Gathering of Eagles: Evolution of a Revolution
Perhaps you have heard of it: a not-so-secret conference where the who's who of EMS assemble once each year. Dubbed the "Gathering of Eagles," most medical directors for the nation's 25,30 largest cities' 9-1-1 EMS systems, along with members of the FBI, U.S. Secret Service and other key federal agencies, meet to discuss advances in EMS research, clinical issues, operational lessons learned and newly-proposed changes to patient care. Together, this small cadre of emergency medical specialist leaders not only oversee the medical aspects of the day-to-day 9-1-1 calls in our nation's most populous cities, most of them also contribute medical expertise to homeland security/preparedness planning in communities in which nearly 50 million Americans dwell and earn their livelihood.
In 1998, Dr. Paul Pepe (previously an assistant to the medical directors in Seattle and EMS director for 14 years in Houston, TX) was called on by field providers in Pennsylvania (where he was then Commonwealth medical director) to put on a "state-of-the-art" or beyond educational offering that would challenge the status quo in EMS care. The goal was to create a venue where leading EMS physicians could exchange ideas among themselves and let EMS personnel, managers and medical directors (and anyone else interested) eavesdrop. With assistance from Dr. Ray Fowler, the original Basic Trauma Life Support (BTLS) program director, and Dr. Jeff Clawson, the developer of Emergency Medical Dispatch (EMD), Pepe had the beginnings of a faculty for his impromptu get-together. He also managed to recruit many of the leading, innovative EMS medical directors from several major U.S. cities, including Drs. Marshal Isaacs from San Francisco, Dave Persse from Houston, Jim Dunford from San Diego, Ed Racht from Austin, Paula Willoughby from Chicago and many other acclaimed EMS physicians.
Within one week, Pepe had established the first "EMS State of the Science: Evolution and Revolution" meeting. Despite its last-minute organization, that first conference seemed to come together successfully. The formula worked then, and it has continued to attract the best and brightest for the past seven years. Regulars today include Drs. Mike Copass from Seattle, Marc Eckstein from Los Angeles, Crawford Mechem from Philadelphia, Peter Moyer from Boston, Corey Slovis from Nashville and Bill Fabbri from the FBI. Last year, they were joined by U.S. Surgeon General Richard Carmona and the White House Medical Unit training director, both last-minute drop-ins.
With no dues, management structure or even infrastructure, Eagles instead seems to be more of a grassroots conference/effort, with the medical directors staying in close contact throughout the year, and debating and changing medical standards on the spot. Instead of the usual carefully choreographed curriculum found at other conferences, Eagles prefers to focus on EMS topics "du jour" - covering clinical, operational and administrative aspects that are in the spotlight at the time of the meeting. Past subjects have included hot-button topics like compression-only CPR, FBI interaction with local EMS systems, tactical EMS physicians, utilization of prehospital thrombolytics in the urban environment, ambulance diversions and the various issues surrounding nontransport options, and a roll-out of both Basic and Advanced Disaster Life Support classes. Presentations at the February 17 - 18, 2006, conference in Dallas, TX, will surely be just as cutting-edge.
The method of instruction is also decidedly different. Presentations must be only 10 to 15 minutes long, with a brief time period (<5 minutes) for Q and A while PowerPoint presentations are switched out. The other key feature has been the so-called "lightning rounds," in which the faculty, as a panel, is interrogated freely by the audience about a subject. In turn, bullet (20-second) answers must be given by each of the 25 faculty members. This rapid-fire style allows more topics to be covered in the 2-day conference. Considering these professionals' busy schedules, another interesting element of the gathering is a shared dedication to this event. As Pepe points out, "At most conferences, speakers do their presentation and then leave. At Eagles, everyone stays for everything."
All of these factors combined make "A Gathering of Eagles" arguably one of the most dynamic, informative and forward-thinking conferences in the EMS field. Look for a feature article in a future edition of EMS Magazine that will offer an overview of issues discussed at the conference. For additional information, contact Francie Issa at UT Southwestern Medical Center at 214/648-3784, or visit https://gatheringofeagles.us/.
Raphael M. Barishansky, MPH, EMT-B, is executive director of the Hudson Valley Regional EMS Council in Newburgh, NY, and a member of EMS Magazine's editorial advisory board. He can be reached at rbarishansky@gmail.com.
