Emergency physicians might think that in the wake of the perennially popular TV show “E.R.” and the slew of hospital dramas that followed, elected officials have a pretty good – if somewhat skewed – idea about what goes on behind the emergency department’s swinging doors and in emergency care generally. But that’s not necessarily the case, several ACEP members discovered, when they hosted their legislators as part of the College’s advocacy outreach efforts.

“Even at the Congressional level, there’s a misconception about what moves the money in health care. Many think that that it’s physicians – and in the emergency medicine area it isn’t,” said Brian Oliver, M.D., a Salt Lake City emergency physician who hosted emergency department visits with two legislators last summer.

“People are surprised to learn that physician fees are roughly only 6%-7% of the ED bill,” he said. “And some people don’t realize that we don’t have the option not to see a patient.”

Nicholas Vasquez, M.D., an attending emergency physician at St. Joseph’s Hospital and Medical Center in Phoenix, was able to address another myth – about the patients emergency departments actually serve – when he recently hosted Carlos Sierra, who works with Sen. John McCain (R-Ariz.). The senator’s aide had inquired about reports he had heard about emergency departments being clogged with uninsured patients and illegal immigrants.

“That [uninsured] argument is a 1980s reality. I countered it by explaining that the majority of people we take care of are citizens, they’re insured, and they have doctors,” Dr. Vasquez said. “Those patients have sought access to the system, but for one reason or another, couldn’t get it. That’s the reality today – and ERs are a good example” of where patients go when the rest of the medical system fails them.

Vidor Friedman, M.D., chair of the College’s governmental affairs committee, concurs with Dr. Oliver and Dr. Vasquez. He maintains that one of emergency medicine’s key challenges is that physicians have the mistaken notion that most people understand what the specialty does and who emergency physicians treat.