To resolve these issues, Dr. Rosenau and Dr. Gerardi advise:

• Enacting liability reform (which the poll ranked as the most important solution to improving emergency care)
• Urging the government to increase the number of paid slots for physician training
• Enticing psychiatrists to see more patients by increasing Medicaid rates to Medicare rates
• Using telemedicine to increase access to psychiatrists who have inadequate availability due to manpower shortages and limited insurance/federal/state program participation
• Increasing the number of intensive outpatient treatment centers and programs
• Increasing inpatient capacity
• Addressing unfunded mandates, such as EMTALA

Action Needed

Armed with the poll’s results, Dr. Rosenau and Dr. Gerardi urge ACEP members to share the information with individuals who have decision-making power (eg, state and federal legislators, medical societies, and hospital administrators). For an even greater impact, Dr. Rosenau and Dr. Gerardi recommend becoming involved in local politics or supporting your state’s medical society chapter.

Dr. Gerardi said that congressional representatives are willing to listen because emergency physicians care for many of their constituents. “Stories illustrating the data win the day inside the halls of Congress,” he said. “If you can’t visit your congressman, share your stories with ACEP, and we will take them to Washington, D.C., for you.”

Stories illustrating the data win the day inside the halls of Congress. —Michael J. Gerardi, MD, FACEP, ACEP President-Elect

ACEP is urging Congress to make a firm commitment to emergency medicine patients by holding a hearing to examine whether additional strains are occurring in the ED safety net as a consequence of ACA.

Future Outlook

Dr. Rosenau maintains that all U.S. citizens deserve health care coverage. Of those polled, 34 percent believed that the ACA will have a positive impact on access to emergency care in the long term.

But in the near and middle term, there is a danger that there won’t be adequate infrastructure to ensure adequate care. “We need Congress to act,” Dr. Rosenau said. “Many politicians think emergency medicine contributes to the high cost of medical care, but ultimately, it is a valuable service for a reasonable price for 136 million people per year.”

“ACEP’s poll should be viewed as an alarm and a call to action,” Dr. Rosenau concluded.

Karen Appold is a writer in Pennsylvania

Reference

1. Association of American Medical Colleges. GME funding: how to fix the doctor shortage. Available at: https://www.aamc.org/advocacy/campaigns_and_coalitions/fixdocshortage/. Accessed June 10, 2014.