, no department, no representation on the executive committee, no leadership positions in the hospital, and, of course, we had no specialty status. We had to learn to make our own way. We look at things differently now. There’s a lot more corporate medicine, and we have the benefit of clinical and even financial guidelines, regulations, and rules that ACEP has been instrumental in developing for us over the years. A lot has changed.
KK: John and Harry, what prompted you to start an emergency medicine group?
HM: John and I were on a ski trip while we were interns, and both of us had been working in emergency rooms as interns. Four of us in medical school decided to form a group. John and another were interning at St. Elizabeth’s. I was interning up at Indiana University in South Bend. Another gentleman was in Minnesota. The possibility came about for St. Elizabeth’s Hospital—who was using residents, family practice guys, and others to staff the emergency department—to form a group.
JS: I still have the original letter that I sent to the hospital administrator when Harry and I and two others had decided to form this group. This is a one-page proposal, $15 an hour was what we asked for, and we offered to have a group of four physicians committed to St. Elizabeth’s, committed to a career in emergency medicine. He signed it, and off we went.
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5 Responses to “Emergency Medicine Founders Discuss Origins of the Specialty, How It’s Changed, and What the Future Holds”
December 18, 2016
Cindy Pearsall Sussman MD FCEPI was sorry to not see a credit given to Dr David Wagner, the real “grandfather of Emergency Medicine” in your article. Dr Wagner was a general surgeon at the Medical College of Pennsylvania in Philadelphia and noted the immense need for an Emergency Medicine residency program. His was the first, and paved the way for many more to come. As a graduate of that program, I am proud to say that we were well prepared for just about anything that came our way. Dr Wagner deserves credit for having the foresight and energy to get the field on its feet.
December 18, 2016
Cindy Pearsall Sussman MD FCEPCorrection- Dr Wagner was a pediatric surgeon
December 18, 2016
MarianKevin,
Thank you for an insightful article regrading the history of emergency medicine and where we are headed.
I find it ironic that there are two articles in this edition of ACEP eNow discussing diversity in emergency medicine, however, your interview panel lacked diversity. I am certain that this was not intentional, but it certainly highlights the unawareness at times of this particular issue.
December 19, 2016
Kevin Waninger MD FACEPEven more important, Dr. David Wagner was a great role model and a really nice man. I am a better doctor, and even more important, a better colleague, friend and father, because of my interaction with Dr. Wagner.
November 22, 2018
Kathleen Nakfoor, Ed.D, MBA, MSIS, RNI had the privilege of working with Dr. John Wiegenstein, MD and Dr. Eugene Nakfoor, MD from 1970 to 1975. I was told “history is being made in this emergency room” and know this to be a fact. I recall working with Dr. Wiegenstein the nights before he head off, yet, to another meeting to battle for EM as a speciality. He entertained us with stories of his less than impressive luggage when checked into the presidential suite. I was well aquatinted with stories of progress being made in EM.
What has been overshadowed by the enormity of ACEP formation and EM becoming a specialty, are the historical changes that were made in emergency department management. I recall Eugene Nakfoor, MD, also a founding ACEP member, telling me stories of the fact no one knew how to bill for services, such a practice was unprecedented. He garnered “departmental status” in which he controlled all hiring and firing of the entire staff.. He and the nurses developed the original scribe system, not the one in existence today. There has never been such a well managed emergency department using the scribe; actually a pivotal individual with whom the department was organized.