The quote “90 percent of life is just showing up” has been attributed to various people. In advocacy, that number is wrong. One hundred percent of advocacy is showing up, and ACEP LAC 2025 was another demonstration of ACEP members willing to show up in Washington, D.C., to advocate on behalf of emergency medicine.
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ACEP Now: June 2025 (Digital)By Clark Azubuike, MD, MPH
I was genuinely excited about ACEP’s Leadership and Advocacy Conference, as I had heard from mentors that it was the conference to attend if you wanted to learn how the sausage was made in emergency medicine health policy, nationally and statewide. I flew in from Texas, where I am rounding out my second year of residency training, and attended as a member of the EMRA Leadership Academy.
As I prepared to attend the conference, I wondered: What can we do to address the complex problems affecting emergency care in the U.S. health care system? I saw this conference as an opportunity to learn and understand how policy makes a difference in the health system, connect with fellow advocates, and contribute to work beyond the clinical setting.
This is also my first time visiting Washington D.C., and I found it a beautiful city. D.C. is historical and quaint, teeming with ambitious and enthusiastic people. I woke up excited and headed downtown to the conference hotel, where there was already buzz and excitement in the building; the who’s who in emergency medicine were parked in the conference hall.
What stood out to me was the diversity of participants from all over the country sharing different experiences, strategies, and actions taken to achieve common goals to improve emergency services for patients and the well-being of emergency physicians. Everyone I spoke with was welcoming and willing to connect, listen, learn, and share ideas. I also had the opportunity to interact with elders and leaders in organized emergency medicine.
ACEP’s Young Physicians Section/EMRA health policy primer was an eye-opening experience. It provided insight into policy-making and various approaches to addressing different issues, from homelessness and its effect on emergency department (ED) visits, to understanding reimbursement, to understanding medical-legal challenges facing emergency physicians. I also learned about how various ACEP state chapters were addressing local challenges facing their EDs and patient populations.
A few sessions from the other LAC main events stuck with me. One involved success with using data to address the boarding crisis. Another involved efforts from representatives to limit the scope of practice expansion using resources available from ACEP. I also found the practical sessions covering resolution writing, best practices for persuasive advocacy, understanding the legislative process and timelines, engaging with lawmakers, and advocating for national and statewide issues very useful. The primer on understanding the behemoth public programs of Medicaid and Medicare provided the necessary context to understand the history and contemporary issues faced by these systems.
I attended the Emergency Medicine Foundation dinner, where I interacted with donors and board members who were funding research priorities in emergency medicine.
The Capitol Hill Day was the culmination of the conference, providing the opportunity to meet with lawmakers and staffers, discussing and advocating for legislation that advanced the priorities of patients and our emergency physician colleagues. These visits seemed daunting at first, but being paired with LAC veterans made it an engaging and meaningful process for newbies such as myself.
As I reflected on the experiences on the flight back home, I remained grateful for the opportunity to interact with leaders, colleagues, and fellow physicians. I left LAC feeling inspired! I recognize that there is still a lot of work to be done, but in the words of Dr. Martin Luther King, Jr., “The arc of the moral universe bends towards justice.” I am filled with hope and optimism. I will be in D.C. again next year.
Dr. Azubuike is an EM resident at the Texas Tech University Health Sciences Center in Lubbock, Texas.
It is certainly not an understatement to say the results of the 2024 elections have created unprecedented political dynamics and great uncertainty in Washington, D.C. Although all presidents entering the White House utilize executive orders to establish their priorities, President Trump has used this tool to definitively lay out his vision for the next four years in many realms, including health care. In addition, the Republican sweep in winning the White House together with the U.S. House and Senate has given the Republican party the opportunity to make significant changes in how the federal government directs, funds, and manages the delivery of health care in this country. New leadership in the executive branch, especially within the Department of Health & Human Services, has brought significant restructuring of the agency and a new focus on the health of the nation.
