Newsletter of the Society for Academic Emergency Medicine
PRESIDENT’S MESSAGE Funding for Emergency Medicine Initiatives Emergency Medicine has come a long way in the past 25-30 years. The number of residency programs has grown tremendously and academic departments have sprouted. Yet in comparison to other Marcus Martin, MD more established specialties such as Internal Medicine, Surgery and Pediatrics we still have a great distance to go in terms of funding. All medical specialties need resources for continued development. Financial resources for emergency medicine are typically derived from revenues generated through patient care. But generally patient care revenue in academic emergency medicine is not enough due to many reasons such as the payer mix, contractual adjustments, safety net factors leading to high volume of self pay, indigent and free care. Gross collection rates average around 50% for most emergency departments, with many struggling to attain that level. Improved documentation, accurate coding and appropriate levels of reimbursement by the third party payors can all help. Department chairs, medical directors and business managers are challenged with the goal (at minimum) to obtain budget neutrality after compensating for salaries, benefits and all other expenses including; supplies, equipment, dean’s taxes, travel, billing and collection fees, etc. Beyond budget neutrality is the desire to obtain resources for salary raises, incentive pay, contributions to reserve and ample funds left to support various academic endeavors. When patient care revenue alone is not enough to subsidize expenses, our operations may depend upon allotments from the hospital and the medical school to make ends meet. We have been referred to throughout the history of emergency medicine as loss leaders for the hospital, although we know the downstream effect is very positive for hospitals. The emergency department evaluates, stabilizes and admits to the hospital and the hospital derives income from this process. Patients treated and released from the ED, as well as those admitted, are revenue sources for the health system as the hospital bills for the patient encounter. There is also the downstream effect of revenue generation for clinics and ancillary services. Academic emergency medicine must look to other sources of funding in addition to patient care revenue and hospital and (continued on page 18)
September/October 2001 Volume XIII, Number 5
Emergency Medicine Activities at the AAMC Annual Meeting The Association of Academic Chairs of Emergency Medicine (AACEM) and SAEM have developed a number of educational sessions to be held on November 4 during the AAMC Annual Meeting. The sessions will be held at the Omni Shoreham Hotel in Washington, DC. All emergency physicians are invited to attend any of the sessions described below at no charge. However, pre-registration for the lunch session is required. Please register for the lunch session via e-mail at saem@saem.org. Contact the SAEM office with any questions. The sessions begin in the Senate Room at 9:00 am with a presentation entitled, “Preserving the Emergency Medicine Safety Net.” Panelists will include James Hoekstra, MD, James Gordon, MD, and Lynne Richardson, MD. At 11:00 am a session entitled, “NIH Funding Opportunities for Patient-oriented Research” will feature Belinda Seto, PhD, Director of the Office of Reports and Analysis (ORA) and Deputy Director of the Office of Extramural Research (OER). Dr. Seto is responsible for developing and maintaining the Computerized Retrieval of (continued on page 13)
AEM Call for Papers “Assuring Quality” The Editors of Academic Emergency Medicine announce the next AEM Consensus Conference on “Assuring Quality” to be held on May 18 in St. Louis. The conference will aim to describe means of defining, assessing, measuring, and researching the delivery of quality emergency care in the clinical setting. We believe the conference is a logical progression in our consensus series, which has included “Errors in Emergency Medicine,” and “The Unraveling Safety Net.” We therefore issue this call for papers related to the topic of Assuring Quality. Submitted manuscripts are due on March 1, 2002. Accepted papers will be published in the late fall of 2002, along with Proceedings from the consensus conference. Please submit eligible papers to the AEM editorial office in Lansing at aem@saem.org. Electronic submission of the original and a blinded copy are preferred. Submit also a cover letter clearly indicating that your submission is for the Assuring Quality Consensus Conference. General instructions for authors appear at www.saem.org/inform/journal.htm. Any questions regarding this call for papers on the AEM Consensus Conference can be directed to Michelle Biros, MD, at biros001@maroon.tc.umn.edu or Jim Adams, MD, at: jadams@nmh.org.