The candidates discuss major issues facing emergency medicine

Each year, ACEP’s Council elects new leaders for the College at its meeting. The Council, which represents all 53 chapters, 39 sections of membership, the Association of Academic Chairs of Emergency Medicine (AACEM), the Council of Emergency Medicine Residency Directors, the Emergency Medicine Residents’ Association (EMRA), and the Society for Academic Emergency Medicine, will elect the College’s President-Elect and four members to the ACEP Board of Directors when it meets in October. This month, we’ll meet the Board of Directors candidates.

Michael J. Baker, MD, FACEP (Michigan)

Current Professional Positions: director of telehealth, EPMG/Envision; medical director, Munson Healthcare Cadillac Hospital, Cadillac, Michigan; clinical assistant professor, Michigan State University College of Osteopathic Medicine, East Lansing; ED informatics representative on the clinical excellence committee and chairperson for optimizing information technology, Trinity-Health; adjunct clinical instructor, University of Michigan College of Medicine, Ann Arbor; core faculty, University of Michigan/St. Joseph Mercy Hospital emergency medicine residency; attending physician, member of the telemedicine clinical quality committee, and Cerner physician liaison, St. Joseph Mercy Hospital, Ann Arbor

Internships and Residency: emergency medicine residency, University of Michigan

Medical Degree: MD, Ohio State University, Columbus (1993)

Response

ACEP’s strategic plans revolve around both threats and opportunities. The unpredictability of the COVID-19 health emergency represents a threat to ACEP. ACEP risks losing members to furloughs and burnout. Lower volumes and reimbursement will drive a reduction in the cost of care. Some emergency physicians have experienced a 20 percent wage drop. Cutting CME benefits will drive our members to low-cost options for education. As hospitals cut positions to save money, more work will fall on the physician. Emergency physician positions might be filled with nurse practitioners or physician assistants who must be adequately supervised and trained. ACEP must connect with members and support them in the workplace during this challenging time.

The second threat is the consolidation of insurers, health systems, and physician groups. Although ACEP has faced consolidation in the past, the level experienced today could restrict competition. As insurance carriers face reduced competition, they will force new ways to lower payments to physicians. One example is the ongoing attempts to pass unfair “surprise billing” legislation. Reduced competition among employers raises physician concerns with ensuring fair compensation, quality patient care, due process, and a safe working environment. ACEP’s vision statement declares, “Emergency physicians practice in an environment in which their rights, safety, and wellness are assured.” ACEP leaders can work with payers, health systems, and physician groups to establish fair workplace policies, promote appropriate reimbursement, and encourage competition.

One of ACEP’s most significant opportunities is to create and analyze big data through CEDR, E-QUAL, and EMF-sponsored research. Reliable data can support the adoption of new concepts, such as telemedicine and electronic records improvements. The consolidation of health systems provides opportunities to collect data in a standardized way. For example, I worked to convince a 93-hospital health system to support CEDR reporting for any participating emergency center. Lastly, EMF must be strongly supported in its vital support of independent research efforts and developing future researchers.

ACEP’s other opportunity is to push for insurance reforms. The COVID-19 pandemic demonstrated the value of emergency medicine to the health care system. Our work with disaster preparedness and ACEP’s quick development of COVID resources such as the ACEP COVID-19 Field Guide (acep.org/corona/covid-19-field-guide) stunned many outsiders who portrayed the emergency center as a high-priced place to receive medical care. ACEP can use that realization to push for fair payment, end narrow networks and surprise billing, and identify mechanisms to ensure adequate health care coverage. ACEP continues to push for a fair resolution to the surprise billing issue and advocates alongside state chapters advocacy, emergency physician groups, and other medical organizations. ACEP can re-affirm its commitment to its vision that “All patients have health care coverage that ensures access to emergency services. Legally mandated health care services are fully funded.” ACEP needs Board members who can quickly recognize and respond to new threats and opportunities