The Pulse Spring 2025

SPRING 2025

Bridging Generations: Building the Future of Osteopathic EM Together

SCIENTIFIC ASSEMBLY HIGHLIGHTS RSO UPDATE PG 14

WELLNESS COMMITTEE UPDATE

PRACTICE ADVOCACY COMMITTEE UPDATE

PG 18

PG 22

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The Pulse VOLUME LV No. 1 EDITORIAL STAFF Benjamin Godfrey, DO, FACOEP, Assistant Editor Megan Heller, ACOEP Association Manager Claire Krzyzewski, Graphic Designer

The Pulse is a copyrighted quarterly publication distributed at no cost by ACOEP to its Members, Colleges of Osteopathic Medicine, sponsors, exhibitors, and liaison associations recognized by the national offices of ACOEP. The Pulse and ACOEP accept no responsibility for the statements made by authors, contributors, and/ or advertisers in this publication; nor do they accept responsibility for consequences or response to an advertisement. All articles and artwork remain the property of The Pulse and will not be returned.

TABLE OF CONTENTS 4

PRESIDENT’S REPORT Jennifer Axelband, DO, FACOEP

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WORKPLACE VIOLENCE Jennifer Axelband, DO, FACOEP

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A MESSAGE FROM THE PRESIDENT-ELECT John Dery, DO FACOEP-Dist, FACEP, FAWM

EXECUTIVE DIRECTOR’S DESK 11 Amanda Mahan

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12 2025 SPRING SEMINAR

Deadlines for the submission of articles are as follows: January issue due date is November 15; April issue due date is February 15; July issue due date is May 15; October issue due date is August 15.

The Editorial Board of The Pulse reserve the right to decline advertising and articles for any issue.

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©ACOEP 2025 – All rights reserved. Articles may not be reproduced without the expressed, written approval of ACOEP and the author.

ACOEP is a registered trademark of the American College of Osteopathic Emergency Physicians.

MENTORSHIP: A TOOL FOR PHYSICIAN WELLNESS 18 Tiffany Brown, DO PEBBLES OF PURPOSE: EMBRACING

PHYSICIAN WELLNESS IN EMERGENCY MEDICINE 19 John Dery DO FACOEP-Dist, FACEP, FAWM ACOEP PRACTICE ADVOCACY COMMITTEE UPDATE 22 Jeremy Selley, DO, FACOEP MISSION TRIP: TAKE A CHANCE 25 Jeremy K. Selley, D.O. FACOEP WOMENS COMMITTEE UPDATE 26 Jacqueline M. Dziedzic, DO, FACEP, FACOEP

29 FALL SCIENTIFIC ASSEMBLY HIGHLIGHTS SCIENTIFIC ASSEMBLY 30 2024 FOEM COMPETITION AWARD WINNERS

32 2025 SCIENTIFIC ASSEMBLY SAVE THE DATE! SPRING 2025 THE PULSE

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PRESIDENT’S REPORT

Jennifer Axelband, DO, FACOEP, FCCM

NEXT IN LINE: PAVING THE WAY FOR TOMORROW’S EM LEADERS

A

s emergency physicians, we are always looking ahead— preparing for the next shift, the next challenge, and the next breakthrough. But just as importantly, we must also look to the next generation of leaders who will carry our specialty forward.

As I reach the halfway point of my term as President, I’m reminded of why I first joined ACOEP in 2003—this organization has always been about people stepping up to shape the future of osteopathic emergency medicine. Now, my focus is on ensuring that the next generation has the mentorship, leadership opportunities, and support to continue that legacy.

I have been fortunate to have many amazing mentors in my life both professionally and

personally. When I reflect on my career as a clinical physician and as a leader in emergency medicine, I know I would not have been as accomplished today if Dr. Chuck Prestosh had not been a driving force in my life. He provided advice, guidance and influence. He saw potential in me that I would have never recognized on my own. In the past, I had teased him on multiple occasions telling him I would have his job one day. I was referring to his job when he was my program director in emergency medicine. Little did I know he saw broader horizons for me and paved the way for me to step into a different job of his, President of ACOEP. Thank you Chuck for believing in me and seeing a future for me that I never dreamed possible.

A Legacy of Leadership Osteopathic emergency medicine has always been built on resilience, adaptability, and an unwavering commitment to patient care. But what makes ACOEP truly special is its dedication to supporting and elevating its members at every stage of their careers.

Over the years, I’ve seen firsthand how the strength of our organization lies in its people— mentors who have shaped my own career, colleagues who have challenged and inspired me, and now, the next generation of leaders who are stepping forward with fresh ideas and new energy.

We must invest in these future leaders now, ensuring they have the opportunities, guidance, and resources to carry our specialty forward.

What We’ve Accomplished So Far During the first half of my term, we’ve focused on strengthening leadership pipelines, expanding opportunities for residents and students, and reinforcing mentorship across all levels of ACOEP. Some key efforts include: • Amplifying the Resident Student Organization (RSO): We’ve worked to increase resident and student participation in decisionmaking, leadership roles, and professional development initiatives.

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• Expanding Mentorship & Networking: ACOEP has prioritized strengthening mentorship programs, ensuring that our newer members have access to experienced physicians who can guide and support them.

• Enhancing Professional Development: Through educational opportunities, leadership training, and advocacy initiatives, we’re equipping members with the tools to thrive in an ever-changing emergency medicine landscape.

Mentorship Starts with Connection Mentorship isn’t just a benefit of professional engagement—it’s a responsibility we all share in shaping the future of osteopathic emergency medicine. One of the most meaningful ways to connect with future leaders is through ACOEP’s conferences, where mentorship happens organically. Whether it’s over coffee, during a skills lab, or in a networking session, these moments create lasting professional relationships that shape careers.

If you’re looking for ways to guide, inspire, or even learn from the next generation, the best place to start is by being present.

A simple conversation could spark a lifelong mentorship,

provide career-changing advice, or even inspire someone to take the next step toward leadership.

Looking Ahead With only a few months left in my term, I remain focused on one key goal: ensuring that ACOEP remains an organization where leadership isn’t just for the few, but for everyone willing to step forward.

Whether you’re a seasoned physician ready to mentor, a resident looking for guidance, or a student eager to get involved, your voice matters.

There is no single path to leadership in emergency

medicine—but there is a place for each of you in shaping its future.

Our specialty is built on those who came before us—and those next in line to lead. Let’s pave the way for them together.

I look forward to seeing many of you at our upcoming events and to working alongside you to strengthen the future of osteopathic emergency medicine. –•– With gratitude and excitement, Jennifer Axelband, DO, FACOEP, FCCM President, ACOEP

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PRESIDENT’S MESSAGE

Jennifer Axelband, DO, FACOEP, FCCM

WORKPLACE VIOLENCE IN HEALTHCARE: NAVIGATING THE COMPLEXITIES UNDERSTANDING THE CONFLICT BETWEEN PATIENT RIGHTS AND HEALTHCARE WORKER SAFETY: YOUR VOICE IS IMPORTANT

I

n addition to my president’s report, I want to take this opportunity to highlight a critical issue affecting all healthcare workers—workplace violence. Whether directly or indirectly, most healthcare professionals have experienced or been impacted by it. Recently, I had a personal connection through a colleague who chose to resign after an encounter related to workplace violence.

The Event A patient presented to the ED for seizure events with altered mental status concerning for status epilepticus.

The seizure events were so impressive in presentation that the patient required multiple doses of medication to manage the seizure events.

Ultimately, the patient required intubation for respiratory concerns of failure to manage secretions and airway protection.

Fortunately, the patient stabilized rapidly, no seizure events were identified on EEG and the patient was successfully extubated and continued to do well. Several hours after extubation, the

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patient had multiple seizure-like events that were not identified as seizures on EEG and therefore did not require additional medication dosing. Between these events, in an unpredictable manner, the patient would alternate in behavior at times agitated and other times calm. The agitation included inappropriate and abusive verbal comments and physical contact consisting of grabbing, punching, kicking and biting of the healthcare team members. During an episode of agitation, the patient attempted to kick a healthcare team member. In self-defense, the

healthcare provider interrupted the motion of a lower extremity kick by redirecting the patient’s extremity to the bed and securing the patient’s extremity to avoid further potential injury and harmful contact. The event was reported, and the patient’s family submitted a grievance against the healthcare team member. The outcome resulted in the healthcare member resigning. Over the years, I’ve seen firsthand how the strength of our organization lies in its people— mentors who have shaped my own career, colleagues who have challenged and inspired me, and

Awareness of the SAVE Act The SAVE (Safety from Violence for Employees) Act is legislation aimed at protecting healthcare workers from workplace violence.

