Leaders in Medical Education

Dr. Alexander M. Rosenau, American College of Emergency Physicians

Osmosis Team
Jul 7, 2014

Dr. Alexander M. Rosenau serves as the president of the American College of Emergency Physicians. He is also senior vice chair of emergency medicine and an emergency physician at Lehigh Valley Health Network in Allentown and Bethlehem, Pennsylvania, as well as associate professor of medicine at Morsani College of Medicine at the University of South Florida. In his past, he has served as president of Pennsylvania ACEP and received the U.S. Public Health Service National Health Service Corps Achievement and Commendation awards. We had the pleasure to speak with Dr. Rosenau about his experiences in medicine and his hopes for the future of medical education.

How did you decide on a career in medicine?

I have loved the sciences ever since I was young. I also had a lot of influence from my mother who is a nurse and a great listener. Medicine was the perfect way for me to meld my love of the sciences with taking care of people.

What made you pick emergency medicine as a specialty?

Well, like most medical students I loved every specialty during clinicals, during internal medicine I thought “hey this is fun, it’s like being a detective” in surgery I found it really fun to be able to use my hands and in radiology I enjoyed solving the puzzle held in the image. I ended up doing a traditional rotating internship and went to the Sullivan county Medical Center, which is owned and run by the Philadelphia College of Osteopathic Medicine (PCOM). I stayed in Sullivan County as a public health service officer for three years. There were 6500 people in the county and it was near a place called World’s End State Park, if that gives any indication of how rural it was. I became the director of the medical center and was supposed to be working with another doctor but he went off to pursue a residency elsewhere. It was scary as a very recent medical school graduate to assume all of that responsibility. I did well though and ended up becoming the director of two nursing homes in the area, and hosted 10 medical students monthly. We serviced the Red Rock Job Corps Center and the nursing homes. We worked at all hours, and saw all kinds of crazy cases. It’s where I fell in love with emergency medicine. While I was up there I did house calls, resuscitations, sometimes in the middle of the street, and rescues and loved every minute of it. After I had finished my service with the public health service corps. I applied for a residency at Botsford General where I went on to become certified in both the osteopathic and allopathic boards. Now I’m the Senior Vice Chair of Lehigh Valley Health Network’s Department of Emergency Medicine and the regional EMS Council Medical Director. Being the President of the American College of Emergency Physicians is a real privilege and its joyful work on behalf on my colleagues. ACEP is the founding organization of our profession, represents 33,000 members. It has EMF, a 5 million dollar research fund; NEMPAC, the 4th largest specialty advocacy fund for our work in DC and we serve as a management services organization for CORD, EMRA and SEMPA.

It seems that more medical students are pursuing interdisciplinary careers and degrees. Can you describe how you managed to combine your career in medicine with your interest in leadership?

It wasn’t by chance. I always knew I wanted to affect change for the better. I started out by doing some work as the County EMS medical director, I taught the medics, did some teaching and presentations during residency, and got involved in the education of the nursing staff. Then, I became involved in the finances of EM because my chair at the time, Dr. Michael Weinstock, asked me to. He then suggested that I would find a lot of satisfaction in getting involved with ACEP. I met people of all different ages and experiences and was always looking for who could teach me something. To learn more about the business side of medicine I took 150 credits to become a certified physician executive. I started reading the Harvard Business Journal along with the EM journals and Scientific American. When it comes down to it, ER docs are always systems thinkers; they are part of the solution, not the problem. These past few years I have had the chance to give back and be a mentor myself. Emergency Medicine is filled with talented people, helping to open the door for the young docs is very satisfying. Once our new members walk through that door they just contribute so much to our profession and the community.

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Every few weeks there appears to be a new report discussing burnout rates of physicians and the fact that many would decide not to pursue medicine if given the chance. In this somewhat disheartening environment, do you have any advice for current medical students about avoiding burnout? Or any other general advice?

Have interests in medicine beyond just your specialty. Over the years I have done work in research, administration, EMS, and education and it has really helped me keep my drive going. Family life is also an important thing to cultivate to take your mind off of medicine. You should also make sure you partake in activities of wellness i.e. hobbies. I mean, if you go on vacation for two weeks out of the year, it’ll just be business as usual as soon as you get back. If you have hobbies and interests it’ll mitigate stress year round. If I’m being honest, I take my own advice on this 2/3 of the time, it can be tough to balance it all, but you have to give it a shot.

What are a few things that you would change about the way we train our physicians?

Roll back the current restrictions a little bit so we can involve 4th years even more in patient care. I would also ensure that there are enough GME spots for all graduating physicians. Taking more time with the patients to touch and perform physical diagnosis would also be a huge improvement. As a D.O. and a proud graduate of PCOM I think this aspect of Osteopathic training has really given me an edge in clinical medicine. It is a very important part of medicine that is often overlooked.

How does it feel being the first D.O. ACEP President and do you think it will have an effect on the relationship between M.D.’s and D.O.'s in specialties other than EM?

I’m actually the second DO president, but the first one to be elected directly by the ACEP Council. As far as being a DO is concerned, ACEP is agnostic to your degree, and I am a member of ACEP and ACOEP. ACEP and ACOEP do very similar things and work together often. There is no reason for the relationship between MDs and DOs not to be as close as possible; we all practice the same medicine. I believe that the relationship between these two schools of thought has gotten significantly better over the past 10-15 years. There have been plenty of other DOs in powerful positions. I am not a pioneer of this but rather my position as President of ACEP serves as evidence of the equality, strong relationships and respect among Emergency Medicine MDs and DOs.