Overview of the Eagles History

 

In February of 1998, the elected leadership of the paramedic association of Pittsburgh, Pennsylvania, requested a meeting with Dr. Paul Pepe, the soon-to-be-named Commonwealth Medical Director for the state of Pennsylvania. They asked if he could put on a "state-of-the-art" -- or even a "beyond-the-state-of-the-art" educational offering. Over the previous two decades, Pepe frequently had presented many different challenges to the status quo in EMS and resuscitative care at many national and scientific meetings -- often based on his own ground-breaking research and findings in Seattle and Houston. In most cases, his recommendations eventually became standard of care worldwide, but usually years later. In essence, the paramedics thought they could have their own personal glimpse into the future!

 

Coincidentally, Dr. Pepe had just heard from two of his old friends, Dr. Ray Fowler, the original National Program Director for Basic Trauma Life Support©, (now International Trauma Life Support©), and Dr. Jeff Clawson, the national guru of Emergency Medical Dispatch. Both were planning to visit Pittsburgh three weeks later, just about the same time. The three of them planned to get together and talk about their latest projects. Putting one and two together, Dr. Pepe had the beginnings of a faculty for an impromptu March 3rd - 4th course for the paramedics.  Within the next week, he had put together the first "EMS State of the Science: Evolution and Revolution" meeting. Inspired by the coincidence of Fowler's and Clawson's arrivals, he made a spur of the moment decision to call on several other top-notch colleagues.  In addition to Fowler and Clawson, he was able to also recruit many of the leading, innovative EMS medical directors from several major U.S. cities, including Drs. Marshal Isaacs from San Francisco, Jim Dunford from San Diego, Dave Persse from Houston, Brian Zachariah from Dallas, and several others. Despite the last minute request, these friends all agreed to drop their previous plans and contribute. The concept was to expand upon the original planned conclave with Fowler and Clawson in terms of exchanging ideas among each other and then let the EMS personnel, managers and medical directors (and anyone else interested) eavesdrop.

 

Even with the short notice and limited marketing (mostly word of mouth), the auditorium at Allegheny General Hospital in Pittsburgh was packed with EMS personnel. The audience included everyone, from front-line EMTs and paramedics to regional leaders, including the State EMS Director for Pennsylvania , Peg Trimble. The course was not only cited for its aggressive content ("EMS Response: Do You Always Have to Send an Ambulance?" and "Mouth-to-Mouth Ventilation: Is it Really Necessary?"), but also for its hard-hitting, "to the point", bullet 15 minute ("900 second") presentations. These didactics were amplified by faculty panels that clearly exuded enthusiasm, a great sense of humor and camaraderie. The audience members cited that they were impressed by the understated world class caliber of expertise from a cadre of articulate doctors who were not at all pretentious and could readily “roast” each other publicly, a clear sign of mutual respect. Dozens of the evaluations stated the same phrase: "…best conference I've ever attended." 

 

Even the faculty raved about the conference content. Jeff Clawson (founder of the National Academies of Emergency Dispatch) said, "I've never taken so many notes since medical school !  I was truly spellbound by each and every talk and follow-up discussion". Ray Fowler, also one of the key founders of the National Association of EMS Physicians (and its second membership-elected national President) said, "I'll promise you this, if we do this again, it will be the one meeting I definitely won't miss!” (and, to date, he has not). “Let's absolutely make it annual event", said Marshall Isaacs, "I'll be there every year".

 

And they all did return the next year --- but with some new friends. By 1999, the original "Evolution and Revolution" group now included the likes of Drs. Ed Racht from Austin and Mike Sayre from Cincinnati .  By the year 2002, the cadre had expanded to include Drs. Michael Copass and Leonard Cobb from Seattle, Marc Eckstein from LA City, Joe Ornato from Richmond, Paula Willoughby from Chicago, Crawford Mechem from Philadelphia, Peter Moyer from Boston, Corey Slovis from Nashville, Don Gordon from San Antonio, and several others including the current President (or President-Elect) of the National Association of EMS Physicians and the American College of Emergency Physicians (NAEMSP). Hearing about the roster, one EMS-oriented member of the media remarked in a report, "This is a gathering of Eagles" . . .and the name stuck.

 

Today, the meeting is called: EMS State of the Science: A Gathering of Eagles”. In the year 2000, Dr. Pepe moved to Dallas, also national headquarters for the American Heart Association, the American College of Emergency Physicians (ACEP) and a more central location for the national team of faculty. Since then, Dallas has become the “Eagles Nest” as well.

 

Over the past few years in Dallas, the Eagles formula has not only worked, it is now being emulated and exported elsewhere. Without any advertising, the two day annual summit has steadily grown and attracted hundreds of persons from the EMS community, including EMS educators, chiefs, administrators, progressive medics, medical directors, media, and the leaders of professional organizations, government officials and related industry leaders.