Hospital administrators must be aware of this act and ensure its principles are integrated into their policies and procedures. This act underscores the importance of safety in healthcare settings and provides a legislative framework to support it.

Conclusion

now, the next generation of leaders who are stepping forward with fresh ideas and new energy.

Workplace violence in the healthcare sector is a growing concern that presents significant challenges for both healthcare workers and administrators.

Instances of violence, coupled with conflicting policies regarding patient rights and healthcare worker safety, create a complex environment that requires careful navigation and robust policy frameworks.

Zero-Tolerance Policy Establishing a clear, zerotolerance policy for workplace violence can set the standard for acceptable behavior and ensure that all incidents are taken seriously. This policy must be communicated effectively to all staff members, patients, and visitors to create an environment

where violence is neither tolerated nor excused.

Conflict Between Patient Rights and Healthcare Worker Safety The conflict between patient rights and healthcare worker safety is a delicate issue. While patients have the right to receive care and be treated respectfully, healthcare workers also have the right to a safe working environment. Instances where healthcare workers are terminated or chose to resign for defending themselves highlight the need for policies that protect both patient rights and worker safety. Hospital administrators must be aware of and address these conflicts through comprehensive policies and training programs. Balancing these rights requires a nuanced approach and clear guidelines to protect both parties.

Workplace violence in healthcare is a critical issue that demands urgent attention and action. By understanding the factors that contribute to violence, its impacts, and the preventive measures that can be taken, healthcare organizations can create safer environments for their workers and patients. Ensuring the wellbeing of healthcare professionals not only enhances their quality of life but also improves the overall quality of care in this indispensable sector. Balancing patient rights with healthcare worker safety, being aware of legislative measures like the SAVE Act, and implementing comprehensive policies can help navigate these complexities effectively. ACOEP has been actively focused on and collaborates with other associations to address this urgent matter. The safety of healthcare workers cannot be overstated.

Your voice is important. Advocate for healthcare workers safety. –•–

Advocate for Healthcare Worker Safety

References • Occupational Safety and Health Administration (OSHA). (n.d.). Workplace violence in healthcare. Retrieved February 21, 2025, from https://www.osha. gov/healthcare/workplace-violence • Workplace Violence Laws in Healthcare: EBG’s 50-State Survey, Retrieved February 21, 2025, https://www.casapinellas.org › wp-content › uploads

Click Here for More Details

• Workplace Violence Laws in Healthcare: EBG’s 50-State Survey PDF, Retrieved February 21, 2025, https://www.bing.com/

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THE ON-DECK CIRCLE

John Dery, DO FACOEP-Dist, FACEP, FAWM

CODE BLUE CHRONICLES: INSIGHTS FROM THE FRONTLINES OF EM A MESSAGE FROM YOUR INCOMING ACOEP PRESIDENT

I

n the past year, American emergency medicine physicians have encountered a myriad of challenges that threaten both the quality of care and the sustainability of their practices.

Among the pressing issues are the impending impact of a new presidential administration on healthcare policy, evolving reimbursement structures, persistent supply chain disruptions, and increasing burnout and staffing shortages. These challenges, interwoven with the complex dynamics of modern healthcare, require adaptive strategies and robust policy responses to ensure that emergency departments can continue to provide critical services.

Political Uncertainty and Healthcare Policy The upcoming presidential transition has amplified concerns among emergency medicine physicians about potential shifts in healthcare policies. Recent analyses suggest that changes in regulatory frameworks and funding allocations could alter the landscape of emergency care delivery. For instance, Johnson et al. (2024) note that presidential transitions often bring a re-examination of healthcare priorities, potentially impacting federal support for emergency services and disaster preparedness initiatives. Such policy shifts could result in alterations to Medicaid funding, research grants, and federal reimbursement programs, 8 | THE PULSE SPRING 2025

thereby affecting the operational capacities of emergency departments across the nation.

Emergency physicians must therefore prepare for policy uncertainties by engaging in advocacy and staying informed about legislative developments that could influence clinical practice and hospital operations (American College of Emergency Physicians [ACEP], 2024).

Evolving Reimbursement Models Changes in reimbursement structures represent another significant challenge for emergency medicine. Recent modifications in Medicare and Medicaid payment models have forced physicians to adapt to new performance metrics and bundled payment systems. Garcia et al.

(2023) emphasize that these adjustments may inadvertently penalize emergency departments that manage high-acuity cases, as current reimbursement models often fail to fully account for the complexity and resource intensity of emergency care. The financial strain is compounded by the growing administrative burden, which diverts valuable time away from patient care. In response, emergency departments are increasingly turning to data analytics and process optimization to negotiate fair reimbursement rates while maintaining highquality care. The adoption of innovative care delivery models, such as tele-emergency services and coordinated care pathways,

may also help mitigate the adverse financial impacts of these reimbursement changes (National Emergency Medicine Institute, 2023).

Supply Chain Disruptions Recent supply chain disruptions have further complicated the practice of emergency medicine.

The COVID-19 pandemic exposed critical vulnerabilities in the procurement and distribution of

essential medical supplies, and these challenges persist today.

According to Kumar et al. (2024), shortages of personal protective equipment (PPE), critical medications, and diagnostic supplies continue to disrupt emergency care operations.

These supply chain issues not only hinder day-to-day clinical

activities but also compromise the ability of emergency departments to respond effectively to surges in patient volume during public health emergencies. Hospitals are now investing in more robust supply chain management systems and forming strategic partnerships with local manufacturers to ensure a steady supply of critical resources. Additionally, there is a growing call for federal and state-level policies to establish strategic reserves and incentivize the production of essential medical supplies, thereby reducing dependence on global supply chains that can be easily disrupted.

Burnout and Staffing Shortages The fourth challenge facing emergency medicine physicians is the escalating issue of burnout and staffing shortages.

The demanding nature of emergency care, compounded

by the stressors of political uncertainty, financial instability, and operational inefficiencies, has contributed to unprecedented levels of physician burnout. Lee et al. (2023) report that burnout among emergency physicians has reached critical levels, with significant implications for both patient care quality and physician well-being.

Staffing shortages exacerbate these issues, as overburdened physicians struggle to provide timely and effective care.

Hospitals and healthcare systems are beginning to address these challenges by implementing wellness programs, restructuring shift schedules, and increasing support staff. Moreover, there is an emerging emphasis on integrating mental health resources and resilience training into emergency medicine curricula to help physicians manage the high-pressure environment of

emergency care (American Journal of Emergency Medicine, 2024).

The challenges facing American emergency medicine physicians are multifaceted and interdependent. The uncertainties brought by a new presidency, changes in reimbursement models, persistent supply chain disruptions, and escalating burnout and staffing shortages together paint a picture of a field in flux. Addressing these issues requires coordinated efforts from policymakers, hospital administrators, and the physicians themselves. As emergency departments continue to serve as the frontline of healthcare delivery, proactive strategies—including policy advocacy, technological innovation, and workforce support—will be essential in ensuring that emergency medicine can meet the evolving needs of the American public. –•–

References • American College of Emergency Physicians. (2024). The future of emergency medicine: Policy and practice in a changing healthcare landscape. Annals of Emergency Medicine.

• Garcia, M., Patel, R., & Thompson, L. (2023). Financial pressures and reimbursement reforms in emergency care. Journal of Emergency Medicine Finance, 12(2), 95–102.

• Johnson, D., Ramirez, S., & Lee, H. (2024). Presidential transitions and their impact on emergency healthcare policy. American Journal of Health Policy, 18(1), 45–53.

• Kumar, P., Nguyen, T., & Smith, J. (2024). Supply chain vulnerabilities in emergency medicine: Lessons from the COVID-19 era.

Critical Care Supply Chain Review, 7(1), 30–38.

• Lee, A., Miller, J., & Davis, K. (2023). Burnout in emergency medicine: Causes, consequences, and coping strategies. American Journal of Emergency Medicine, 41(3), 210–218.

SUMMER 2024 THE PULSE

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THANK YOU TO OUR SPONSORS!

