ACEP and our specialty have developed progressively over the past 50 years, but the developmental journey wasn’t the same for all. Many contemporary emergency physicians may believe that when milestones were reached and barriers were overcome, such achievements advanced the lines of progress evenly. From a historical perspective, our evolution was not nearly so clean and uniform. Although some states, such as Michigan, enjoyed early recognition of our specialty, other parts of the country did not.
When I was a family medicine resident, emergency medicine was barely recognized as a specialty and there were no emergency medicine residencies in Tennessee. As interest in emergency medicine grew, the unique body of clinical knowledge was matched by the need for strong leadership and expertise to manage ED operations. So, ironically, in 1979, the year when emergency medicine became the 23rd recognized medical specialty, TeamHealth was born in Knoxville, Tennessee.
At that time, I partnered with Lynn Massingale, MD, FACEP, and John Minchey, MD, to form Southeastern Emergency Physicians. John Staley, MD, became a partner in 1987. Our goals were quite simple—to work with area hospitals to find a better way to care for patients with emergencies, a better way to operate emergency departments, and a better way to develop careers in our new specialty. We saw the hospitals around us facing a new challenge. They needed reliable, 24-7 physician coverage in their emergency departments, but no one was ultimately responsible for making sure the shifts were covered. With little or no backup, some hospitals were just one physician’s illness or travel delay away from an unstaffed emergency department and an emergency uncared for. We knew that was not sustainable.
Emergency medicine has blazed many trails in the past 50 years, and we are committed to our specialty and hope toexpand the sphere of influence offered by emergency medicine to many other sectors in the health care industry.
Some may wonder if today’s TeamHealth was yesterday’s vision of four young physicians, and the clear answer is, “no.” Never in our wildest dreams did we believe that our effort to bring sense to chaos locally would result in one of the largest physician groups in the nation. Just as emergency medicine and ACEP have evolved (and perhaps reinvented themselves to a certain degree over the years) so has TeamHealth. For that matter, TeamHealth wasn’t even called TeamHealth until 1994, when we developed a national footprint by acquiring other quality, regional groups and leaders from around the country.
Contrary to some opinions, our goal wasn’t to grow for the sake of growth—many with that model and approach have come and gone. We grew because we thought we could do a better job and wanted to support the practice of emergency medicine, much like our early mission in eastern Tennessee. If our group could improve the delivery of emergency care to a community and enhance the careers of aspiring emergency physicians, we were all in.
In subsequent years, that mission expanded to include groups looking for safety through strength in numbers, expertise in ED operations, risk management, and many other areas. Early on, we recognized our limitations and the need to add strong, non-physician leaders with business skills to our team. We utilized their strengths to help us manage the non-clinical side of the equation, making certain the mission was always driven by physician leadership, but well-informed by the brightest minds in health care management.
Today, many groups find value in joining a larger organization, removing the headwinds so commonly encountered in today’s health care environment. Our goals have never included conquest, but instead, true collaboration and servant leadership. Our model is a good fit for many, but may not be the preference of others. Just as in 1979, we welcome those who find TeamHealth to be a good fit, while respecting the choices of those who do not. Larger groups, whether by design or unintentional evolution, are an important part of emergency medicine’s history and share responsibility with those working in other models for the future success of our specialty.
TeamHealth’s story includes expansion beyond emergency medicine. Interest in improved efficiency and quality provided by integrated care delivery models has inspired further expansion of TeamHealth’s mission to include multiple service lines, including anesthesiology, behavioral health, hospital medicine, post-acute care, urgent care, occupational medicine, and orthopedic and general surgery surgicalists, among others, making TeamHealth one of the largest multispecialty clinician groups in the nation, with nearly 20,000 physicians, physician assistants and advanced practice registered nurses working to actualize our mission.
Our roots and foundation were built in emergency medicine and it remains the cornerstone of what we do today. “No shoes, no shirt, … no problem,” has been the historical mantra quoted by many ACEP leaders. We are proud of those roots and ACEP’s mission. Emergency medicine has blazed many trails in the past 50 years, and we are committed to our specialty and hope to expand the sphere of influence offered by emergency medicine to many other sectors in the health care industry.
Congratulations, ACEP, on a wonderful 50 years! The advancements and achievements in our past will pale in comparison to what we will accomplish together in the years to come.