 

The faculty has evolved as well. Today, the national audience of hundreds of EMS and trauma leaders have the opportunity to meet and interact with the accountable, jurisdictional emergency medical directors for most of the (9-1-1) emergency medical services (EMS) systems from the 25 - 30 largest cities in the United States (U.S.) as well as the medical directors/officers of several key federal agencies such as the Federal Bureau of Investigation (FBI), the U.S. Secret Service, U.S. Department of Health and Human Services (HHS), U.S. Department of Homeland Security (DHS), and, of course, the White House Medical Unit (Table I).

 

Last minute drop-ins often include high-profile leaders such as the U.S. Surgeon General, elected federal officials or the White House Medical Unit Training Directors/Coordinators.

 

As the direct medical overseers of the 9-1-1 EMS systems for the nation’s largest, highest-risk population centers, these unique physicians have a pivotal role, not only in the medical aspects of homeland security preparedness and response, but also in the day-to-day resuscitative and EMS-trauma care provided for the communities approximately 50,000,000 Americans through nearly an estimated 10,000 paramedics, EMTs and public safety first responders. 

 

Also, as a core and cohesive group of innovative public leaders, they shape much of the nation’s de facto strategic planning for patient treatment and disposition during resuscitations and multiple casualty incidents, including those involving bio-terrorism and other weapons of mass effect events. More importantly, they are the key linkages between the medical establishment (hospitals and health professionals) and the governmental security entities (city managers, public health officials and out-of-hospital first responders). As a result, they are highly sought-after as a focus group for federal agencies, congresspersons, national organizations and the like.

 

At the request of the audience, the group also routinely publishes position papers for their own use, but the publications become useful tools for providers nationally.

 

Again, the method of instruction is decidedly different. Each of the renowned speakers has only approximately 15 minutes (900 seconds) to present and then another 5 min to answer questions from the audience. This rapid-fire style allows more topics (>30) to be covered in the 2-day conference. The second most popular feature is the so-called “lightning rounds” in which the entire faculty takes the stage and are drilled by the audience about any subject and each one must give a response in less than 20 seconds unless the moderator gives them more leeway. Usually, it’s a hands-up, thumbs-down instant poll or a “reverse” lightning rounds in which the Eagles interrogate/poll the audience for instant feedback. National standards of care have been decided “on the spot” during an Eagles lightning rounds when this cohesive group reaches a rapid consensus in front of the audience and decide to take the agreed-upon protocol back home to their respective municipalities in which those 50,000,000 Americans dwell.

 

Instead of the carefully-choreographed curriculum planned months or years in advance, the Eagles prefer to focus on EMS topics “du jour” – covering those clinical, operational and administrative aspects that are in the spotlight at the time of the meeting. The program is planned a week or two ahead of time and none of the audience knows what will be on the program until the day they show up! Yet they continue to return, again and again, year after year, knowing that the “menu” will be reliably “delicious.

 

Despite their busy schedules, the group also provides a two-day pre-conference think-tank where they serve as a focus group for groups ranging from industry researchers, the U.S. Department of Homeland Security and the U.S. Congress to the American Heart Association and various EMS industry and national media. Therefore, another interesting element of the “gathering” is the shared dedication to this event.  As Dr. Pepe points out, “at most conferences, speakers do their presentation and then leave – not at Eagles; everyone stays for everything.” Moreover, they take great pride in the fact that they have no dues, by-laws, officers or management structure; they simply have cell phones!

 

The Eagles consortium works hard not to be another distinct splinter group, and they exude and express loyalty and coordination with the leadership at all of the other key related organizations such as ACEP, NAEMSP, the American Heart Association and other such groups. They consider themselves more of a nationally-integrated de facto network of responsible officials who are working directly for the public good. Despite consensus or recommendations from organizations and government, they generally are the “FDM’s” (the final decision makers) when it comes to implementing medical protocols and training for the thousands of prehospital care providers working under their medical oversight. As a result, the Eagles team stays in close contact throughout the year, debating, exchanging ideas and even changing medical standards for themselves although others are welcomed in to listen to what they say.

 

All of these factors have combined to the “EMS State of the Science: A Gathering of Eagles”, a meeting that almost all past attendees will validate as being the most dynamic, informative, and forward-thinking conference in the field of emergency medical services today.