With this political reality, ACEP members rallied in Washington for ACEP LAC25 to ensure the voice of all emergency physicians, and the needs of our members and our patients, were heard by legislators on Capitol Hill. This year, ACEP members went to the Hill to advocate on three critical issues:
- Supporting the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act (H.R. 2936), which would dedicate public health funding to creating bed-tracking systems and investigate innovative models to improve patient transfers.
- Supporting the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929 / S. 266), which would continue the federal financial support of programs designed to address mental health issues for health care workers.
- Protecting federal support of emergency care, specifically by lobbying Congress to maintain eligibility for Medicaid beneficiaries and fair reimbursement to emergency physicians through the Medicare Physician Fee Schedule.
The attendee numbers tell the story that ACEP members did indeed show up to advocate on Capitol Hill and network with peers and ACEP leaders. A total of 492 members attended the conference and went to the Hill to advocate for EM, including 202 attending for the first time, 88 emergency residents, and 14 medical students. Always the conference’s highlight, ACEP members participated in 297 Capitol Hill visits to offices representing 42 states, the District of Columbia, and Puerto Rico. There were 216 House visits and 81 Senate meetings with a balanced split of 157 meetings with Democratic offices and 137 meetings with Republican offices.
Every meeting with a member of Congress or a Congressional staffer is a critically crucial step in building a relationship with the policymakers who decide the future of health care. Relationships, whether in our personal lives or on Capitol Hill, are the currency of trust. Once that relationship is built and trust is established, you can create an opportunity to be an invaluable source of information for policymakers. By the very nature of the work we do and the care we provide, we can share stories of how federal policy affects real patients. Only 21 members of Congress are physicians, and yet all of them will vote on laws that dictate how we practice and the resources we will or will not have to provide that care. Given this reality, it is critically important to become the go-to person policymakers trust and rely on to guide their positions on health care issues.
This year’s conference had a positive vibe, and the LAC Planning Workgroup crafted a great Day 1 lineup of educational presentations, focusing on a back-to-basics theme. The educational program began with a primer on how Congress and executive agencies are structured and the jurisdictions of each in shaping health care. Following that were presentations titled “Bad Behavior of Insurers under the No Surprises Act,” “What’s the Scoop on Scope,” “Strategies on Effective Advocacy,” “The Basics of Medicaid,” and “Growing Threats to Clinical Autonomy” (which focused on increasing threats to care protected by EMTALA). Last, the “Board Out of Our Minds” presentation discussed federal efforts to address the crowding crisis, including highlights of the crowding summit held by the Health Resources and Services Administration in October 2024 due to ACEP’s persistent advocacy with Congress and the White House.
Day 2 started off with great conversations with key members of Congress, including Rep. John Joyce, MD (R-PA) who serves as co-chair of the GOP Doc Caucus, and Rep. Kim Shrier, MD (D-WA) who has been a staunch supporter of physician issues. Next up was a tandem conversation with Rep. Tom Suozzi (D-NY) and Rep. Brian Fitzpatrick (R-PA), who are both members of the solution-oriented Problem Solvers Caucus in the U.S. House.
And last, before heading to Capitol Hill attendees were briefed on the recently released RAND Report titled “Strategies for Sustaining Emergency Care in the United States,” which describes the incredible value emergency physicians provide to society, including services beyond care of the individual patient. The report highlighted that emergency physicians serve a strategic role in providing public health, behavioral health, disaster care, and other services for which they are not currently compensated. This report will serve as the basis for new advocacy strategies on behalf of emergency physicians and our specialty for years to come.
If you want to be part of the incredible voice of emergency physicians ACEP carries to Capitol Hill each year, join us next year for LAC from April 26-28, 2026, in Washington, D.C.!
Dr. Cirillo is ACEP President-Elect and serves on the ACEP Board of Directors. He practices emergency medicine for AdventHealth in Colorado and serves as the director of government affairs for US Acute Care Solutions.
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