In the Beginning…
When Ohio Chapter ACEP was founded in 1972, its mission was simple: to promote quality emergency medical care and to represent the interests of Ohio’s emergency physicians. In the decades that followed, the Chapter’s scope of activities has expanded greatly and now includes influential work on public policy, world-class educational resources, and emergency physician leadership development.
When Ohio ACEP was chartered, the profession of emergency medicine was quite different than it is today. The specialty was not yet an officially recognized medical specialty, and its early advocates sometimes faced resistance in their search for legitimacy. The American College of Emergency Physicians—the first professional organization for emergency physicians—had been founded only four years before in response to increasingly chaotic emergency departments’ need for full-time emergency physicians.
The first emergency physicians knew that theirs was a medical specialty distinct from others in the House of Medicine. This emerging medical field had a deeply ingrained spirit of generosity and an inherent duty to serve all patients, often without the promise of consistent compensation.
Some would say these unique guiding principles made for equally unique character of the doctors themselves. Emergency physicians thrived on difficult cases and were at their best in the often-frenzied setting of the emergency department. In the beginning, they were short on resources, but their energy and determination provided the drive that would help make emergency medicine what it is today.
Continuing Medical Education: An expanded role for the Chapter
Continuing medical education is one of Ohio ACEP’s most well-known functions today, but its first course offering would not be until six years after the Chapter’s charter. The first Advanced Cardiac Life Support (ACLS) course was offered in 1978 and instructed by Ohio ACEP President, Dr. John Cahill and future Chapter President, Dr. Bruce Janiak, who is also the nation’s very first residency-trained emergency physician!
Subsequent courses developed and offered by Ohio ACEP included non-clinical topics such as reimbursement best practices and emergency department risk management. In 1982, an early version of the Oral Board Review Course was first offered, giving attendees a chance to practice the Oral Board Exam with mock emergency cases.
With the introduction of the Emergency Medicine Review for the Written Board Exam in 1985, there was a shift in the way Ohio ACEP thought about its role in Ohio emergency medicine. The EMR Written Board Preparation course would later be thought of as the Chapter’s “financial lifeline” as it helped to bring in much-needed revenue used to invest back into its membership. Today, the Board Review is a nationally-recognized educational event attracting physicians from all over the world.
In the years that followed, Ohio ACEP would go on to offer a wide variety of course programming, seminars, and educational conferences on topics as diverse as rural pediatric health hazards, quality assurance for physician EMS directors, emergency medicine ultrasound, and simulation-based neonatal training. In 2010, Ohio ACEP acquired the respected Dr. Carol Rivers’ line of written and oral board products, adding to the Chapter’s outstanding educational offerings. Ohio ACEP would go on to develop and release a number of other products, including digital and online educational resources.
Ohio ACEP and EMS
In the same year as the first EMR course, the first Basic Trauma Life Support (now International Trauma Life Support, or ITLS) course was offered. This was an early indication of Ohio ACEP’s enduring commitment to EMS and pre-hospital care. In 1988, Ohio ACEP aggressively pursued a grant to fund its ITLS program. ITLS Ohio is now one of the most successful, well-respected trauma life support programs in the nation.
As Ohio ACEP gained members and stability, it would utilize the grant and the expertise of its membership to develop the ITLS program. In 1990, Ohio ACEP offered the first EMS Medical Directors’ Course. Designed to provide instruction on the unique demands of the state’s EMS medical directors, the course covered everything from disaster planning and operational issues to grant funding and grievance procedures.
In 1995, Ohio ACEP physician leaders and Ohio EMS professionals were instrumental in introducing the first Pediatric ITLS course to cover the special needs of the critically injured child. In addition, these leaders were at the forefront of developing the Pediatric Trauma Life Support: For Prehospital Care Providers textbook. ITLS Ohio leaders continue to serve as a resource to other chapters for pre-hospital pediatric trauma care and training.
Today, ITLS Ohio strives to promote awareness of the importance of EMS care, improve the standards of pre-hospital care, and act as a resource to all EMTs, paramedics, nurses, and physician EMS directors. ITLS Ohio is one of the largest and most active chapters of ITLS, and the chapter leaders have received numerous awards in recognition of their leadership.
