“Most of the population does not understand that, and the critical portion of the population who doesn’t is the politicians,” said Dr. Friedman, a managing partner of Florida Emergency Physicians who practices in Orlando. “These site visits give legislators a reality check, and hopefully opens their eyes to the bigger picture.”

For his part, Dr. Oliver found that both Congress members – Reps. Rob Bishop (R-Utah) and Jim Matheson (D-Utah) – were reasonably conversant on general health care issues. But Rep. Bishop found the experience especially enlightening, he added, from the standpoint of EMTALA’s effects on operations and the mechanics of triaging diverse patients. “Rep. Bishop hadn’t been in a hospital since he was born, so everything was eye-opening to him,” he said.

Primarily, the visits afforded Dr. Oliver an opportunity to talk about pressing national issues in emergency medicine – access problems, boarding, ambulance diversion, and the rapidly escalating rate of emergency department visits nationally. He and the legislators also discussed local issues, such as disaster preparedness planning, and some of Dr. Oliver’s concerns, including faulty data from a recent Press-Ganey report about Utah emergency department wait times.

Dr. Oliver advises keeping the visit to the emergency department focused and the group size small, to avoid “having the visit turn into a circus.” But he acknowledges the merit of also talking about the big picture in health care and where emergency departments fit into it. Legislators may not realize, for example, that most health care legislation either directly or indirectly affects emergency departments because they’re often the “front door” to the system. Activities such as hosting emergency department visits can provide context for policymakers in the future, he said.

“As health reform comes down the pipeline, there is going to be a tug of war, and it’s useful for ER doctors to have a voice in what happens as things move through Congress,” Dr. Oliver noted. “I think that emergency medicine is more affected by any and all health care legislation than other specialties because everything kind of trickles down to us.”

ACEP Board member Kathleen Cowling, D.O., who works for Covenant HealthCare in Saginaw, Mich., has hosted several legislator visits in recent years. She knows from firsthand experience how relatively little policymakers know about the cases and real-life challenges emergency physicians deal with daily. For example, she frequently must dispel the mistaken notion that most emergency department patients present with minor problems.