The American College of Emergency Physicians held its annual Scientific Assembly Meeting October 1-4, 2022 in San Francisco.  The convention is intended to enable the nation’s 30,000 ER doctors to socialize and discuss the pressing medical issues of the day.  Oblivious to the end of the pandemic, organizers required attendees to be fully vaccinated.  After stepping over the homeless people on the streets, ER doctors had to present negative results of COVID tests that had been done within the past 24 hours to be allowed into the venue. 

When asked about blackouts in California and if they would impact the venue, Dr. Marc Futernick commented, “as far as ACEP, energy is not the problem.”  The member of the California ACEP Board of Directors went on to say, “I’m not sure how it is being spun in your neck of the woods (some nefarious democrat plot), but the homeless situation in SF has gotten so severe it will impact the experience.  To those unaccustomed to it, I imagine it will be downright scary.  It’s a horrible situation, unlike anything I’ve seen before, and I work just blocks from Skid Row in LA which is the largest homeless population in the country.” Futernick is an outspoken physician and climate activist who is a staunch defender of Governor Newsom’s radical climate change and anti-police/pro-crime agendas.  Dr. Futernick has avoided answering questions about the economic turmoil, homelessness and health effects plaguing the state due to Newsom’s policies. 

ACEP 22 opened with the Keynote Speaker Dr. Glaucomflecken, a comedian turned ophthalmologist.  Interestingly, despite repeated statements that ACEP is not politically biased, ACEP invited the comedian who is well known for his far-left, anti-conservative humor.  In June 2020, in a now-deleted professional tweet, Dr. Glaucomflecken stated “That makes sense, the methods needed to eliminate systemic racism are political. It's the acknowledgement of its existence and the willingness to do something about it that has nothing to do with politics and everything to do with being a decent human.”  In another professional tweet, he commented “It’s fun to think about Trump needing an eye exam and they call Rand Paul who shows up without any equipment because he doesn’t remember how to do an eye exam & they find an old tonopen & spend 2 hrs trying to calibrate it before realizing it’s not a tonopen it’s a reflex hammer.”  Dr. Glaucomflecken does not appear to be a neutral keynote speaker.

2022 has been a very difficult year medically for the U.S.  2021 saw over 107,000 deaths from fentanyl overdoses.  Obesity, drug use, depression, and suicidality spiked during COVID and show no signs of improving.  Worse, the current disasters are on the heels of pre-COVID research showing that the life expectancy for millennials and generation X will be less than their parents, mostly due to drug overdoses and obesity-related diseases.  This is the first time this has happened in decades.  “Researchers at the Sanford School of Public Policy set out to study the difference in mortality rates between generations and racial groups, to better understand the factors that contribute to the overall decrease in life expectancy for Americans.  According to the Centers for Disease Control and Prevention, U.S. life expectancy has decreased from 78.9 years in 2014 to 78.6 years in 2017.”

Given this bleak medical landscape, rational Americans should expect ACEP to be tackling America’s biggest health problems at their annual ‘meeting of the minds.’  Instead, the three main topics of discussion were (no order):  1. Maintaining COVID pandemic billing profits, 2. Climate change, 3. Racism in medicine.

ACEP’s misguided focus didn’t end at the convention.  Afterwards, ACEP was silent about the recent California Bill AB2098 signed September 30, 2022 that threatens revocation of physician licensure if doctors have private informed-consent discussions with patients that differ from the narratives that government medical authorities have mandated.  ACEP President Dr. Gillian Schmitz said that ACEPs silence on the matter was because “ACEP typically does not support or oppose state legislation.”  Interestingly, as recently as June 24, 2022, ACEP released a policy statement about the sacred doctor-patient relationship.  “ACEP believes that emergency physicians must be able to practice high quality, objective, evidence-based medicine without legislative, regulatory, or judicial interference in the physician-patient relationship. This strong principle was codified in a policy statement approved by the ACEP Board of Directors yesterday.”  ACEP had released a similar statement in 2021 when it opposed Texas abortion laws.  In a sit-down interview in September 2022, Dr. Schmitz called defenders of physician freedom of speech and patient rights 2% radical right-wing extremists.

Fentanyl overdosing was also not a focus of discussion at ACEP22.  The issue has also not been found in any of ACEPs journals in the past year.  ACEP moderators blocked recent attempts to generate a discussion on how to tackle the problem in its doctor chatrooms.  ACEP also hasn’t published a policy statement on the issue since 2019.  Perhaps the issue that involves drugs, police, and open borders is unwelcome before a politically charged midterm election.

Like the rest of America, doctors are still human.  They are entitled to some lighthearted socialization during a break from the stress of patient care in the nation’s overcrowded emergency rooms.  However, there still needs to be a business focus on important issues.  I attended the Special Operations Medical Association annual meeting in 2007 in between combat tours with Special Forces in Afghanistan.  Most lectures and displays were rightfully focused on combat casualty care.  ER doctors could be expected to have the same focus on critical medical issues such as fentanyl overdoses, obesity-related morbidity and mortality, government policies causing increases in violent crime and murder, and declining economic conditions that are reducing Americans’ ability to pay for medicine and doctor appointments.

It is becoming clear that emergency medicine, like modern medicine, no longer has the best interests of patients in its agenda.  Profits, social issues, physician censorship, and political pet projects seem to be guiding medical policy and therefore practice in America.  Americans deserve better.  In the end, the one who suffers is the patient, who gets treated using something other than ethical evidence-based medicine.

Dr. William Sullivan is an emergency physician and lawyer.  He served ACEP for years as a legal expert and recently quit the organization.  He eloquently captures the problem and dangers of modern medical organizations in an article he wrote in September 2022.  “ACEP is a once great organization that has strayed from its mission. ACEP has come to value diversity of gender more than diversity of thought. By censoring ideas that are contrary to its political ideology, ACEP values directives more than it values discourse. ACEP appears more interested in furthering the interests of ACEP than with furthering the interests of ACEP members.”

Image: ACEP