“Prediction is very difficult, especially about the future.”
Both baseball legend Yogi Berra and Nobel laureate Neils Bohr are credited with versions of this saying. Regardless of who gets credit for the witticism, it certainly holds true for EMRA and emergency medicine. On every shift, we are faced with uncertainty, which we tirelessly battle with clinical decision rules, diagnostic imaging to “rule out the worst case scenario,” and shared decision making with patients. From risk stratifying a patient with chest pain, to deciding if someone diagnosed with pneumonia is safe to go home or needs to be admitted, our job is to work with limited information and make the best decisions possible for the patient in front of us. Of course, no decision rule or algorithm is perfect. Social issues, financial challenges, and health literacy all have an impact on patient compliance. We have all seen patients bounce back despite the best of intentions and best care on an initial visit. As one of my mentors, Dr. Chandra Aubin, taught us in residency, we should be grateful for these return visits and tell our patients, “Thank you for giving us a second chance to care for you.”
Economics is an interest of mine, and had I not become an emergency physician, studying the science of incentives and motivation would have been a welcome career option. EMRA and our specialty enjoy the strong positions we hold today
(hard to predict at our origins 40 years ago!) thanks to the intrinsic motivation and passion of our past and present members. As hard as it is to get ourselves to feel motivated sometimes, it is exponentially harder to do the same for others, be it our patients or our colleagues. EMRA offers a cadre of benefits and opportunities to members to augment their intrinsic drive and abilities. As we have matured into a 12,000-member organization, offering print and electronic publications; almost $80,000 of scholarships and awards annually; and leadership opportunities second to none, now our challenge is to answer the difficult question, “What's next?” To phrase this differently, as if EMRA were a patient, “What's EMRA's disposition and follow-up plan?” With the patient analogy, I by no means intend to imply that EMRA is ill. Just the opposite — we are financially stronger than ever, and today have the largest membership base that we have ever held. As EMRA president, my concern is that I do not want us to become ill with complacency in our success, and miss the opportunity to continue to push ourselves as an organization to become even better.
By the time you are reading this, the EMRA Board of Directors will have met for our January strategic planning and board meeting. Your elected leaders will have spent a long weekend focusing their collective talent and energy into trying to make EMRA stronger and more successful in fulfilling our mission as the voice of emergency medicine physicians in training, and in securing the future of our specialty. As dedicated as your EMRA board is, we need your support, ideas, and feedback to best serve you and future members of our great organization. Please take a moment to reflect on what you value most from EMRA membership, but also on what you feel is perhaps lacking that we should add to better meet the needs of future EMRA members. In Think Like a Freak, the latest book from Freakonomics authors Levitt and Dubner, the authors try to go beyond the interesting data and anecdotes from their previous writings, and instead share their approach to looking at problems and challenges. They suggest that the first step to finding a solution is to first have clearly and correctly identified a problem or challenge (Engineering 101). Beyond problem identification, thinking like an outsider, or someone with a fresh perspective, also can be invaluable. Our board needs the ideas and input of not just EMRA veterans, but also new members to keep us relevant and forward thinking.
I guarantee you that no matter how much you feel you are taking advantage of EMRA member benefits, there is more you can be getting out of your membership. Start by using the complementary educational benefits like EMedHome and EM:RAP, but don't stop there! Join a committee or division to meet colleagues with similar interests and land the fellowship or job you've always wanted, or nominate a deserving colleague for an EMRA award to be given national recognition for how they have helped you and others. Apply for a scholarship to attend the ACEP ED Directors Academy, SAEM Annual Meeting, or ACEP15 (all of which now offer complimentary or waived registration for members who are scholarship recipients!).
Share with us what motivates you, and together our collective passion can make EMRA membership more rewarding tomorrow than anyone could have ever predicted today.