EXECUTIVE DIRECTOR’S DESK

Amanda Mahan Executive Director

BUILDING THE FUTURE OF OSTEOPATHIC EM TOGETHER Greetings ACOEP Family, I’m excited to introduce myself as the new Executive Director of ACOEP and to share a bit of my journey with you. My passion for osteopathic medicine runs deep, and I’m committed to not only honoring our history but also working alongside all of you to shape the future of our profession.

About Me

I

joined ACOEP with eight years of experience in association management, with osteopathic associations in particular.

I’ve been proud to be a part of the staff team at the Maine Osteopathic Association (MOA) since 2016 and the Executive Director since 2020. This journey has been profoundly meaningful to me, especially as my own childhood primary care physician was a DO who continues to be a member of MOA. I’ve served as a national leader on the board of the Association of Osteopathic State Executive Directors (AOSED), and I am honored to continue in this role as AOSED’s President-Elect.

My involvement has also extended to the American Osteopathic Association (AOA), where I currently serve on the Bureau of Affiliate Relations and the AOA’s Strategic Planning Committee.

These experiences have allowed me to engage with osteopathic leaders across the country and build a broad, interconnected network that will support ACOEP’s work going forward.

Outside of work, I’m a lifelong Mainer, and home for me includes my husband and our Black Lab, Dill. I have many passions, including travel (I do

travel advising for friends and family), weddings (as a recovering wedding planner), and I serve on the Board of my local humane society. When I’m not doing these things, you can find me bingewatching a good documentary, soaking in the beauty of Maine or exploring local culinary gems.

My Priorities for 2025 and Beyond As I step into this role, my focus for 2025 is to strengthen our osteopathic identity and connections and create more opportunities for all of you to get involved. This is your organization, and I want it to be a community that inspires, supports, and truly represents your interests. Whether at the Spring Conference or through a simple email, my door is always open! I am here to listen, learn, and support you in any way I can.

Embracing Our Shared Osteopathic Legacy This year is a milestone for both ACOEP and the osteopathic profession. ACOEP is celebrating its 50th anniversary, and the osteopathic profession as a whole marks 150 years of rich history.

As we reflect on these incredible milestones, we must also think about how to honor the past while continuing to innovate and grow.

The last decade has brought significant change and growth to our profession. And with change comes new challenges and adjustments. I’m excited to work with all of you to ensure ACOEP remains a relevant, inclusive, and proud home for osteopathic emergency physicians for the next 50 – and hopefully the next 150 –years.

Building the Future Together Moving forward, I encourage you to take pride in our osteopathic identity and engage actively within our community. ACOEP is most successful when we work together, honoring the wisdom of past generations while embracing new ideas and innovations. We are stronger together, and our collective contributions will shape the bright future of osteopathic emergency medicine.

I look forward to meeting you at the Spring Conference and hearing your thoughts, ideas, and feedback. Onward, together.

Warm regards, Amanda Mahan Executive Director, ACOEP Amandam@affinity-strategies.com

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Schedule and Agenda Pre-Conference Sunday, April 27, 2025 10:00­­-11:00am

Executive Committee Meeting

8:00am-5:00pm

RSO Programming

1:00-3:30pm

Board Meeting

1:00-4:00pm

POCUS Ultrasound – Basic Drew Jones, DO, Peter Alamia, DO, Andrea Wolf, MD

Day 2 Monday, April 28, 2025 7:00­­-7:30am

Demystifying urine electrolytes, renal tubular acidosis, and other stuff

7:30­­-8:00am

Updates in EM Part I

8:00-8:30am

Breakfast in Exhibit Hall

8:00am-12:30pm

RSO Programming

8:30­­-9:00am

Complications of Dialysis/AV Fistulas

9:00am-12:30pm

FOEM Case Study Poster Competition

9:00-9:30am

Upper Extremity Injuries of the Shoulder and Elbow

9:30-10:00am

Contrast Induced Nephropathy, Is it Real?

10:00-11:00am

EM Over Easy LIVE Show

11:00-11:30am

Break in Exhibit Hall

11:30am-12:00pm

Upper Extremity Injuries of the Wrist and Hand

12:00-12:30pm

Sepsis in 2025

12:30-1:00pm

Updates in EM Part II

1:00-1:30pm

PERCing through the YEARS: Updates in PE Management

2:00-5:00pm

FOEM New Innovations in Emergency Medicine Competition

2:00-5:00pm

Residency Fair

2:00-5:00pm

Bedside Ultrasound – Procedures

6:00-8:00

Welcome Reception

CME Statement: The American College of Emergency Physicians (ACOEP) is accredited by the American Osteopathic Association (AOA) to provide osteopathic continuing medical education for physicians. The ACOEP designates this program for a maximum of 32.0 AOA Category 1-A credits and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Osteopathic Family Physicians (ACOFP) and ACOEP. ACOFP is accredited by the ACCME to provide continuing medical education for physicians.

ACOFP designates this blended learning activity for a maximum of 32.0 AMA PRA Category 1 Credits™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.

Day 3 Tuesday, April 29, 2025

Day 4 Wednesday, April 30, 2025

7:00­­-7:30am

Updates in ED Documentation Part I

7:00­­-7:30am

Updates in Pediatric Sepsis

7:30­­-8:00am

A Wound Care Conversation

7:30­­-8:00am

Legal Lessons Part I

8:00-8:30am

Breakfast in Exhibit Hall

8:00-8:30am

Breakfast in Exhibit Hall

8:30­­-9:00am

Crucial Conversations in the ED

8:30­­-9:00am

Break Bad News to Kids

Lower Back Emergencies 9:00-9:30am

Shoulder Injuries in the ED

So You’ve Been Sued?

9:00-9:30am

Visual Diagnosis: Derm Edition!

9:30-10:00am

Sickle Cell in the ED Cocci and Complications

Pressors in the ED Part I 9:30-10:00am

Plant Exposures

Interfacing with EMS ENT Tricks of the Trade

10:00-11:00am

ER Cast LIVE Show

11:00-11:30am

Break in Exhibit Hall

10:00-10:30am

Lower Extremity Injuries in Kids

Updates in ED Documentation Part II

10:30-11:00am

EMS to ED near Misses

Tricks of the Trade Ortho Part I

11:00-11:30am

Break in Exhibit Hall

11:30am-12:00pm

12:00-12:30pm

Pressors in the ED Part II

11:30am-12:00pm

Choose Your Own Adventure: 3rd Trimester OB Emergencies 12:30-1:00pm

The Returning Traveler Tricks of the Trade Ortho Part II

1:00-1:30pm

Burning Questions with a Pharmacist

2:00-5:00pm

Entrepreneurial Workshop

The Crashing Cancer Patient

12:00-12:30pm

Legal Lessons Part II

12:30-1:00pm

ACOEP Membership Meeting

5:00-9:00pm

CORE/COLA Review

Day 5 Thursday, May 1, 2025 7:00­­-7:30am

Trouble Shooting Pacers and Defibrillators

Workshop Details

Date/Time

Member

NonMember

7:30­­-8:00am

Diplopia in the ED

POCUS Ultrasound Basic

Sunday April 27 1-4PM

$400

$450

8:00-8:30am

Breakfast in Exhibit Hall

8:30­­-9:00am

Rethinking Running Your Codes

POCUS Ultrasound Procedures

Monday April 28 2-5PM

$400

9:00-9:30am

Peripheral Vascular Trauma

9:30-10:00am

Why ED Observation?

Aesthetics Course No CME Offered

Tuesday April 29 2-5PM

$250

$250

10:00-10:30am

Patient Safety and Quality Improvement in the ED

Wednesday April 30 5-9PM

$300

$350

10:30-11:00am

Break in Exhibit Hall

11:00-11:30am

EKG’s Pearls and Pitfalls

12:00-12:30pm

Child Abuse in the ED Part I

12:30-1:00pm

10 Tips to Get Your ED Observation Unit Started

1:00-1:30pm

Child Abuse in the ED Part II

CORE/COLA Review

$450

Register Today for the 2025 Scientific Assembly!

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ACOEP RSO BOARD

Savannah Volkert, PGY-1 ACOEP-RSO President

RSO UPDATE

HELLO FROM THE RSO! What are we up to?

W

e are excited to provide you with an update on what we have been working on this year!

ACOEP-RSO is an organization that prides ourselves on our commitment to mentorship and advising of any medical student with an interest in EM, with a special emphasis on our osteopathic medical students!

