ACEP 2023: A few Insights from Council & New Resolutions

Dr. Ellie Gilbertson, PGY3

You’ve probably heard of “ACEP Council”, if not just as the overinvolved group of people who meet for an extra two days prior to ACEP’s renowned Scientific Assembly. Comprised of representatives from each ACEP state chapter as well as from CORD, EMRA, and SAEM, the Council is a body that votes on resolutions once per year that affect issues both in the day to day AND the larger-scale lives of emergency physicians.

This year, the Utah Chapter of ACEP sent delegates including UCEP members Alison Smith, Jim Antinori, Brendan Milliner, and resident physicians Alex Franke and Ellen Gilbertson. As a small state, Utah only holds four votes, which pale in comparison to populous states like California, which are granted upwards of 15.

We considered 62 resolutions this year, 44 of which were adopted and 10 of which were outright rejected, while 7 were referred to the Board of Directors. Generally, resolutions that are referred to the Board tend to be somewhat controversial, or those that fail to reach a productive conclusion during Council floor debate.

Lively discussion usually happens around issues with social repercussions; for example, in 2022 Council debate centered around the controversial Roe v Wade decision and how access to pregnancy termination fits into or changes the care of emergency physicians. This year, the heat took hold when gun control issues were brought to the spotlight.

Three resolutions were passed this year surrounding the topic of gun control:

  • Resolution #35: Declaring Firearm Violence a Public Health Crisis
  • Resolution #36: Mandatory Waiting Period for Firearm Purchases
  • Resolution #37: Support for Child-Protective Firearm Safety and Storage Systems

One resolution was abandoned:

  • Resolution #38: Ban on weapons intended for Military or Law Enforcement Use

Representatives from coast to coast took turns over the course of almost two hours fine-tuning the verbiage of these resolutions, many of which were vetted by the College’s Tactical and Law Enforcement Medicine Section; there was argument over whether or not to include “smart gun technology”, which ultimately was excluded from final verbiage secondary to controversy over the effectiveness of these techniques. Dissenting opinion largely centered around concerns that ACEP taking a stance on this issue is not a barrier to its solution, and assertions that such policy statements could be divisive for membership (recent polls demonstrate that up to 10% of ACEP members strongly disagreed with the College taking a formal position on gun control). However, supporters noted that the AAP and ACS have consensus policy statements regarding gun control, and that ACEP is an equally large stakeholder in the sequelae of gun violence.

Council also deliberated on matters of resident education. Ultimately, Resolution 21: Mitigation of Competition for Procedures between Emergency Medicine Resident Physicians and Other Learners was passed. Council almost unanimously was in favor of this resolution, which is congruous with years of policy statements supporting ongoing physician education and the assertion that all patients deserve a medical doctor. In passing this resolution, ACEP supports resident procedural education and experience and asserts that the presence of other learners and healthcare personnel must not negatively impact the resident education and experience. It was accompanied by the wholehearted passage of Resolution 43: Adopt Terminology “Unsupervised Practice of Medicine”, in reference to the execution of medical care as practiced by midlevel providers, and a nod toward transparency with regard to care provided by Pas and NPs.

Finally, larger scale resolutions like the following were also adopted in October. Resolution 31: Combating Mental Health Stigma in Insurance Policies – which effectively states that physicians who have a chart-documented history of anxiety or depression ought not to have those diagnoses weighed into their ability to or cost of disability insurance— passed with flying colors. So did Resolution 48: Medical Malpractice Certificate of Merit, which asserts that in cases of malpractice suit, an affidavit of merit must be from a board-certified Emergency Physician specifically rather than the previous more general ‘physician of any specialty’.

From hot button social topics, to academic capitulations, to discussion on the ever-changing roles of midlevel providers in the ER, to the mental health of ourselves and our colleagues – ACEP Council’s adopted resolutions this year hope to make us stronger, happier, and safer in small but important ways.