I am serving as President of the NJ chapter of ACEP and was asked to give a little of my background for the website. First, the name I go by is "Ty" - my real name is Anthony but Tony never seemed right and the nickname was assigned before I can remember. I have been practicing Emergency Medicine in New Jersey for almost 20 years. The first ten years at Robert Wood Johnson University Hospital in New Brunswick and the last 9 years at Somerset Medical Center as the Chairman of the Department of Emergency Medicine.

Born and raised on Long Island, my undergraduate degree was in Biochemistry at Brown University and I went to SUNY Upstate in Syracuse for medical school. From there I did my emergency medicine residency at Allegheny General Hospital in Pittsburgh. I decided to pursue a career in medicine during college when faculty and friends encouraged me. No one in my family was a medical doctor but I worked as a lifeguard, volunteered for the Red Cross and in a hospital during high school.

In Syracuse, I originally thought I would go into Family Practice. It became clear through my rotations that I liked the excitement of the emergency department, enjoyed procedures and felt like the acute care phase of treatment often dictated the patient outcome. Emergency Medicine was a new and expanding specialty and I felt would be right for me. As time has gone on and I've accepted more administrative duties, I still look at myself first and foremost, as an emergency physician. In medical school I met my wife, Lynn, who is a practicing Pediatrician and we have 2 daughters, a college sophomore and high school senior.

My philosophy has always been that to be a good emergency physician you need to be able to multi-task, make quick decisions and work in an often chaotic environment. You must also be well trained but also compassionate, friendly and able to relate to patients and families when they are not at their best. Emergency physicians hold a unique place in the medical profession. Not always appreciated by patients or colleagues, we must set and maintain high standards and always do what is right for the patient. Even over my years I have seen a change in perception, for the better, of what we do. Our relationship with nurses and other hospital staff is critical to the care of our patients. The diversity and complexity of emergency medicine makes the "team" approach vital and I would encourage everyone practicing to embrace this concept.

A concern about emergency medicine careers has always been burnout. The high stress and fast pace can take its toll. Being part of the team, recognizing your limitations and remembering the positive impact you make on people's lives can help you avoid this. I am very glad I chose emergency medicine and am looking forward to working with you on advancing emergency medicine in New Jersey. I can be reached by e-mail at ahartmann@somerset-healthcare.com or phone at (908) 595-2349.

When I was asked to write something for the web site as the President of NJACEP, my first response was to provide a long detailed copy of my CV as my "bio." Unfortunately, that really wouldn't help you understand my persona nor be able to fully appreciate what brought me to represent this fine organization. Well, you can say I'm a Jersey dude, a pure bred, born and raised all my life here, except for medical school and student rotations. I must admit, I'm embarrassed to say I've never been to LBI! My family moved around for a few years in central Jersey until my parents settled into Bound Brook in 1968 where I went to high school and eventually met my wife, Laura.

I always had an interest in the sciences - especially in biology - and was in awe when I read my father's Red Cross first aid book (1940's edition). Medicine looked like "fun." I have learned that many forces shape one's life, and frequently, through serendipitous interactions, one's life can drastically change.

The biggest influence on my life came when my mother pointed out an article in the weekly local town paper recruiting for "kids" from the ages of 13-17, to join a newly formed "cadet corps" at the local volunteer rescue squad. Well, I was naive, but interested, went to the meeting and signed up. Perhaps, that was a turning point in my life since that experience convinced me to pursue a career in medicine. I graduated in the first EMT course run in NJ in 1972 and had a passion for emergency medical services. I attended Rutgers College, graduating in 1979, but at the time medical school was extremely competitive and I was persuaded from applying by the Dean since he said my GPA was not competitive enough.

I had few role models in medicine, except for a family practitioner in town. He was loved by all his patients and would make frequent house calls. He had a gentle demeanor and loved what he did. He also lived in the biggest house in town! So medicine was looking better and better - of course that was in the late 70's and early 80's.

I decided to work as a full time security guard at what was then Raritan Valley Hospital, working the night shifts so that I could complete my last prerequisite for medical school - biochemistry at the local community college. But again, as fate would have it, the State of NJ decided (after many public hearings) to close the hospital and convert it into a facility for the developmentally disabled. I had completed my biochemistry course but needed another full time job so, on a whim, and by luck, I found an ad in the local paper for a pathology technician - yes, the person who assisted with autopsies at a local hospital. After four interviews I was hired.