We continue to host quarterly calls with the “Emergency Medicine Interest Groups” or EMIGs from each osteopathic medical school. In these calls we hold space for medical students from all over the nation to collaborate and share what they have been up to. This strengthens our EMIGs and our specialty as these emerging leaders learn from each other and bring innovative ideas back to their individual schools.

In addition, we continue to host quarterly mentorship calls focused on helping our medical student members to navigate complex facets of the journey towards becoming an emergency medicine resident and ultimately an attending physician. These include topics such as writing personal statements, applying for audition rotations through VSLO, creating a rank list, and navigating the SOAP process.

Finally, we are currently looking forward to our spring conference in sunny Arizona! We have many exciting opportunities planned for our student and resident members including a toxicology escape room, various skills labs, lectures on topics ranging from snake envenomations to pediatric fever, 14 | THE PULSE SPRING 2025

and an opportunity to get involved with the local community walking shelter dogs at a local rescue!

Why join ACOEP as a resident or student?

As a current emergency medicine resident, and the president of ACOEP-RSO, my involvement in ACOEP has allowed me to form countless connections within the emergency medicine community that continue to inspire me and fuel my journey. I am endlessly grateful for the friendships and mentors that I have obtained through ACOEP that advocated for me to get interviews, read over my applications, and continue to provide career advice and guidance. I encourage any student or resident reading this to present research at our upcoming conferences, join committees, and network at in-person conferences.

I cannot overstate the value of connecting with mentors, attending conferences, and applying for leadership positions!

Lessons from Residency: What I Wish I Knew as a Student As a current resident, I wish I could tell my medical student self to take the opportunity to really try to glean insights from each individual specialty. Each rotation gives you a small look into the greater scope of medical care in this country, and you likely will not have the opportunity to participate in some of these facets of patient care for the remainder of your career. Embrace the stage of your training that you are in and continue to learn and grow!

In addition, I would encourage my medical school self to master the basics of writing a clear and concise SOAP note, giving an

excellent patient presentation, and performing a solid physical examination that you do time and time again. This strong foundation will carry you far and will allow you to be a more successful and efficient physician!

Finally, do not lose yourself or your humanity in this educational gauntlet. I urge you to continue to cry with patients, hug them, empathize with them, and bring them the turkey sandwich. Even on the longest of days, because ultimately, this job is a privilege in every sense and this ability will continue to keep you grounded and feeling fulfilled from day to day.

Finding the Right Mentor: How to Build Meaningful Professional Relationships ACOEP and the RSO is here to help model mentorship and also help our resident and student members to connect with mentors.

We are a community made up of osteopathic emergency physicians, who strive to make the pathway easier for those who walk behind us. I encourage you to reach out to ACOEP, ACOEP-RSO, attend conferences, make connections at your home program, connect with faculty and residents on away rotations, and reach out to alumni from your school.

Mentorship in my own career has helped me to navigate a complex application process, match into a residency program of my dreams, and find my niche within the world of emergency medicine. Good mentorship continues to push me to become the best version of myself, and navigate any

challenges that I face in residency, emerging stronger because of it. I and the rest of the RSO board seek to do the same for students who navigate these same processes in the years after us!

Preparing for Residency: What You Can Do Now to Set Yourself Up for Success Program directors are looking for self-motivated, hard-working individuals, who are going to be team players in their residency program. Continue to push yourself to learn and grow both as an individual and as a student.

In addition, programs are looking for passionate and interesting residents to spend the next several years with! I wish I could tell my medical student self to do things that make you happy and excite you in your journey. If you continue to partake in experiences that you are passionate about, you will likely gain more from them and ultimately be a stronger candidate because of it. I would also encourage students to try new things, because it is perfectly acceptable to discover new passions along your journey.

Finally, when beginning to apply for residency programs, start by searching for programs in areas of the country that you want to live in. Consider whether you want an academic, a county, or a community program, or apply to a variety of these and discover this about yourself along the way. The things that I love about my program are location, breadth of experiences (from working in a county hospital, rotating through a major academic institution, and spending time gaining rural experience through Indian Health Service), caring faculty, and finally an amazing close-knit group of co-residents!

Ultimately if you find an excellent program in a location that you love, with a group of co-residents who support you and endlessly build you up, and caring faculty who advocate for you and teach you… you will continue to grow and thrive and ultimately excel in residency!

The Future of Osteopathic EM: How Residents & Students Can Lead the Way As a member of ACOEP-RSO, I encourage my fellow members to use their voice to advocate

for osteopathic emergency medicine’s future. You can do this by running for the ACOEPRSO board at our upcoming fall conference in Nashville, joining committees, and participating in our leadership academy each fall! I cannot say enough about the leadership skills that I have gained from my time involved in leadership through ACOEP. If you have thoughts and opinions on the proposal to make emergency medicine a four year residency, I encourage you to fill out this form.

We encourage our members to make their voices heard! Finally, consider attending our spring conference where we will host a town-hall for members to voice their concerns and comments.

ACOEP and ACOEP-RSO will continue to advocate for the best interests of our members.

Thanks for listening, and that’s all for now! Cheers! –•– Savannah Volkert, PGY-1 ACOEP-RSO President Creighton University-Phoenix Resident

Spring Seminar 2025 RSO Schedule Pre-Conference Sunday, April 27, 2025

Day 2 Monday, April 28, 2025

RSO Joins General ACOEP Sessions

8:00-8:25am

ACOEP RSO Welcome Address

7:00­­-7:30am

8:30-8:55am

Inhalation, Blast, and Thermal Injuries: Choose Your Own Adventure Series

Demystifying Urine Electrolytes, Renal Tubular Acidosis, and Other Stuff

7:30­­-8:00am

Updates in EM Part I

9:00-9:25am

Understanding Snake Envenomation and Its Management

8:00-8:30am

ACGME Q&A & Breakfast in Exhibit Hall

9:30-10:00am

TBD

8:30­­-9:00am

Complications of Dialysis/AV Fistulas

10:00-10:25am

AOiA Sponsored Break

9:00-9:30am

Upper Extremity Injuries of the Shoulder and Elbow

10:30-10:55am

“Ditch the Ditch Digging” EM Fellowships

9:30-10:00am

Contrast Induced Nephropathy, Is it Real?

11:00-11:25am

TBD

10:00-11:00am

EM Over Easy LIVE Show

11:30-11:55am

Post Cardiac Arrest Syndrome

10:30-11:00am

Break in Exhibit Hall

12:00-1:00pm

Lunch

1:00-5:00pm

LAB (Airway Obstacle Course, Escharatomy & Burn presentation, Pericardiocentesis/thoracentesis/ paracentesis, Ultrasound Station)

11:00am-1:00pm

Wilderness Medicine Hike

1:00-2:00pm

Lunch

2:00-5:00pm

Residency Fair

Day 3 Tuesday, April 29, 2025 9:00-9:30am

Volunteering at Sun Valley Animal Shelter

RSO AT THE 2025 SCIENTIFIC ASSEMBLY

Join Us at the ACOEP-RSO Residency Fair!

Monday, April 28, 2025 | 2:00-5:00 PM Renaissance Phoenix Glendale Hotel & Spa Glendale, Arizona The ACOEP-RSO Residency Fair offers a more intimate setting where programs can connect directly with students preparing to

Registration is Open Now – Don’t Miss Out! Spots are limited, so register today:

Register Here

apply for residency. ACOEP’s smaller, focused event allows more personalized conversations and meaningful interactions with future Emergency Medicine physicians.

• Recruit Top Talent: Meet driven and passionate students eager to join Emergency Medicine.

• Promote Your Program: Share what makes your residency unique in a relaxed, one-on-one environment.

• Build Connections: Network with students and fellow programs to strengthen the future of Emergency Medicine.

For questions, contact: Janelle DePriest, OMS III Graduate Medical Education Chair, ACOEP-RSO jdepriest@mail.kansashsc.org | gme.rso@acoep.org

ACOEP WELLNESS COMMITTEE

By Tiffany Brown, DO

WELLNESS COMMITTEE UPDATE MENTORSHIP: A TOOL FOR PHYSICIAN WELLNESS

W

e all know the definition of a mentor is a person with more experience or knowledge who provides guidance, support, and advice to a less experienced individual, helping them learn and grow, often acting as a trusted counselor or role model in their development journey.

Mentoring was introduced in the medical field in the late 1990s and has shown itself to be an invaluable professional and personal resource for healthcare leaders at every age and career stage. Given the growing interest around burnout in healthcare settings, understanding the role of mentoring in the experience of burnout could be key to its prevention in such an environment.