 

 

Respectfully submitted,

 

 

Raymond L. Fowler, MD

Eagles Historian

 


  Consortium

(Core Group, Associate Members as well as Special Faculty for the February 15th - February 18th, 2006  Eagles Coalition Meeting, Dallas, Texas, USA):

 

 

U.S. Metropolitan Municipalities EMS Medical Directors

 

 

New York City

Bradley J. Kaufman, MD - Division Medical Director for the Fire Department of New York; Assistant Professor, Emergency Medicine, State University of New York Health Science Center at Brooklyn; Kings County Medical Center, Brooklyn

 

City of Los Angeles:

Marc Eckstein, MDEMS Medical Director, City of Los Angeles, Los Angeles Fire Department; Associate Professor of Emergency Medicine, University of Southern California

 

City of Chicago:

Paula J. Willoughby-DeJesus, DO, MHPEMedical Director and Assistant Commissioner, Chicago Fire Department; Assistant Professor of Medicine, University of Chicago; National President, American College of Osteopathic Emergency Physicians

 

City of Houston:

David E. Persse, MDPhysician Director, City of Houston EMS and Public Heath Authority, City of Houston Department of Health and Human Services;  Associate Professor, Department of Surgery, Baylor College of Medicine; and Associate Professor, Department of Emergency Medicine, University of Texas Health Sciences Center at Houston 

 

City of Philadelphia:

C. Crawford Mechem, MDMedical Director, City of Philadelphia EMS, Philadelphia Fire Department; Associate Professor, Department of Emergency Medicine, the University of Pennsylvania, Philadelphia 

 

City of Phoenix:

John V. Gallagher, MDEMS Medical Director, City of Phoenix Fire Department; Base Hospital Medical Director, St. Lukes Medical Center, Phoenix

 

City of San Diego:

James V. Dunford, MDMedical Director, City of San Diego EMS; Professor of Clinical Medicine and Surgery, Department of Emergency Medicine, the University of California, San Diego

 

City of Dallas:

Paul E. Pepe, MD, MPH Director, City of Dallas Medical Emergency Services (for Public Safety, Public Health and Homeland Security); Medical Director, Dallas Metropolitan BioTel (EMS) System; Professor of Medicine, Surgery, Public Health and Chair, Emergency Medicine, the University of Texas Southwestern Medical Center and the Parkland Health and Hospital System, Dallas

 

City of San Antonio:

Donald Gordon, Ph.D, MD - EMS Medical Director for San Antonio & Leon Valley Fire Department and the First Responder Network;  Professor, Emergency Health Sciences Department, University of Texas Health Science Center, San Antonio, TX

 

City of Indianapolis:

Michael L. Olinger, MD Medical Director, City of Indianapolis EMS and Indianapolis Motor Speed Way; Director, Division of Out-of-Hospital Care, Department of Emergency Medicine, and Associate Professor of Emergency Medicine, Indiana University School of Medicine, Indianapolis

 

City of San Francisco:

S. Marshal Isaacs, MDMedical Director, City of San Francisco EMS, San Francisco Fire Department;  Clinical Professor of Surgery, the University of California, San Francisco; Attending Physician, San Francisco General Hospital, San Francisco

 

City of Columbus:

David Keseg, MD - Medical Director, Columbus (Ohio) Division of Fire. Chief Development Officer, Premier Health Care Services; Clinical Instructor, Ohio State University

 

City of Austin:

Edward M. Racht, MDMedical Director, City of Austin and Travis County EMS; Associate Clinical Professor of Surgery, University of Texas Southwestern Medical Center at Dallas; Chair, Governor’s EMS and Trauma Advisory Council, Texas Department of State Health Services

 

City of Milwaukee:

Ronald G. Pirrallo, MD  - EMS Medical Director, City and County of Milwaukee; Associate Professor of Emergency Medicine, Medical College of Wisconsin

 

City of Boston:

Peter H. Moyer, MDMedical Director, City of Boston EMS; Past-Chair and Professor of Emergency Medicine, Boston University School of Medicine, Boston, MA

 

City of Nashville:

Corey M. Slovis, MDMedical Director, Nashville EMS, Nashville Fire Department; Professor and Chair of Emergency Medicine, Vanderbilt University, Nashville, TN

 

City of El Paso:

James R. (Randy) Loflin, MDMedical Director, City of El Paso EMS; Associate Professor, Emergency Medicine, Texas Tech University Health Science Center, El Paso, TX

 

City of Seattle:

Michael K. Copass, MDMedical Director, Seattle Medic I Program, City of Seattle EMS, Seattle Fire Department;  Professor of Medicine and Neurology, University of Washington, and Director of Emergency Services, Harborview Medical Center, Seattle

 

City of Fort Worth:

John Griswell, MDMedical Director, MedStar (City of Fort Worth EMS), Ft Worth

 

City of Portland:

John Jui, MD, MPHMedical Director, City of Portland and Multnomah County, Oregon; Medical Director, Oregon State Police and Deputy Team Commander, Oregon DMAT; Professor, Department of Emergency Medicine, Oregon Health and Science University, Portland, OR