The day that Raritan Valley Hospital closed, that same family practitioner that I had worshipped when I was younger had a massive stroke. I was there that morning at 5:00 a.m. with the rescue squad to try to help him out, in that big beautiful house. I will never forget finding him on the light colored carpet in his bedroom adjacent to his bed, unconscious, seizing, posturing, and knowing that he was doomed. And what was worse was that he could not be transported to the hospital - his hospital, that he had supported financially and with his practice. So we began a long ambulance ride to what was then Middlesex General Hospital (most of you now know it as Robert Wood Johnson in New Brunswick). He never regained consciousness and died approximately a week later.

My thoughts of pursuing a career in medicine waxed and waned for the next five years, until one of the pathologists I worked with continued his monthly encouragement (it bordered on nagging) as to why I didn't want to apply to medical school. I had attempted one round already and had little ambition to spend additional time and money. He was a MD and suggested perhaps osteopathic schools. The rest is history. My wife and I packed up everything we owned, placed our furniture in storage, and moved to Maine in a one room pre-fabricated home. We essentially gave up everything and took a gamble. After all, what was in Maine - moose, cold, snow, a seven-hour ride from home, I think you get the big picture. I graduated from the University of New England College of Osteopathic Medicine and completed a rotating internship at St. Michael's Medical Center in Newark, N.J. - a grueling year of very hard work. I began a family practice residency at Somerset Medical Center. However, after one year, I decided that family practice was not for me - although I enjoyed the concept of the gate-keeper and taking care of the entire family from neonates including OB to geriatrics, I could see the early pressure of managed care. I envisioned that big insurance companies would slowly erode into the quality of care and the deleterious effects on primary care.

Thus, I entered into an emergency medicine residency at Morristown Memorial Hospital where I completed my training, including serving as chief resident, and then took a position as a member of the faculty. I have practiced there for the last eleven years. Currently, I serve as the Vice-Chairman, of the Department of Emergency Medicine and Associate Director of the ED. I also serve as the Medical Review Officer for Corporate Health Service and the medical Director for Travel MD and Work Med at the hospital.

My continued interests with emergency medicine led me to participate in NJ-ACEP many years ago, first serving on the Board of Directors and then advancing up the officer track. I welcome representing the approximately 600 physician members of our outstanding chapter for the 2005-06 year. I have always been interested in the political process (clearly influenced when I was in high school and given the honor to enroll in an experimental two-year program called Leadership Involvement Program - LIP). It was LIP that has enabled me to stay abreast in politics and learn more about the legislative process both on a local, state, and national level. Perhaps my observation of the Watergate Hearings during a trip to Washington in 1974 had something to do with my interests in the political process. I continue to serve as the STATPAC chairman and serve on the NEMPAC Board of Trustees and the Federal Governmental Affairs Committee for National ACEP for the last two years.

Despite my leadership roles both on the local and state level, I have maintained an active practice of emergency medicine, still working 50% of my shifts at night. The practice of emergency medicine is ever changing with many demands placed on our specialty - regulatory, legal, financial, moral, and ethical.

I married my high school sweetheart twenty-four years ago, and we have two children, Amanda, age 15, who is trying to find out what adolescence is all about, and Andrew, age 7, who wants to be a Marine. We have resided in Bridegwater Township for the last eleven years.

As the year progresses, I am always willing to discuss your concerns and issues on the state of affairs and the direction for our organization and its members. I can be reached either by e-mail at william.felegi@ahsys.org or office phone 973.971.7973.

Good Afternoon.

It is a distinct honor and pleasure to serve you as the new President of NJACEP.

The road to this office has not been an easy path but one I have finally reached.

It has been both a personal and professional goal to serve you in this capacity.

I have followed many true leaders in this organization, and I would like to thank those past presidents who are with us here today….

Before I continue, it is important for me to thank my family and my personal support system, my wife Laura, and my daughter Amanda and son Andrew, who unselfishly allow me to spend as much time with serving you and NJACEP.

I ask that you indulge me with a few minutes of your time…. to allow me the opportunity to speak with you about the direction of our organization, the practice of emergency medicine in our great state and our direction for the coming year.