Each year, ITLS Ohio holds the Emergency Care Conference, considered Ohio’s premier EMS educational gathering, attracting over 300 pre-hospital professionals a year. Beginning in 1998, Ohio ACEP also hosted the annual EMS Star of Life Awards to recognize the stars of EMS excellence in Ohio. The award ceremony is designed to raise the profile of emergency medical services, celebrate its unsung heroes, and reunite EMS caregivers with individuals whose lives they were able to save.
Public Education and Awareness
Throughout the 1980s and 1990s, Ohio ACEP turned significant focus to the general public, promoting awareness of everything from ED overcrowding to public safety.
In 1986, Ohio joined several other states by passing a law requiring seat belt use in automobiles. Though state seat belt laws would later prove effective in reducing the rate of car accident fatalities, the laws were considered somewhat controversial at the time. Some were unconvinced of the safety of seat belts, while others objected to the laws on grounds of personal liberty.
To help explain the new law and address common concerns, Ohio ACEP and the Wright State University Medical School’s Department of Emergency Medicine teamed up to develop an educational brochure. This marked one of the first times Ohio ACEP was involved in developing materials to enhance awareness among the general public.
In a similar public safety initiative, EMRO—Ohio ACEP’s body of active emergency medicine residents—designed a brochure entitled “Pull to the Right” as part of a 1989 campaign to educate drivers on the importance of yielding right-of-way to emergency vehicles. The brochure would later receive official recognition by the Ohio Department of Highway Safety and the Governor’s Traffic Safety Committee.
Later that year, Ohio ACEP and Mothers Against Drunk Driving (MADD) joined forces to promote their “Tie One On For Safety” campaign against intoxicated driving.
Today, Ohio ACEP continues this tradition with “NIX Opiates”, a unique program which brings emergency physicians into Ohio high schools to speak candidly with students and parents about opioid addiction, abuse, and overdose.
Emergency Physicians: a new political presence in Ohio
Branching out into public policy and advocacy was a logical next step for Ohio ACEP. Though the Chapter had been involved in advocacy activities since its beginning, 1989 ushered in a new era of action when the respected lobbyists Rick Ayish and Carolyn Towner were hired. Later that year, Ohio ACEP offered its first Legislative Seminar, allowing members to develop their advocacy skills while participating in an open exchange of ideas with state officials.
In 1990, the Ohio Emergency Medicine Political Action Committee (EMPAC) was established to help elect pro-emergency medicine candidates for public office. One of the PAC’s first fund-raising campaigns urged members to contribute “$90 for the 90s.”
Ohio ACEP’s increased advocacy efforts yielded results quickly. In 1992, the Chapter used its expanded clout—and its continued commitment to quality pre-hospital care—to help draft and pass a bill creating the State Board of Emergency Medical Services. Dr. Jim Augustine, who would later become Ohio ACEP President, served as the board’s first director.
In recognition of the Chapter’s reach and influence among emergency physicians and emergency department staff, the Ohio Department of Health awarded Ohio ACEP a grant in 1993 to develop a video tape explaining proper treatment of patient victims of sexual assault. The tape would later be released to Ohio emergency departments to accompany the new state protocol for collection of forensic evidence and treatment of sexual assault survivors. Today, Ohio ACEP is active on the board that revises and improves that protocol on a continuous basis.
In 1995, a roundtable meeting with Ohio Attorney General Betty Montgomery, the State Highway Patrol, State EMS Board, and other key stakeholders was held at Ohio ACEP headquarters to discuss hospital emergency departments’ responsibilities for collecting evidence in suspected cases of drunk driving. The meeting highlighted not just the expanded influence of Ohio ACEP, but the ongoing evolution of the emergency medicine specialty.
Ohio ACEP wielded further legislative sway in 1997, when it helped to draft and promote a bill that now defines what constitutes an emergency medical condition, using the “prudent layperson standard.” Using this standard, the law requires an insurer to cover a patient’s emergency treatment based on the patient’s presenting symptoms, rather than their ultimate diagnosis. This is an important protection for patients who would otherwise be expected to diagnose their own symptoms—chest pain, for instance—and decide whether or not they are experiencing a medical emergency.
The 21st Century
The new millennium provided Ohio ACEP with new challenges and new opportunities. Having purchased its office building in 1998, Ohio ACEP’s increased equity and financial stability allowed it to focus on rising to these new challenges. As a result, much of the early 2000s were characterized by “thinking big.”
In 2001, Ohio ACEP scored a major legislative victory by supporting and helping to pass a bill which extended legal assault protections to emergency department staff. The bill later cleared the Ohio Senate, 32-0, and the Ohio House and was promptly signed into law by Governor Taft.