Mentorship helps prevent burnout in emergency medicine by providing a supportive network where individuals can share their experiences, receive guidance on managing stress, gain a sense of belonging, and feel empowered to 18 | THE PULSE SPRING 2025

navigate challenging situations, ultimately lessening the feelings of exhaustion and leading to increased job satisfaction and a reduced risk of burnout.

A mentor can also offer practical strategies for coping with the demands of the emergency department, validate concerns, and help maintain a healthy work-life balance.

Mentors can be a source of social support. They can foster discussions during stressful situations and frustrations their mentees may face in the emergency department. It feels great to have someone who knows what you are going through and dealing with. Especially, someone who can relate and has gone through the same emotions before. They can help you navigate those challenges which help to lighten or lift that burden which in turn helps you to breathe, bounce back and move forward.

Mentors also provide guidance and feedback. It is a more personal relationship than when you were in residency training. In fact, you already know the medicine, but a mentor helps build your confidence in decision-making and improve your clinical skills. This helps you to feel more prepared to manage complex cases and reduces your stress related to uncertainty.

So, when more than one critical patient presents to your ED and you are alone, they may say “see the one that is most critical, give verbal orders for the other one and have the unit clerk to consult the specialist.” It is about prioritizing, making the best decision at that time and using your resources.

Now look at you. You are less stressed because you developed those skills and will be able to apply them the next time.

Your mentor has had more experience in the field and is able to share their own experiences and give more insight and perspective on situations. This will in turn help mentees prepare for the challenge, re-evaluate/ reframe the challenge, and see and find potential solutions for that situation. I know hearing ER stories good, bad, and ugly reshapes your thinking especially for cases that may have been near misses. Those stories make you brush up on that topic, replay what to do in that situation and help you to remember to avoid that mistake. You are then better but also grateful for that insight and knowledge that you would not have known and may have had to find out the hard way if it were not for your mentor.

As a mentor you can also learn more about your profession. As the profession grows and changes over time, so do certain methods, ideas, and practices. As a mentor, you may learn and hear about new methods of doing things from your mentee. Some of the old ways of doing things are becoming extinct. continued on page 20

ACOEP WELLNESS COMMITTEE

By John Dery DO FACOEP-Dist, FACEP, FAWM

PEBBLES OF PURPOSE: EMBRACING PHYSICIAN WELLNESS IN EMERGENCY MEDICINE

I

n the frenetic world of emergency medicine, where seconds can decide life or death and every shift is a blend of triumphs and tribulations, maintaining physician wellness is both an art and a necessity.

As a practitioner who has spent countless hours in high-pressure environments, I have learned that self-care is not a luxury—it is the foundation of effective patient care. Amid the chaotic rhythms of our profession, I have developed a simple yet profoundly meaningful ritual: at the end of every shift, I collect a small rock, each one a tangible reminder of a moment— good or bad—that defined that day.

These humble stones, carefully stored in a box at home, symbolize the reality of my career, reminding me that every shift, with its mix of success and struggle, has contributed to the lives of hundreds of patients.

The Highs and Lows of Emergency Medicine

society often celebrates our successes, it is equally important to acknowledge and learn from the less favorable outcomes. In my own practice, the collection of rocks represents this balance.

Each stone—whether a symbol of a life saved or a hard lesson learned—serves as a reminder that every experience is integral to the tapestry of my career.

The Ritual of Collecting Rocks At first glance, the act of collecting rocks might seem trivial or even eccentric. However, this ritual has evolved into a deeply personal and reflective practice. At the end of each shift, I take a moment to pause, breathe, and contemplate the events of the day. I pick up a small rock, often finding one that resonates with the mood of the shift. On days filled with hope and accomplishment, I might choose a smooth, warm stone that feels

reassuring to hold—a token of the lives touched and the resilience witnessed in the emergency department. Conversely, on days shadowed by loss or frustration, I select a rock with a rough texture, a silent acknowledgment of the pain and the complexities inherent in our work.

This simple act of collecting a rock does more than commemorate the day—it serves as a daily debrief with myself, a moment to honor both the victories and the setbacks. Over time, the growing collection in my box at home has become a physical record of my journey, a testament to the fact that my career has mattered. Each stone is a reminder that I have faced the most trying moments and the most exhilarating victories, and that each experience has contributed to my growth as a physician and as a human being. continued on page 20

Emergency medicine is a realm where the outcomes are as unpredictable as the patients who cross our threshold. On some shifts, the adrenaline of a successful resuscitation or the relief in a family’s eyes after a critical intervention reminds us of why we chose this demanding field. These moments shine like small beacons amid the often overwhelming darkness. Yet, there are also shifts marked by the weight of loss—outcomes that defy our best efforts. Such days carry a heavy burden, and the memories of these experiences can gnaw at the spirit long after the shift ends.

Balancing these extremes is essential for sustaining our long-term well-being. While

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PEBBLES OF PURPOSE: EMBRACING PHYSICIAN WELLNESS IN EMERGENCY MEDICINE Embracing Vulnerability in a High-Stress Environment The emergency department is a crucible of high stress and time compression. We operate under conditions that demand rapid decision-making, where the margin for error is slim and the stakes are always high. In such an environment, vulnerability is often seen as a weakness. However, I have come to understand that acknowledging our emotional responses—to both good shifts and bad—is a critical component of physician wellness.

Collecting these small tokens of memory allows me to be vulnerable with myself. It is an acknowledgment that I am not invincible, that there are days when the weight of responsibility feels almost unbearable. Yet, in embracing this vulnerability, I find strength. The ritual teaches me to accept that not every day will be perfect, and that the imperfections are what make our contributions real and meaningful. By honoring

continued from page 18 It will help you to stay abreast of new techniques and alternative ways of doing things. It opens you to innovative approaches and prospectives by listening to others.

Having a great mentorship relationship provides you with support, trust, and open communication. With a mentor, you can ask for help without feeling scared or nervous, you have someone you can bounce ideas off, vent about the challenges of the day without worry, learn from their experiences and mistakes, identify your areas of improvement, and develop new skills.

Mentorship can give us a sense of belonging and connection within the emergency medicine team, which is important in such a high-pressure environment. You do not and should not have to do it alone!

20 | THE PULSE SPRING 2025

both our successes and our failures, we can foster a more sustainable, empathetic approach to our work.

The Ripple Effect of Self-Care Prioritizing physician wellness is not just about individual self-care—it has far-reaching implications for the quality of care we provide. When we take time to reflect on our experiences, to process both the highs and the lows, we are better equipped to engage compassionately with our patients. The ritual of collecting rocks reminds me that every patient interaction, whether it ends in a resounding success or a quiet tragedy, shapes my professional identity. It reinforces the idea that our work is not measured solely by clinical outcomes, but by the humanity we bring to each encounter.

Moreover, this practice encourages a culture of openness and resilience among colleagues.

When we share our experiences

Mentors can teach effective strategies for managing stress in the emergency department. There is a reason they have been there thriving for this long. They can advise you on time management such as how to effectively see patients and do notes and decrease the amount of time you spend after work charting.

They can help you develop strategies and techniques to help you manage difficult patients. This allows you not to get frazzled, argue or lose your cool with your patients. More importantly, mentors can teach you the self-care practices they have used to become resilient and show up every day and be effective. Remember, you cannot lose sight of your “why.” It is the sole reason that you are in medicine.

A great mentor-mentee relationship can benefit both parties.

Mentees benefit from the knowledge they otherwise would never have learned from a book, clinicals or

and the lessons learned from our personal rituals, we can support one another in navigating the emotional challenges of emergency medicine. In doing so, we create an environment where wellness is prioritized, where every member of the team feels seen and valued—even on the toughest days.

In the relentless pace of emergency medicine, where every shift is a microcosm of hope and despair, focusing on physician wellness is imperative. My ritual of collecting small rocks has become a symbol of my journey—a tangible reminder that every day, regardless of its outcomes, contributes to a career that has truly mattered. These stones, collected one by one, embody the essence of our practice: the blend of triumphs and trials that define the human experience.

As we continue to navigate the complexities of emergency care, let us remember that each shift, with all its imperfections, is a step toward a more compassionate and resilient future. –•–

online. That guidance in turn helps them to avoid many mistakes, to identify their weaknesses, and their clinical and knowledge gaps early, which will give them an advantage on their journey to success in the ED. Mentors find satisfaction in knowing that their mentee is doing great things and that they have positively influenced and helped to advance their mentees’ career. Not only is it highly rewarding, but it also helps mentors to further develop their leadership skills and enhance their professional networks.