Today, I want to speak about three key traits that I think epitomize the profession known as emergency medicine - passion, advocacy, and integrity. These three characteristics are what our practice is made of, and we cannot loose sight of what we are here for… our patients.

I sometimes think that perhaps physicians and organized medicine have failed ... failed by allowing managed care, personal injury attorneys, and government to interfere with our practice and ultimately our ability to offer unimpeded care to those who visit us every day.

But our profession is different from others … we wear the white hats … make no mistake about it … we have passion for our profession … we act as the safety net for all who enter that automatic door of the ED, 24/7, regardless of the patient's ability to pay, regardless of insurance issues, regardless of the time of day, or regardless of the patient's condition.

As many of you are aware, I strongly believe in political advocacy not only for our profession but also more importantly for the people we serve daily - our patients.

There is no other specialty or sub-specialty in the house of medicine that offers 24/7 access to medical care.

There are many impediments to our practice - diminishing reimbursement, Medicaid cuts, Medicare cuts, PIP cuts, uncompensated care, government interference, increasing regulations, managed care, medical liability, lack of on-call specialists, overcrowding, the list is endless … but yet, somehow we go on … on to provide excellent emergency care … and why? Because we have passion for what we do and what we believe in!

What directions do we need to take?

First, we need everyone's support when we are called upon to make phone calls, write letters, or call on your colleagues to aid us in the political process. It is not unusual for NJACEP to call upon its members to contact their elected officials, but this year we may have a unique opportunity with our legislature.

Through the work of our Board and Bev Lynch, our lobbyist and executive director, we have been successful in gaining support for a bill to ease the burden of medical liability for OUR practice and specialty.

We have been proactive rather than reactive.

Specifically, a bill may be introduced to limit non-economic caps for emergency care.

We are unique in that emergency care, under EMTALA, is an unfunded federal mandate to provide a screening exam and appropriate care despite the patient's ability to pay.

There is no other field of medicine that is expected to provide such care, not be entitled to any compensation, not be able to conduct risk stratification of patients by filtering out high risk patients, and ultimately, be responsible for any bad outcome a patient suffers despite the patient's injuries or disease process.

This is our unique opportunity to be proactive for our membership and ultimately our patients.

Where I am skeptical, we cannot focus on the past failures of our state legislature to pass meaningful medical liability reform. Yes, the Republicans - our allies for tort reform, are the bill's sponsors. But the Democrats have allowed the bill to be introduced - a first for our specialty.

Where I would like to stand here next year and report that we have been successful; I would be remiss in not being pragmatic. This will be a tough battle, one in which we are ready to fight with your help.

It is especially important this year that as many of us participate in ACEP's national rally for tort reform to be held on the Capitol's West lawn during the ACEP Annual meeting in Washington, D.C. on Tuesday, September 27th. For those of you attending the meeting, we will host the annual NJ reception the preceding night.

Secondly, it is vital that ever member of our organization donate to our political action committee - STATPAC. Over the last six years, we have continued to demonstrate a strong growth in the amount of money we have collected and I thank all those who have and continue to donate.

Our average donation per physician has increased, and the number of donors has grown. I know it is not easy to part with your hard-earned income, especially when everyone wants to cut more and more from reimbursement.

We have, however, developed a successful PAC which has allowed us access to be at the table to discuss key issues which affect our everyday practice.

Our formal mailing has just gone out, and I am happy to report that as of today, we are already half-way to our goal of $30,000 for this cycle.

We should not be ashamed to donate to a PAC. This is part of the game and the personal injury attorneys are very good at playing the game at our expense.

We will be working earnestly in the coming year to advocate for our less fortunate patients - those on Medicaid who may be forced to provide a co-pay for emergency department visits.

Despite federal cutbacks to the state and huge federal and state budget deficits, it is ridiculous to save Medicaid dollars by passing the expense on to these patients at the sake of jeopardizing their access to emergency care and, for many, their only source of medical care.

A society is judged on the way it treats its weakest members - we cannot and will not allow this to happen!

We will continue to work with the Department of Banking and Insurance to protect our patients' interests in reimbursement paid for PIP - Personal Injury Protection - and develop an equitable payment schedule.

We will also continue to negotiate to allow emergency medicine risk retention groups and captives access to the state malpractice subsidy fund.

We will work toward finalizing our Leadership Development Chapter Grant to encourage and cultivate new leaders for our organization.

