Consolidation and corporate investment in medicine are rapidly changing the health care landscape. The past two years of the pandemic have put an increased spotlight on the outsized impact of horizontal consolidation and vertical mergers on emergency physicians and patients.

ACEP has long fought to protect the autonomy of the emergency physician, but the shifting landscape has led us to increase our efforts to address your concerns on consolidation. It is within this uncertain environment that ACEP’s new strategic plan was developed, and a core strategy of the advocacy pillar is focused on creating awareness around the business of emergency medicine and having difficult discussions about possibilities and protections.

Find more detailed information, including videos and full comment letters related to the following activities, at acep.org/physicianautonomy.

Prioritizing the Physician-Patient Relationship

March 2022: ACEP filed an amicus brief in the AAEMPG v. Envision case, upholding the sanctity of a physician’s duty to patients and the importance of allowing them to practice medicine without undue pressure from outside forces. Through this filing, ACEP is applying its might on behalf of our nearly 40,000 members in legal efforts to assert the physician’s right to autonomy in medical decision-making. The Emergency Medicine Residents’ Association (EMRA) also filed a Declaration of Interest in support of the ACEP position.

April 2022: ACEP believes the physician-patient relationship is the moral center of medicine that can never be compromised. On April 6, the Board of Directors reaffirmed this position by approving the ACEP Statement on Private Equity and Corporate Investment in Emergency Medicine. The core beliefs outlined in the statement reaffirm that, “any practice structure that threatens physician autonomy, the patient physician relationship, or the ability of the physician to place the needs of patients over profits should be opposed,” and that, “financial motives should never supersede an emergency physician’s autonomy to make bedside decisions in the best interest of the patient.”

Raising this Problem to the Government

February 2022: Earlier this year, the Federal Trade Commission (FTC) reaffirmed its commitment to working closely with the Department of Justice (DOJ) to review and update the agencies’ merger guidance, particularly around vertical consolidation. ACEP staff spoke to the FTC directly about this issue and was encouraged by them to formally respond to the FTC’s Request for Information on Merger Enforcement on behalf of ACEP members.

April 2022: ACEP gathered, analyzed, and combined more than 100 ACEP member responses about the daily impact of consolidation to illustrate patterns as part of its formal comment letter submitted to the FTC on April 20.