If I’m missing some of the frustrations, by the way, they are what our board members and chapter leaders are finding out when we go to these meetings and get involved locally. We go to chapter meetings and members step up to say some situation is headed to an intolerable level. ACEP is there to listen and ready to solve problems. An organization can’t be successful or have the resources to put forth to solve a problem unless it has content and dedicated members. Members are our lifeblood.

KK: What would you say to the emergency physician who says, “I get all the benefits even if I don’t pay my dues because everyone else paid their dues”? Basically, herd advocacy.

MG: I’m not going to say that everyone should contribute to the overall welfare of our specialty. That’s your own personal choice. I just think that if people were to investigate what the College is doing, they would find colleagues who are like-minded. Camaraderie and esprit de corps are invaluable to your own personal being. If you stand on the outside, you will feel isolated and lonely. You won’t be part of the overall changes that impact you. Our members have the benefit of thought leaders constantly debating, having discussions, and writing about where things are heading. You are at a disadvantage if you don’t see what is coming.

KK: What has ACEP been doing to support members in meeting Physician Quality Reporting System (PQRS) requirements?

MG: I feel like our specialty has been wrestling with a technical expert panel, trying to find quality measures that the Centers for Medicare & Medicaid Services (CMS) will accept for emergency medicine. It has been a very frustrating process because, even working through the National Quality Forum and others, our recommendations sometimes fall on deaf ears.

In 2014, CMS removed approximately 75 of 370 measures for all of medicine, many that impacted emergency medicine. Fortunately, we also learned that there was another option for PQRS reporting, called a QCDR.

ACEP met with some experts in Washington, D.C., in August and found if we were to create our own QCDR, then we could create our own quality measures, get them approved by CMS through the QCDR methodology, disseminate them to our members, and be able report in 2015. Otherwise, we were looking at a potential 6–10 percent reimbursement cut in 2017 if reporting is not done in 2015. Obviously, this was a front-burner item—some things present themselves and we have no choice but to address them immediately.