 

City of Tucson:

Terence Valenzula, MD, MPH - Medical Director, Tucson Fire Department, Professor of Emergency Medicine, University of Arizona, Tucson, AZ

 

City of New Orleans:

Jullette M. Saussy, MD - Director of EMS, City of New Orleans; Clinical Instructor, Louisiana State University School of Medicine, Section of Emergency Medicine, New Orleans, LA

 

City of Cleveland:

Thomas E. Collins, MDMedical Director, City of Cleveland EMS, Cleveland OH

 

City of Atlanta:

Eric W. Ossmann, MDMedical Director, City of Atlanta - Grady Memorial Hospital EMS; Assistant Professor and Section Director for Prehospital and Disaster Medicine, Department of Emergency Medicine, Emory University, Atlanta GA

 

City of Honolulu:

Elizabeth A. (Libby) Char, MD – Director of Emergency Services Department, City and County of Honolulu; Assistant Professor of Clinical Medicine, University of Hawaii, Honolulu, HI

 

City of Miami:

Kathleen S. Schrank, MDMedical Director, City of Miami Fire Rescue and Professor of Medicine, Emergency Services, University of Miami – Jackson Memorial Hospital, Miami FL

 

Louisville, KY:

Neal J. Richmond, MDChief Executive Officer, Louisville Metro EMS; Assistant Professor of Emergency Medicine, University of Louisville Medical Center, Louisville, KY.

 

City of Richmond:

Joseph P. Ornato, MDMedical Director, Richmond Ambulance Authority, City of Richmond EMS; Professor of Emergency Medicine and Internal Medicine (Cardiology) and Chair of Emergency Medicine, Virginia Commonwealth University, Richmond, VA

 

City of Raleigh:

Brent Myers, MD, MPH Medical Director, Wake County EMS System, Raleigh

 

 

   

Federal Public Safety Agency Medical Directors/Medical Officers

 

 

Federal Bureau of Investigation:

William P. Fabbri, MD – Medical Office for the Federal Bureau of Investigation (FBI), Washington DC

 

United States Secret Service:

Nelson Tang, MD – Medical Director, United States Secret Service & U.S. Department of Homeland Security Immigration & Customs Enforcement (ICE); Assistant Professor, Department of Emergency Medicine, the Johns Hopkins University, Baltimore, MD

 

The White House

Richard J. Tubb, MD – Brigadier General, U.S. Air Force, MC, CFS; Physician to the President; Medical Director, White House Medical Unit, Washington, DC

 

Jeffrey C. Kuhlman, MD, MPH Captain, U.S. Navy; White House Physician, White House Medical Unit, Washington, DC

 

ACEP-NAEMSP:

 

Dean Wilkerson, JD, MBA, CAE – Executive Director, American College of Emergency Physicians; Dallas (Irving) TX

 

J. William Jermyn, DO – Chair, EMS Committee, American College of Emergency Physicians and EMS Medical Director, Missouri Department of Health and Senior Services, Jefferson City, MO

 

Robert E. O’Connor, MD, MPHPresident, National Association of EMS Physicians; Vice-Chair, Emergency Cardiovascular Care Committee, American Heart Association; Director of Research and Education, Department of Emergency Medicine, Christiana Care Health System, Newark, Delaware; Professor of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA

 

 

AMERICAN HEART ASSOCIATION:

 

Michael Bell Vice President for Emergency Cardiovascular Care Programs, American Heart Association

 

Jo Haag, RN, MSN – Director of Training, National Emergency Cardiovascular Care Programs, American Heart Association

 

Brian Eigel, PhD – Assistant Director of Science, National Emergency Cardiovascular Care Programs, American Heart Association

 

 

SPECIAL GUEST FACULTY:

 

Terry Bavousett - State EMS Director, Texas Department of State Health Services, Austin, TX

 

Steve Janda  - State Trauma  Director, Texas Department of State Health Services, Austin, TX

 

Edward M. Dolan, EMT-BProgram Specialist, Office of Grants and Training, Preparedness Directorate, U.S. Department of Homeland Security, Washington, DC

 

Lori Moore, Dr PH, MPH, EMT-P – Assistant to the General President, International Association of Fire Fighters, Washington DC

 

Raymond L. Fowler, MD – Past-President and Co-Founder, National Association of EMS Physicians; Inaugural National Program Director, Basic Trauma Life SupportÓ; Associate Professor, Emergency Medicine, University of Texas Southwestern Medical Center and the Parkland Health and Hospital System; Deputy Medical Director for Operations, the Dallas Metropolitan BioTel (EMS) System, Dallas TX

 

Gary M. Vilke, MD   Medical Director, San Diego County EMS; Professor of Clinical Medicine, University of California, San Diego; CA