Catherine A. Cummings, MD, FACEP
Thank you all for the support and hard work you devote to Rhode Island ACEP and the advocacy that you do for Emergency Medicine. Please come celebrate this work at the Annual Meeting in Newport on June 19.
I didn’t believe them at the time, but several past presidents of RIACEP told me that taking on this challenging role would be one of the highlights of my career. Now, having done this, I couldn’t agree more and I also see at the end of my tenure, that there is so much more to be done, and Otis Warren is ready with great ideas and enthusiasm.
One area of unfinished advocacy revolves around the RI Department of Health and their change in philosophy to embrace “just culture” in their investigations of individual physicians, PA’s and NP’s and in facilities investigations. The issue that initiated this change was that over the past year, because of required facilities reports, the DOH used those reports and initiated investigations into providers for self-reported errors, particularly surrounding their EHRs. This has been reported in the national press. Our efforts immediately resulted in no further punitive, unfavorable outcomes of investigations that we are aware of, just being investigated takes its toll on the doctor and on the overall safety of the system as self-reports decline. The longer lasting impact is that the RI DOH reports since implementation of their “Just Culture” algorithm, the resulting professional investigations have been reduced to 2 over the past 3 months. They explain that in those 2 cases, an obvious deviation from policy and not a systems error occurred. RI ACEP is continuing to work with the DOH to ensure we have a robust, transparent system that protects and promotes a culture of safety in actions and not just words. You can be an important part of this effort by simply contacting me.
Another ongoing advocacy issue, led by Joe Lauro, is moving the e911 Dispatchers toward using T-CPR and EMD standards. It is always delicate when dealing with budgets and the legislature, but it seems the RI State Police have embraced this initiative that has the potential to save hundreds of lives by initiating bystander CPR.
It would be a big mistake not to mention our involvement at the national level and the impact that one of our members is having, Tony Cirillo. This month ACEP held the Leadership and Advocacy Conference in Washington, DC (see pictures). The two issues that we took to the Hill are both items that Tony has devoted thousands of hours of effort. First, Mental Health parity and treatment. It is unconscionable the way mental health is dealt with in EDs across the country with delay, holds and disparities in treatment. ACEP is advocating for the passage of legislation that will provide grant funding to communities to address their individual issues to improve these problems. Another important issue is to take the “patients out of the middle” of insurance company surprise bills and unfair practices. One legislative initiative is to ban out of network deductibles for emergency care which are generally double the in-network amount. Your auto insurance deductible doesn’t double when you go on vacation, why should your health insurance? The other initiative is to use arbitration in determining a fair payment when an out of network disagreement occurs similar to NY state’s approach. The insurance companies are formidable opponents of these common-sense approaches, but ACEP is also quite determined.
It has been an honor to serve in this role. Thank you all again.