communication in all directions

The final area I’d like to concentrate on is communication within ACEP—separate from the demonstration to the members of the College’s value.  I feel that communications in both directions—from members to leadership, and vice versa, can and should be improved.  And, of course, we need to address the line of communication which has never been more important (or more achievable)—communication between EP’s ourselves.

We need to work on top-down dissemination of news and information.  Not only would this add considerable value in itself to the membership, but would go a long way towards the College’s stated goal of transparency.  I think that, to this end, we need to expend some resources in reimagining both the style and the means with which ACEP leadership and staff communicates with the College.  The style is the easy part to fix—I think that members of the college, as highly educated, highly engaged people who represents multiple different viewpoints across the political spectrum can handle (and, as our society becomes more fractious, even demand) some more subtlety from ACEP communications.  We may not be satisfied with press-release-style messaging, without some background on how a decision came to be made—especially if it’s a decision we don’t agree with.  This communication style change costs nothing, but would go a long way towards improving morale, especially given our College’s broad footprint and disparate geographic locations and makeup.  The most recent example of this was the minor kerfluffle regarding ACEP being a signatory to the COVID vaccine mandate recommendation;  everyone eventually ended up on the same page, but the road to this could have been easier with some more explicit and subtle explanations of decisionmaking.

The most severe recent example in ACEP messaging is the Workforce webinar.  It seems that this momentous and widely absorbed piece of messaging did not undergo supervision that really thought through, and fundamentally understood, that the way this data was presented would so deeply affect an individual human—a human who is so busy running around a department for 8-24 hours at a time that they can’t always find time to urinate—that little else would be spoken of during the year.  The cost of this lack of oversight (for this event alone) in person-hours lost trying to regain the narrative, in decreased member engagement, and in frank lost dues, cannot be calculated.  Let’s dedicate resources to make it part of our College’s messaging process to supervise outgoing messaging with the innate understanding that these messages may be a member’s only contact with the College, and that their perception of the worthiness of the College itself will live or die on their perception of our messaging.

The College could also profit from improvement in communication in the other direction—from individual EP’s to the national organization.  To this end, the distance between the Chapters and the national office needs to be cut down.  The Chapters exist (in part) to transmit the voices of individual physicians, who may not have easy access to communication with the hub in Dallas.  We do this through Council, of course, as a representative democracy, but for the rest of the year, the Chapters should have continuous communication with the central office.  As of now, those communications are dependent on Chapter execs (not all Chapters even have dedicated executive directors) or ad-hoc personal contacts that members in the Chapter might have with leadership.  This needs to be improved, systematically, and this won’t cost anything, either!  We need to break down the barriers between Chapter staff and Dallas staff, and I would also propose that we appoint Chapters to have dedicated Board.   

And then, there’s communication amongst EM docs.  We already have a platform where thousands of EP’s across the country come every day to communicate asynchronously.  It is, far and away, the most popular mode of idea exchange among EP’s, and it exists without participation by ACEP in any meaningful way.  Although its existence itself is somewhat fortuitously unlikely (do many other specialties have such a Zocalo?), it still suffers from its protoplasm—it’s still Facebook.  And because of this, it has some of Facebook’s worst innate traits;  1) it is a poor place for subtle and nuanced discussion (something we often need in EM), 2) extreme voices are rewarded and magnified beyond their legitimate levels of influence, and 3) people feel emboldened to treat others in much harsher ways than they ever would in real life.  These downsides are probably the reason that ACEP doesn’t participate, either formally or even informally with any regularity.  Unfortunately, that means that ACEP is near-universally left out of the conversation, except by its detractors.  This has to change.  Either ACEP designs and deploys a separate platform which EP’s find so compelling and so valuable that they visit it every day, or we formalize our participation in EMDocs.  I already know which I recommend—we know where all the members (and potential members!) are.  Let’s be there, with them, and make ACEP a part of the conversation in a positive way.