Are you ready to become a mentor?

Do you want the opportunity to help others, make new friends, enhance your leadership skills, and enhance your chances of moving forward? Are you ready to give back to the profession and develop the next generation of leaders?

If so, mentoring could be a fantastic opportunity for you. –•–

CHECK OUT ACOEP’S DIGITAL CLASSROOM WHEN YOU NEED ON-DEMAND CME CREDITS

Digital Classroom Link

Selley’s Social Club Places to try while in Glendale, Arizona!

• Spa Botanica A full-service spa at the Renaissance Phoenix Glendale Hotel, offering massages, facials, and body treatments.

• Topgolf A high-tech golf driving range with food, drinks, and games for all skill levels.

• Bar Louie A lively bar and grill in Westgate with craft cocktails, burgers, and live music.

• Dave & Buster’s A restaurant and arcade with games, bowling, and sports viewing.​

• Desert Diamond Arena Formerly known as Gila River Arena, this is a major venue for concerts, sports, and events in Glendale..

• Stir Crazy Comedy Club A comedy club in Westgate featuring standup acts and improv shows.​ • Escape Westgate An escape room experience with themed challenges for groups.​ • LumberJaxes An axe-throwing venue for a fun, competitive group activity.

• PopStroke A modern mini-golf venue with two 18-hole courses, a restaurant, and a rooftop bar.

This one is all about you!

These are all the things you said you wanted near a conference and they are all less than a mile away!!

• Tanger Outlets A shopping center with discounted brand-name stores.

• Rainbow Ryders Hot Air Balloon Co. Rainbow Ryders offers hot air balloon rides over the scenic landscapes of Arizona.

Flights typically take place at sunrise and is a memorable experience for those looking to see Arizona from the sky.​ • Westgate Entertainment District With over 20 restaurants and bars, a 20-screen AMC theater, and various shops, it’s a hub of activity and a central spot for visitors looking for a variety of experiences.​

Additional Glendale, Arizona Travel Information

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ACOEP PRACTICE ADVOCACY COMMITTEE

PRACTICE ADVOCACY COMMITTEE UPDATE

By Jeremy Selley, DO, FACOEP Chair, ACOEP Practice Advocacy Committee

ADVOCACY & INVOLVEMENT LINKS ACOEP ADVOCACY UPDATES

TAKE A STAND

acoep.org/advocacy-update

R

acoep.org/about-acoep/committees

JOIN THE PRACTICE ADVOCACY COMMITTEE ising health insurance costs and the monopolization of healthcare by insurance companies is a threat to the entire house of medicine and individual patient consumers.

Since 2010, the cost of healthcare premiums have increased over 84%.

Inflation during the same period has gone up 44%. That means if you had a $500/month health insurance premium/month with an employee sponsored plan in 2010 that same premium is $920-$1000/month today and with some companies the cost is even double that. Healthcare premiums have far outpaced inflation but yet all major insurance companies have recorded major billion-dollar profits.

Why are the health insurance companies making such record profit in the face of rising healthcare costs? Charging premiums and investing those premiums into interest generating assets are the two main ways insurance companies make profits.

Underwriting profit is when insurance companies collect more in premiums than they pay out in claims. Insurance companies also delay claims and earn interest on unpaid claims. Downcoding is a practice involving assigning a lower billing code than what is justified by the medical services provided. By delaying the payment on a claim, the insurance company can pressure the providers and companies into accepting a lower reimbursement amount and double dip by downcoding as well.

An audit trigger is when a provider disputes a downcoded claim and the insurance company initiates an 22 | THE PULSE SPRING 2025

audit to further review the medical record and causing a further delay.

In 2023, 50% of nongovernmental employees insured had a High Deducible Plan (HDP). They allow a lower monthly premiums but have become catastrophic plans for most families with out of pocket maximum over $10,000-$15,000 in some cases. In 2025, the HDP Health Savings Account (HSA) limit is $8550. Unfortunately, the HSA contribution part of the HDP is not required, so this has further created a chasm by keeping monthly premiums and savings contributions low by limiting the amount that truly comes out of most people’s paychecks to help to pay for medical debt incurred. Ideally, you can afford to make both your monthly health insurance premium and the full $8550 yearly contribution to your HSA but most Americans cannot do that. Moreover, contributing and maxing your HSA creates a secret 401K option when you also have the ability to pay for your health-related expenses and keep your HSA invested……also a luxury most Americans do not have.

Vertical Integration of care and maximization of profits is the goal of CVS Health Corporation, The Cigna Group and United Health Group Inc. Together these top three companies comprise 79% of the health insurance market. Their legal and illegal practices and vertical integration monopolies is also why the Federal Trade Commission (FTC) sued these top three and their respective Pharmacy Benefit

DONATE TO A PAC NEMPAC (ACEP) | OPAC (AOA)

KNOW YOUR LEGISLATORS Find Your Rep/Senator

ATTEND NATIONAL ADVOCACY EVENTS D.O. Day on the Hill (AOA) ACEP Leadership & Advocacy Conference

TAKE ACTION NOW ACEP 911 Grassroots Network AOA Grassroots Action Center Managers (PBMs) on September 20, 2024. These organizations have gone unchecked after decades of vertical integration and are detrimental to patient access to pharmaceuticals essential for their care, limiting access to critical patient medications post Emergency Department (ED) visit for insured and uninsured patients alike.

Insured patients face increased copay obligations that can become so extreme that patients may delay taking their medication, skip doses, or even go without them entirely, sometimes with fatal results. Cash-pay patients, including the uninsured face collateral impact from these exclusionary rebates. When generic drugs enter a market, prices tend to fall dramatically.

But pharmacies will not stock what they cannot profitably sell. If generics are disfavored on formularies, pharmacies are disincentivized from stocking those generics, potentially reducing accessibility to less expensive generic products.

PBMs have added their profits and strengthened vertical health insurance oligopoly price-controls while shifting costs towards patients’ out of pocket responsibilities.

PBMs have created detrimental conditions to unaffiliated and independent pharmacies, leading to independent pharmacy closures which has further stifled supply, raised costs, and further limited patient access.

As one example, in 2024 CVS Health had revenue $372.8 billion up 4.2% from 2023 and created $9.1 billon in profit. In 2023 Karen Lynch, CEO of CVS Health made a $21.6 million salary.

CVS Health Vertical Integration/ Monopoly of Care: • Drug Private Labeler – Cordavis Limited • Health Care Provider – MinuteClinic, Signify Health • PBM – CVS Caremark • PBM Rebate Aggregator – Zinc Health Services

• Pharmacy Retail – CVS Pharmacy • Pharmacy Mail Order – CVS Caremark Mail Service Pharmacy • Pharmacy Specialty – CVS Specialty Pharmacy If we do not fix the monopolization and vertical integration of health insurance, they will all become catastrophic policies and will not pay for anything regardless of how much we pay into them. The health insurance companies will eventually run all aspects of medicine and will shift away from health and toward profit only, unless our legislators fix it! The entire house of medicine needs to “take a stand” to fix these problems, but it starts today by you getting involved! Every EM physician reading this can afford $100/month to whatever PAC you choose as well as make sure you pay dues to whatever EM organization you want to represent you. With the changes we need addressed, you cannot afford not to. PAC dollars are what

get us into the door and allow us to develop the relationships we need to get a seat at the table to help educate our legislators. The leaders in our EM organizations facilitate the discussions to help make the change.

What can I do?

1. Donate to any Political Action Committee (PAC) NEMPAC, OPAC 2. Get involved and at least familiarize yourself with your US House Representative and US Senator and ask for their help to: a. Fix the health insurance monopoly b. Take the power out of the hands of the health insurance companies 3. Go to D.O. Day on the Hill or ACEP Leadership and Advocacy Conference (LAC) 4. Sign up for action alerts so that when bills come up you can easily email your representatives asking for their support. –•– SPRING 2025 THE PULSE

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CALL FOR

GUEST EDITORS In collaboration with WestJEM

Help us publish case reports from ACOEP’s annual meetings in WestJEM each year.