Ohio ACEP gained another policy victory in short order with Senate Bill 281, a major medical malpractice reform bill. The bill was signed into law on January 10, 2003. It continues to provide important liability protections, leading to an improved medical malpractice climate in Ohio.
EMRO, the organization of Ohio emergency medicine residents, had been formed in 1980, early in Ohio ACEP’s existence, but a renewed focus on residents prompted the first EM Residents’ Assembly in 2002. The event was offered to provide graduating residents the chance to network with colleagues for career advice and meet with potential employers.
In the summer of 2004, US Congressman Tim Ryan of Youngstown met with Ohio ACEP members at Akron General Medical Center for a “white coat” visit, designed to help government officials better understand the profession of emergency medicine and some of its inherent challenges. Gaining the attention of a major legislative player in Washington was a major “get” for Ohio ACEP and illustrated the continued gains in influence enjoyed by the Chapter and its members.
The following year, a grant from National ACEP allowed the Chapter to flex its PR muscles with a public-oriented awareness campaign, EmergencyCareOhio. The campaign included the creation of fact sheets and media kits, as well as participation in community programs to help improve health care access and quality. The campaign also focused on reforming problems such as overcrowding, an unfavorable medical liability climate, and reimbursement issues.
A “white coat” rally at the U.S. Capitol Building was organized by ACEP in 2005, and the Ohio Chapter was well-represented as emergency physicians from around the nation turned out in force to urge Congress to preserve access to emergency care for all Americans.
In January of 2006, the American College of Emergency Physicians released the first-ever “National Report Card on the State of Emergency Medicine”. Weak public health/injury prevention and an unstable medical liability climate earned Ohio a “C+” grade, and Ohio ACEP utilized the report card as an important public relations tool to spread awareness through radio and print media.
In 2007, Ohio ACEP began a major new initiative combining education, advocacy, and leadership development. The Leadership Development Academy—designed to give members an invaluable opportunity for leadership and advocacy training—was an important milestone in the way Ohio ACEP thought about advancing the emergency medicine specialty. Recognizing that an emergency physician trained in the art of leadership is the specialty’s best possible advocate, Ohio ACEP made the program a primary focus.
Ohio ACEP’s increased influence in policy matters prompted a major, long-term legislative initiative in 2009. Under the leadership of Government Affairs Chair, Dr. Catherine Marco, Ohio ACEP drafted legislation that would grant qualified civil immunity to physicians providing professional emergency care in compliance with the federal law, EMTALA. Senate Bill 86 was introduced by Senator Steve Buehrer, and, as expected, the bill faced stiff opposition from moneyed special interests.
Though the bill did not pass in the 127th General Assembly, Ohio ACEP has repeatedly helped to draft and advocate for similar legislation in later legislative sessions. This signaled a long-term willingness for Ohio ACEP to pursue a difficult policy in the face of entrenched interests determined to stop it. Ohio ACEP continues to fight for liability protections for EMTALA-mandated care.
In 2018, Ohio ACEP notched a major policy victory when it successfully championed House Bill 7, a liability reform bill which strengthens Ohio's "I'm Sorry" law and promotes honest and open communication between physicians and patients.
Ohio ACEP continues to advocate for emergency physicians and their patients today on a wide variety of topics like supporting fair coverage for emergency care, ending the opioid epidemic, stopping surprise billing, and taking on the problems of emergency department crowding and psychiatric boarding.
Ohio Chapter ACEP started as a small group of doctors who envisioned an organization that would help them ensure the best possible emergency care for their patients. Since then, emergency medicine has become recognized as a vital and respected part of our health-care system, and Ohio ACEP has consistently been at the forefront of fighting for that recognition.
Ohio ACEP is now active in legislative and judicial matters, and its influence allows the organization to hold the line against bad policy that would weaken emergency care in Ohio. The Chapter’s perspective is sought by candidates and elected officials alike, and many of its members are state and national leaders in their field. Physicians from around the world attend Ohio ACEP’s acclaimed educational offerings.
In the nearly-five decades since its charter, Ohio ACEP has gone from a small band of physicians to more than 1,600 attendings, residents, and medical students across the state. As members of the Chapter look back on a half-century of service to the state’s emergency physicians, Ohio ACEP stands ready to tackle the challenges and opportunities that lie ahead.