And, our communication with our membership will be improved with updating our web site.

We need to make sure that we continue to support and assist our members, and to better assess membership needs, an internet survey will be conducted during the coming year.

To ensure quality care and patient safety, we will continue to work with the Department of Health and Senior Services to refine the regulations for designated Stroke Centers.

On a more somber note, Health insurer Aetna announced last month that its quarterly profit rose 16% with membership increasing 719,000 to 14.4 million and revenue jumping from $4.8 billion to $5.4 billion a year.

Cigna reported its first quarter earnings soared more than six-fold from last year and United Health Group, the nation's second largest managed care provider, reported a 41% surge in first quarter earnings.

And if that is not enough, there are strong rumors of Horizon Blue of NJ going public.

Where is this leading us? Finally, I ask you, why is the Medicare reimbursement rate considered a measure of adequate physician compensation?

Receiving 110% of Medicare is not OK (let alone 80%). Medicare is an entitlement program for the elderly and disabled. It is where the medical community should give back to society.

It is not a measuring stick that should be used by the FOR PROFIT insurance industry to calculate reimbursement rates. Third party payers should be paying substantially more than Medicare.

We need to cease using the Medicare fee schedule as a measuring stick and no longer consider 110% of Medicare as OK. Medicare is an entitlement program, not a for-profit entity!

The challenges ahead are monumental. The social contract between physicians and patients has been eroded by government, personal injury attorneys, and managed care.

But, perhaps unlike others, we in emergency medicine have maintained our integrity. I recently listened to a dynamic speaker at last months ACEP's Leadership & Advocacy Conference. He spoke of the components of integrity - being honest, empathetic, genuine, and responsible.

We have maintained a high degree of integrity unlike any other specialty. Why? Because integrity is doing the right thing because it's the right thing to do! This is our daily way of life in the Emergency Department. If we continue to advocate for our patients with passion, we will eventually win.

In closing, I hope to come back next year and report that we have been successful in all these endeavors, but if that is not the case, we can all still leave this room with our heads up high because, despite what managed care, personal injury attorneys, and politicians may say to us, we are still an honorable profession.

I thank you for your time and attention, and I look forward to serving you for the coming year.

Get to Know ... Archive

Born and raised in the Philadelphia area, I attended Penn State University and Jefferson Medical College as part of the 5-year Cooperative Program between the two institutions. After graduating from Medical School, I did an Internal Medicine Residency at Mercy Catholic Medical Center outside Philadelphia. I began working for Coordinated Health Services (CHS) right out of my residency and continue to work with some of the same people 17 years later, only now EmCare owns us.

After working on the Pennsylvania side of the river for the first 8 years of my career, I saw the light and began to work full time in New Jersey in 1995, first at Our Lady of Lourdes Medical Center in Camden. In 1998, I moved up to St. Francis Medical Center in Trenton, where I currently am the Director of the Emergency Department.

In the early 1990's, I became active nationally with the organization that eventually became the Association of Emergency Physicians (AEP). I served several years on their national Board of Directors and was their Treasurer for several years. However, I realized during my tenure with AEP, that it is always better to advance your causes from within than to buck the system. Thus, I ran for and was eventually elected to the New Jersey ACEP Board in the late 1990's.

Personally, I am married to the love of my life, Sharon. We celebrate our 20th anniversary this month. She is an Advanced Practice Psychiatric Nurse who specializes in Family Therapy, and she owns a large group practice in the Abington, PA area. We have 3 sons who are currently 17, 16, and 13. Each of my sons is a wonderful, unique individual in his own right, but my middle son has brought me much knowledge, compassion, and understanding. He is disabled with a genetic disorder called Angelman Syndrome. To learn more about AS, go to www.angelman.org.

My wife and I became active in the national organization for AS in the early 1990's, and I was elected to the national Board of Directors in 1997. In 1999, I became national President and presided over the organization, Angelman Syndrome Foundation, until 2003. That has truly been a defining moment in my life. I met and continue to correspond with individuals all over the world and have had the opportunity to speak in Finland. I remain on the national Board and am currently coordinating the local site for our national fund Raiser.

Among all of this, I look forward to a continuing to serve our membership as President of NJ-ACEP for 2004-2005.

