Resident/Student Issues: Advocacy

Crisis in Emergency Medicine - A Call for Activism
by Mark Reiter, MD MBA

Another year goes by, and problems such as the professional liability crisis, reimbursement issues, and the EMTALA unfunded mandate continue to frustrate emergency physicians. Policymakers across the country refuse to enact needed reforms to truly address these issues, rather considering (and often failing to pass) temporizing measures. As emergency physicians, we are in a precarious position. Our ability to provide the best possible care for our patients is compromised by worsening access to on-call specialists needed to perform life/limb saving interventions. At the same time, our own economic viability is in question, as liability premiums for emergency physicians in some areas of the country approach six figures and Medicaid reimbursement remains an embarrassment in much of the country, with a few states barely paying $10 for a Medicaid ED visit.

Still, we must remain optimistic despite the storm clouds hovering above. We cannot ignore the present reality and pretend that the liability crisis and other challenges facing medicine are someone else's problem. Each of us most do our part to help preserve our profession. Activism does work. For example, the AMA, in conjunction with most specialty societies, has successfully lobbied Congress to reverse a projected 5 percent cut in Medicare reimbursement for each of the past two years and instead to increase Medicare rates by 1.5 percent each year. This might not sound like much, but works out to a projected $40,000 difference for the average physician, much more than a lifetime of membership dues in a professional society. However, starting next year Medicare rates are projected to fall by 5 percent or more a year for seven years in a row unless our medical leaders can convince Congress of the folly of such an action.

As residents and fellows, many of us are not in a position to donate money towards causes such as Political Action Committees or the AMA's Professional Liability Reform Fund, but there is much that each of us can do. Here are a few ways that you can help:

• Maintain active membership in professional organizations that are fighting for physician concerns, particularly the AMA, AAEM, and ACEP. Each additional member increases the clout these organizations have, and your dues dollars support important advocacy activities.
  
  
• In conjunction with your professional organization, take a more active role by coordinating state and national advocacy efforts, or assisting with local grassroots activity.
  
  
• Meet, write, or call your state or federal legislators. You can e-mail a template letter of support for key issues in just a few minutes using materials found on the AAEM and AMA websites.
  
  
• Talk to the media. Let the media know how medicine's problems personally affect you and your patients. You can use talking points found in the materials from many professional organizations.
  
  
• Write a letter to your newspaper's editorial section.
  
  
• Educate your patients about important issues like these at every opportunity.

Mark Reiter MD MBA, is the Vice President of the AAEM Resident Section.