Email us at info@acoep.org

MISSION TRIP

Jeremy K. Selley, D.O. FACOEP

MISSION TRIP TAKE A CHANCE

W

hen a medical team member goes on a medical mission trip it is usually from a moment of “right timing” and a “familiar face.” There are so many different organizations out there that go to so many wonderful places and so many people that need help. Conflict zones and natural disasters are other moments of opportunity that arise when folks need care.

There are also many religious organizations that execute a combination of evangelical and medical missions.

“How do I choose or maybe next year?” I hear all the time when I solicit for team members. The cost usually approaches $2000 and 8-9 days off is a lot to commit to. Thankfully most of these trips are tax-deductible secondary to organizations having 401(c)(3) status that includes your team fee and flight. In the 7 years that I have helped coordinate teams, one way I have tried to make it easier for schedule purposes was to schedule a trip over two calendar months. This is usually helpful for our partners so all 8-9 days are not in one calendar month.

“Is it unsafe?” The first time you go on any mission trip out of the country can be nerve racking.

I myself, wrote good-bye letters to my family members the first time I went 8 years ago. That seems really funny to me now, but it was an honest first-time jitters emotion.

Large groups of missionaries traveling together and the places they go are usually all very safe.

If someone you know is coordinating a medical mission trip, take an honest self-reflection of why you wouldn’t be able to go

Change Lives

and take a leap of faith Join a Short-Term Medical Mission! to join them. “Take a Chance!” You may only to Honduras know the one person coordinating the trip, but Thousands in the mountains of Honduras live I promise you come home without basic medical care. As a doctor, you can from the trip a changed change that. Join CHHF’s short-term medical person with an entire missions and provide life-saving care to team of close friends.

Aside from making new those in desperate need. Your acquaintances on your skills will offer relief, hope, and team, the patients you a healthier future for will meet will forever communities with little to no change your life and access to medical services. heart toward medical missions. When you get Make a lasting impact — on that plane ride home you will be overjoyed with volunteer today and be the emotions and I guarantee healing they’ve been waiting most of you will find yourself saying, “how do I sign up for next year?”

“The work goes on, the cause endures, the hope still lives and the dream shall never die!” mission trip and the experience you This is one of my favorite Senator will gain by treating the patients.

Edward Kennedy quotes as he The patients are so grateful to see ended his 1980s Presidential run, you. They will walk miles in the however it means a lot more to sweltering summer heat, some of me because it is so much more which while carrying a baby and than political. I feel this way with additional 2-3 kids in tow. Most about the Carolina Honduras of the time, they don’t even have Health Foundation or CHHF access to healthcare let alone the (www.chhf.org). We all get so busy ability to pay. This is why, speaking in our day to day life, but missionary with their religious leaders about work is by far the single most their health concerns is sometimes rewarding aspect of healthcare. If the only place they have to turn. you are looking to do something to The grace you receive by helping help find that work-life balance or those in need will be returned to you maybe in search of a mental break exponentially. So…Take a Chance! from the day to day stresses that we Commit to a team! It will change encounter, then consider a mission your life. For me, as Mark Twain trip. The people you will work with stated, “The two most important and the patients you will encounter days are the day you are born and create a passion to do more! the day you find out why!” Maybe Grace and Gratitude. This is CHHF is also your reason why? –•– what you can expect by going on a

Be the difference.

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ACOEP WOMEN IN EM COMMITTEE

WOMEN’S COMMITTEE UPDATE

Jacqueline M. Dziedzic, DO, FACEP, FACOEP Chairwoman

THE IMPORTANCE OF MENTORSHIP FOR WOMEN IN EMERGENCY MEDICINE

W

omen face unique challenges and gender specific barriers in emergency medicine (EM) that can hinder career advancement. AAMC published a report on the State of Women in Academic Medicine 2023-2024: Progressing toward equity. 2 It shows progress in representation and some increase in leadership roles, but female physicians continue to be paid less than male physicians and there are high rates of gender harassment.

Representation is improving with the majority of graduating medical students in the U.S. being female;2 but women only account for approximately a quarter of practicing emergency physicians across the country4 so there is still work to do. Some women leave EM as early as residency, and according to a 2023 study by Gettel et al, 5 women physicians leave the EM workforce at an age approximately 12 years younger than male physicians. 8 There have been some increases in leadership roles, with women now representing 27% of US medical school deans, 34% division chiefs and 45% senior associate deans but only 25% female department chairs and only 12% female EM department chairs. 9 Sadly, these numbers have increased and yet they are all still under 50%. A white paper written by Agrawal et al reports that even though recent studies show superior outcomes among patients treated by female EM physicians; disparities in advancements persist. “This substantial decline in proportion 26 | THE PULSE SPRING 2025

“ Be the woman who

of women from medical school to leadership positions among academic EM faculty groups is troubling and speaks to larger issues in the recruitment and retention of women in EM.” 7 Female physicians continue to be paid less than male physicians.

At 26%, for example, the gender income disparity for physicians in the U.S. is substantial. It is wider than in most other occupations. In absolute terms, women physicians earned nearly $110,000 less than their male counterparts, even when controlling for specialty, location and years of experience.⁶ There are high rates of gender harassment in academic medicine “highlighting the urgent need for cultural and systemic changes to create a safer and more inclusive environment.” 2 In EM, more than half of women have reported sexual harassment. 2 Mentorship plays a critical role in overcoming these obstacles, providing support and guidance and opportunities for professional growth. This article explores the significance of mentorship for women in EM, highlighting a successful mentorship program and offering insights on how to find the right mentor. Mentorship is a crucial resource for female emergency physicians.

Significance of Mentorship for Women in Emergency Medicine Mentorship is more than just a professional relationship; it is a pathway to empowerment and growth. “In medicine, it is easy to feel like we are alone in our struggles–whether it’s imposter syndrome, contract negotiations,

fixes another woman’s crown without telling the world it was crooked. Amy Morin¹

discrimination, or balancing home life. But we’re not. In those moments, leaning on mentors is invaluable. They provide guidance, affirmation, and the perspective needed to navigate challenges and thrive.” says Andreia B Alexander, MD, PhD, MPH, Assistant Professor of Emergency Medicine, Medical Director of Health Equity-IU Health Indy Metro Region and Director GME Health Equity Education Pathway IUSM. Mentoring has been positively linked to career satisfaction, perceived success, networking opportunities, stress management, and a more productive academic career.11 For women in EM, mentorship can provide: • Guidance and Support: Mentors can offer valuable advice on navigating the complexities of career progression, including balancing clinical responsibilities with personal life and pursuing leadership roles.

• Networking Opportunities: Mentors often have extensive professional networks, which can open doors for mentees to connect with influential figures in the field and gain access to job opportunities, conferences and collaborations.

• Skill Development: Through mentorship, female physicians can enhance their clinical skills, leadership abilities and research acumen, preparing then for advancement to higher-level positions.

• Confidence Building: Having a mentor can boost self-esteem and confidence, helping women to overcome imposter syndrome and assert themselves in male dominated environments.

A Very Successful Mentorship Program I had the amazing opportunity to sit down and talk with Julie Welch, MD, Professor of Emergency Medicine and Vice Chair of Faculty Affairs & Development at Indiana University who launched the Women in Emergency Medicine Program in 2004. In my opinion, this program is the epitome of what we should strive for in our departments. As posted on their website, “The mission of the Women in Emergency Medicine Program is to provide a supportive environment for personal and professional development. The primary focus is to initiate and cultivate mentoring relationships between women faculty, residents, medical students, spouses, staff and alumni. The program addresses topics pertinent to shared experiences, as well as promotes advocacy, skill building, recognition, advancement, sponsorship and gender equity.”

Per Dr. Welch, the program is so successful because even 20 years later it is still so relevant. “When you focus on equity for one, then everyone benefits.” The group has built initiatives that advance women and gender equity and have also disseminated their work and outcomes in the form of published studies. They have created a family planning elective in emergency medicine residency, developed a women’s leadership

skills training course and implemented a women’s mentoring program to name a few.

They host bimonthly events at the home of a faculty member and discuss a multitude of topics including: work-life policies for women (maternity leave, lactation policies, childcare, and flexible work arrangements), defining success, balancing family and career, time management, career opportunities and obstacles, networking, gender discriminations in the workplacelegal guidance and advice, negotiation and advancement and leadership. Their program follows the feminine style of communication (cooperative, focusing on similarities, togetherness and harmony), thereby facilitating mentoring relationships and collaboration.11, 12 This mentoring program offsets the mentoring demands of faculty by recruiting additional alumni mentors and uses a mosaic of vertical and peer mentoring. The

did I find helpful or supportive and I eventually grew to find my own mentor in another physician who happened to be male, but who was the right fit for me.” Finding a mentor that you admire and feel comfortable with will set you up for success. Also, you may need more than one mentor. A career mentor is devoted to advising you on overall professional development. A life mentor can provide guidance and advice that goes beyond professional life and extends into personal life and can assist with preventing burnout.

