As we approach the end of the year, I want to extend the CAEP Board’s gratitude and appreciation for your tireless efforts to improve the emergency care we give to patients across this country. Our work is primarily delivered in chaotic and crowded EDs, but increasingly includes prehospital care, public health and policy, research, leadership and a raft of subspecialty niches. Canadians are indeed fortunate to have such depth and breadth of expertise in their emergency physicians.
The Board has wrestled with some interesting philosophical questions as of late:
Is CAEP’s central mission to represent the interests of emergency physicians, or those of our patients?
How can we maintain the high standards of an evolving discipline, while being respectful of all our colleagues practicing EM?
We are, by definition, an association of Canadian physicians, but do we also have global responsibilities?
I am reminded of the famous quote ascribed to Hillel—a series of three interlinked questions:
If I am not for me, who will be?
But if I am only for myself, what am I?
And if not now, when?
To the first–CAEP must continue to advocate for its members’ interests—especially in the spheres of education, workplace safety and physician wellness–because without a robust, safe and healthy workforce, and functional EDs, we will not be able to deliver on our responsibilities to our patients. Expect a number of interesting initiatives on these matters in the new year.
To the second–the simple answer is that we are very fortunate, in that the very nature of EM provides us with an opportunity for altruism on every shift, in every patient encounter. But within our profession, we must also be generous and inclusive of the other. Tertiary docs must understand the challenges of rural physicians; researchers must acknowledge the incessant grind of their full-time clinical colleagues; those clinicians must, in turn, appreciate the need for knowledge discovery and translation in advancing our field. Inclusiveness, tolerance and respect for diversity must be over-riding values that guide all our work.
I have had conversations with members recently concerning our responsibility to global EM and global issues beyond EM. The WHO just last year decreed emergency care to be a basic human right and yet, around the world, millions of lives are lost or compromised because of lack of access to care for STEMIs, stroke, trauma and sepsis. What is CAEP’s role beyond our borders?
To the final question-when I was a newly minted EP, nuclear proliferation was escalating international tensions and the threat of global annihilation seemed imminent. I recall attending moving a talk by Dr Helen Caldicott, an academic pediatrician, who had left her practice to advocate for a safer, more socially responsible world. Today, the clear and present existential threat is to the environment. We must ask ourselves what we can do, as individuals and as a profession, to heal not only our patients, but the world.
If not now, when?
Our work takes its toll, so I hope all of you will find some time this holiday season to spend with friends and loved ones. On behalf of the CAEP Board, we wish you a safe, restful and joyous holiday season, and trust you will feel newly invigorated as we enter 2020.
Alecs Chochinov MD FRCPC
President, Canadian Association of Emergency Physicians