Neptune, NJ
Married, two children (ages 11 and 5)

Born and raised in Irvington, New Jersey, I graduated from Union College in Schenectady, NY and attended Rutgers University before graduating from St. George's University School of Medicine in Grenada.

Initially a surgical resident at UMDNJ-Newark, I began working in emergency departments in 1984 and became board certified in EM in 1993. I have worked in several ED's in New Jersey Hospitals including Monmouth Medical Center, Atlantic City Medical Center, Bayonne Hospital, Capital Health System, Brick Hospital, CentraState MC, Beth Israel MC (Newark), UMDNJ-Newark, and St. Michael MC (Newark). Additionally, I have worked in PA hospitals as well including Misericordia and St. Agnes in Philadelphia, and Berwick Hospital and Wilkes-Barre General in the Poconos. Currently, I am working at Bayshore Community Hospital, a 200 bed suburban hospital located in Holmdel, NJ.

In addition to being an active emergency physician, I am a member of National ACEP's Public Relations Committee, and also serve as the Chief Medical Consultant for News 12 NJ, a regional TV station with a viewing audience of over two million viewers. My role at News 12 NJ includes hosting a weekly medical show called "To Your Health," which addresses various community health topics.

I worked in my first job for an orthopaedic surgeon in his orthopaedic research lab, and he was a D.O. and I became very interested in the Osteopathic Profession. I grew up in Pittsburgh, a huge Steelers fan!! So I applied to PCOM and did not have enough science classes, so they gave me a conditional acceptance on completion of those classes. I did complete them, and when I got to medical school, my best friend ended up being an orthpaedic technician who was very bright and had worked in the field for 10 years. He went into orthpaedic surgery and I liked everything as I went through my clinicals, so emergency medicine seemed to be a combination of all fields and the best compromise for me.

I knew I did not want to be a surgeon!!! In medical school I ran SOMA (student osteopathic medical association) nationally, and I loved the administrative aspects of medicine.

I did my internship in North Miami Beach and loved Florida but did not think it was conducive for a great work environment, so I came back to Pennsylvania to Albert Einstein Medical Center to do an EM residency and was elected EMRA president. This is where I met Scott, who is definitely my partner for life, and my real life began. Of course, now living in Philadelphia, I adopted the Eagles as well as kept the Steelers as my teams, and Sunday for both of us is the most important day of the week!!! My family in Pittsburgh then disowned me for not returning to Pittsburgh, as they assumed I would, and I became the black sheep even though I was pursuing an educational dream.

Since administration was in my blood after two other jobs, I now am at Monmouth Medical Center as their ed chairman and love being at the beach with the next two most important pieces in my life, Jacob, 4, and Benjamin, 2. I am very happy to be once again running NJ-ACEP as your current president and am humbled every day by the warmth and friendships that I have developed here.

My biggest goal for this enthusiastic NJ chapter is to get functioning committees and change our lives for the better in our every day working environment that hopefully you all love as much as I do.

My name is Victor Almeida. I am a New Jersey native, born in Newark. I completed my undergraduate education at Fairleigh Dickinson University, my medical training at UMDNJ-SOM and my residency training at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania. I have been working in New Jersey since the completion of my residency in 1994 as a full time clinician.

Currently, I work clinically in the Emergency Department at Union Hospital, a small community hospital located in the northern tier of the state.

Moreover, I serve as the Director of Medical Education providing oversight to the postgraduate training programs. In addition, I also serve as the Osteopathic Program Director at Newark Beth Israel Medical Center, where I assist in the management of our dually certified allopathic and osteopathic training program. I continue my work with NJ-ACEP as the Chairman of the Education Committee for the last three years, bringing my peers continuing medical education programs. Regionally, I sit as a Board Member for the New York College of Osteopathic Medical Educational Consortium. Nationally, I work with a small group of physicians on the Osteopathic Graduate Medical Education Committee for Emergency Medicine and help forge the future leaders in Emergency Medicine.

My newest project is my one month old, born on August 20, 2003, who helps round out the family with my wife Suzy. My other two other children, Victor and Olivia, both under the age of four, subsume whatever free time I have left. Bike rides are family affairs these days. When I had time for hobbies and interests, I enjoy carpentry, gardening and the beach!

Anthony Hartmann

William Felegi

Steve Katz

Bruce Bonanno

Jennifer Waxler

Victor Almeida

© 2003 NJACEP