Peer mentorship is between you and another colleague at a similar career stage. Peer mentorship allows discussion of common career challenges and solutions. A peer mentorship relationship can evolve into amplified networking and mutual support. Ultimately, it is the quality not the quantity of mentors that matters.

Here are some steps to consider when seeking out your mentor:

program has succeeded in being a valuable resource, has led to many achievements, and offers topics for a gender-specific curriculum for women in academic medicine.11

• Identify your goals: Before seeking a mentor, clarify your career goals. Are you looking to advance clinically, pursue research or move into a leadership position? This will help you identify potential mentors who align with your aspirations.

Finding the Right Mentor is Crucial for a Successful Mentorship Experience Being assigned a mentor does not always work well. For example, emergency medicine physician, Jennifer Himmel Salch, DO was assigned a mentor in residency because she was female but they had nothing in common. “We met on two occasions, neither of which

• Look within your network: Start by examining your existing network. Consider senior colleagues or even peers who have had positive experiences in their careers. Networking events, conferences and continued on page 28 SPRING 2025 THE PULSE

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professional organizations like ACOEP’s Spring Seminar are also excellent places to meet potential mentors. Ask for recommendations: Reach out to fellow female physicians, residency coordinators or faculty members for recommendations.

They may know experienced individuals who are open to mentoring.

• Be proactive and approach potential mentors: Don’t hesitate to reach out to someone you admire. Prepare a concise introduction of yourself and express your interest in mentorship. Be clear about what you hope to gain from the relationship and how you believe they could help.

• Establish clear expectations: Once you find a mentor, discuss and set clear expectations from the outset. Determine how often you will meet, what topics you want to cover and how you will communicate.

Bibliography 1. Amy Morin, 13 Things Mentally Strong Women Don’t Do: Own Your Power, Channel Your Confidence, and Find Your Authentic Voice for a Life of Meaning and Joy

• Be open to feedback: A successful mentorship relationship is built on mutual respect and trust and open communication. Be receptive to constructive criticism and advice from your mentor.

In conclusion, finding a good mentorship relationship is essential for female emergency medicine physicians as they navigate their careers.

We are faced with many gender disparities; which are multifactorial and include work life responsibilities, discrimination, harassment and lack of mentorship. 3 In a 2024, health careers women in medicine study, women surveyed recommended: equitable pay, mentorship programs, opportunities for career development and policies that promote work-life balance as things that can help them feel valued and supported in their roles. Simple steps you can take to

Emergency medicine physician workforce attrition differences by age and gender. Acad Emerg Med. 2023 Nov;30(11):1092-1100. doi: 10.1111/acem.14764. Epub 2023 Jun 23. PMID: 37313983; PMCID: PMC10973949.

2. https://www.aamc.org/datareports/data/state-womenacademic-medicine-2023-2024progressing-toward-equity

6. https://www.forbes.com/sites/ joshuacohen/2023/10/10/asubstantial-gender-pay-gap-inhealthcare-persists/

3. Bona, A., Ahmed, R., Falvo, L. et al. Closing the gender gap in medicine: the impact of a simulation-based confidence and negotiation course for women in graduate medical education. BMC Med Educ 23, 243 (2023). https:// doi.org/10.1186/s12909-02304170-y

7. Agrawal P, Madsen TE, Lall M, Zeidan A. Gender Disparities in Academic Emergency Medicine: Strategies for the Recruitment, Retention, and Promotion of Women. AEM Educ Train. 2019 Dec 12;4(Suppl 1):S67-S74. doi: 10.1002/aet2.10414. PMID: 32072109; PMCID: PMC7011407.

4. https://www.aamc.org/datareports/report/us-physicianworkforce-data-dashboard

8. Nikita A. Salker, Andrea Fang, Michelle Lall, Michael Bond, Melissa White, Pooja Agrawal, Kinjal N. Sethuraman, Where Are They Now? Attrition Rates of Emergency Medicine Residency Graduates by

5. Gettel CJ, Courtney DM, Agrawal P, Madsen TE, Rothenberg C, Mills AM, Lall MD, Keim SM, Kraus CK, Ranney ML, Venkatesh AK.

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support your colleagues include: bring up female colleagues’ accomplishments to leadership, encourage flexible schedules as needed, help with shift coverage when women face unpredictable caregiving responsibilities, initiate discussions about burnout and other barriers that are critical to women in medicine, notice and intervene when female coworkers are interrupted or talked over during meetings and recognize and thank the female leaders around you.10 This article explored the importance of mentorship for women in EM, highlighted an amazing mentorship program at Indiana University and offered insights on how to find the right mentor for you. Mentorship will remain a cornerstone in empowering women to achieve their full potential. Continue to get out there and support your amazing colleagues! –•–

Gender, Annals of Emergency Medicine, 2024,ISSN 01960644, https://doi.org/10.1016/j. annemergmed.2024.09.017.

9. How Female Physicians Are Changing the Face of Emergency Medicine Stacey Kelleher March 13, 2023 10. Celebrating Women in Medicine.

Addison Hudgins September 05, 2024 6 11. Welch JL, Jimenez HL, Walthall J, Allen SE. The women in emergency medicine mentoring program: an innovative approach to mentoring. J Grad Med Educ.

2012 Sep;4(3):362-6. doi: 10.4300/ JGME-D-11-00267.1. PMID: 23997883; PMCID: PMC3444192.

12. Tannen D. You Just Don’t Understand: Women and Men in Conversation. New York, NY: Ballantine; 1990.

SCIENTIFIC ASSEMBLY PHOTO FLASHBACK! Thank You for an Unforgettable 2024 Scientific Assembly!

A huge thank you to our attendees, speakers, and presenters for making this year’s Scientific Assembly one to remember! From engaging Hippo Education sessions to a full day dedicated to the best in emergency medicine podcasts, this event was packed with learning, connection, and innovation.

We saw hands-on workshops, two full days of Resident Student Organization (RSO) programming, and a residency fair that welcomed over 30 programs.

The excitement continued with four FOEM competitions, showcasing the next generation of emergency medicine leaders, and we capped it all off with an inspiring awards and fellowship ceremony.

We’re already looking ahead to Spring Seminar 2025 in Glendale, Arizona, April 27-May 1—don’t miss out! Register now to take advantage of early bird savings!

Register Here

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FOEM Fall Competition

Award Winners Scientific Assembly

Congratulations to everyone who participated in the 2025 FOEM Scientific Assembly Competitions!

FOEM Award Winners

Research Posters

1st Place

1st Place

Lucas Gerbasi

Dhimitri Nikolla, DO, MS

2nd Place

2nd Place

Aviya DiStefano

Faith Hendrickson, BS 3rd Place Danielle Deegan

Clinical Pathological Case (CPC) Competition

Oral Abstract

1st Place

1st Place

Shaylor Klein, DO

Eric Wetzel, DO

2nd Place

2nd Place

Jaquelyn Kohler, MD

Christine DePope, DO

3rd Place

3rd Place

Palna Kapadia, DO

Hanna Harris

Thank you again for your participation!

Best wishes in your future research endeavors.

The Board of Trustees of the Foundation for Osteopathic Emergency Medicine thanks you for participating in the competition and hope that you will participate in future events like this as a Resident or apply for research grants as a physician.

The Foundation is here to help serve the research needs of the specialty of emergency medicine and hopes that you have found the creation of a research paper a worthwhile experience worthy of repeating in the future.

Join Our ACOEP Network!

Stay connected with the ACOEP family and enhance your networking opportunities by following us on social media! Whether you’re seeking to foster professional relationships, explore exciting events like our Scientific Assembly and Spring Seminar, or connect with fellow emergency medicine professionals, our social media channels offer a vibrant community and valuable updates. Join us as we build a supportive network that celebrates growth and collaboration in emergency medicine.

Follow us today and be part of our journey toward collective success!

@theacoep

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@acoep

ACOEP Official

American College of Osteopathic Emergency Physicians

info@acoep.org