Emergency medicine is the healthcare system’s go-to specialty for cases which cannot be managed elsewhere in the continuum of care, with patients routinely referred from physician offices, urgent care centers, and ambulatory surgery centers, among other places.

From patients presenting with sprained ankles and earaches, all the way through the critical trauma patients, the AAA patient superbly diagnosed by the emergency physician using bed-side ultrasound, and the chest pain patient who arrests with a STEMI, we have emergency physicians today addressing and treating these patient needs and making the appropriate calls to the appropriate specialists. Emergency physicians manage a critical revenue resource for every hospital.

As opposed to being a focus of expense in healthcare, emergency physicians today actually save insurance dollars through such programs as observation services and workers compensation programs.

What a wonderful opportunity for emergency medicine.

The quarterback, the signal caller is a role that certainly seems to fit emergency physicians, given the parameters and distinguishing characteristics presented above.

Some of the most critical decisions affecting patients and all of their downstream care are initiated by emergency physicians. ACOs and bundled payment models will usher in very different payment and reimbursement models, replacing traditional fee for service.

Some of these issues will be contingent on the political winds of change post 2012 elections, but it is reasonable to assume the current system will be changing regardless of the election outcomes. That said, emergency medicine needs to secure its role, so others do not define it for the specialty. This is a critical moment for the specialty and cannot be missed.

Refining the quarterback role will go far in ensuring emergency physicians are properly recognized and reimbursed in the models of the future. In the words of Bill Gates, “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let yourself be bullied into inaction.”

This is a great time for emergency medicine, and especially a great time to define a leadership role in the emerging new era in healthcare.

John G. Holstein is Director of Development with Medical Management Professionals, a national physician coding, billing and practice management company.

References

1. Rodak, Sabrina. “Are You an Old or New Era Hospital Leader?” Becker’s Hospital Review, May 31,2012
2. Galvin, Robert. “Pay for Performance, Transparency and Value Driven Healthcare.” NY HFMA conference presentation, March 29, 2012.
3. Forbes Insights. Getting from Volume to Value in Health Care. June 2012.
4. Fuchs, Victor R.; Schaeffer, Leonard, D. “If Accountable Care Organizations Are the Answer, Who Should Create Them?” JAMA, Vol. 307, No. 21, June 6, 2012.
5. Muhlstein, David; Croshaw, Andrew; Merrill, Tom; Pena, Christian. Leavitt Partners. “Growth and Dispersion of Accountable Care Organizations: June 2012 Update.”
6. Spoerl, Bob. Putting People at the Front of Accountable Care: Insight From CHI’s Dr. Barry Hoover.” Becker’s Hospital Review, June 20, 2012.
7. Cantlupe, Joe. “Emergency Care for the ED” Healthleaders Media, May 14, 2012.
8. Schur, Jeremiah, MD, MHS; Venkatesh, Anjun, MD, MBA, The Growing Role of Emergency Departments in Hospital Admissions; The New England Journal of Medicine, Vol 367; August, 2, 2012.
9. Gindi, Renee M., Cohen, Robin A., Kirzinger, M.P.H., Centers of Disease Control, Division of Health Interview Statistics, National; Center for Health Statistics, May 2012.
10. Bill Gates. World Economic Forum. Davos. 2007.