Emergency physicians are not the guilty party when it comes to exorbitant out-of-network rates. You’re seeing them with some of the surgical specialties, surgical subspecialties, and hospitals, etc. We are fighting to have a fair database that compiles billions of charges to determine what is the 80th percentile for a usual and customary rate for an emergency physician for a level 3 or 5 code. We feel that would provide us some negotiating stance when we take on payers who are, almost by extortion contracting, forcing us to accept rates that are unacceptable for our practices.

KK: Final thoughts?

MG: Let’s not forget about several other initiatives launched this year. We are tackling the disparity of care available for behavioral health and psychiatric emergencies and the psychiatric boarding problem.

Second, we have created a task force to promote a national discussion on end-of-life care and advance care planning. Emergency physicians are often stuck in the difficult situation of prolonging life because patients and families have not had an opportunity to discuss their wishes on how the patient wants to be treated when nearing death. These discussions should occur when patients are not in crisis, when they and their families are not under the duress of an ailment or terminal illness.

Third, emergency medicine needs to “own” sepsis care. We are the front line in recognizing sepsis and pre-sepsis syndromes and immediately initiating lifesaving therapies. We have convened an expert panel to review and summarize the science and develop educational materials for our members and the public.

Finally, please remember, in these times of change, our specialty will lead our country in creating an improved health care system and, at the same time, we will be recognized for the tremendous value we provide.