As voters across the country braced for uncertainty heading into Election Day 2024, emergency physicians could rest assured that the National Emergency Medicine Political Action Committee (NEMPAC) was looking out for their best interests.

Although ACEP members have differing opinions on issues that drove voters to the polls, most agree on the pressing challenges facing emergency medicine—patient boarding, workplace violence, defending emergency medicine against insurer bad practices, and creating an appealing workplace and opportunities for the next generation of emergency physicians.

Many may question whether to get involved in advocacy amidst a myriad of professional pressures. However, decisions that affect how we take care of our patients are regularly being made by nonphysicians. NEMPAC gives us a seat at the table among thousands of competing interests in Washington, D.C.

ACEP asked several emergency physician advocates across the country to tell us why they got involved with NEMPAC, and why NEMPAC is important to the future of emergency medicine.

Money Buys Access

“It’s not enough to rest on our white coats and initials. Instead, we need to fight fire with fire and open our wallets in order to heal and fix health care in our country.”

— Damian E. Caraballo, MD, FACEP | Florida

Damian E. Caraballo, MD, FACEP, said that during the past decade multiple legislators on both the federal and state level have told him that money is the lifeblood of politics. He said the reality of American politics is that money buys access, access leads to influence, and influence results in laws leading to change. Physicians are outspent by Big Pharma, hospitals, and health insurers, but wonder why they are always first on the chopping block fiscally or in legislation. Meanwhile, Dr. Carabello said, emergency physicians are outspent by optometrists, who are wise enough to understand that PAC money directly affects their bottom line and existential survival.

If emergency physicians and physicians in general want to take back medicine and the doctor–patient relationship, Dr. Carabello said, it is not enough to rest on our white coats and initials. Instead, emergency physicians need to fight fire with fire and open up their wallets in order to heal and fix health care in the U.S.

“If you want to make a difference, give your time,” Dr. Carabello said. “If you really want to make a difference, give your money. If you want to make change, you’re going to have to give both.”

Lobbying Is Essential

“Without a strong PAC, we have no chance, and our patients and practices will continue to suffer.”

— John R. Corker, MD, FACEP | Ohio

John R. Corker, MD, FACEP, pointed out that every day, decisions are made by nonphysicians that directly affect the ability of emergency physicians to care for patients. NEMPAC, he said, gives physicians a seat at these decision-making tables—whether it’s legislation or executive action, Medicare physician payment, or insulin price caps. Elected officials and their decisions have a big effect on patients and practices every day. Dr. Corker said he still has friends on the Hill from his time as a policy fellow.

“When I asked them how it’s possible that physicians’ salaries account for less than eight percent of total health care costs yet remain the only sector of health care that has their payment cut by Medicare every year (hurts us and patients, doesn’t help the budget), their only response was ‘the insurance companies and hospitals lobby better,’” Dr. Corker said. “That’s it, that’s the answer. Without a strong PAC, we have no chance, and our patients and practices will continue to suffer.”

Dr. Corker said it should be recognized that NEMPAC supports a bipartisan group of elected officials who have either proven or promised to support the issues important to our patients and practices. He understands that no candidate is perfect, and rarely does everybody agree on all issues. That is why NEMPAC’s support is revisited each cycle in case new candidates emerge or others don’t live up to their promises.

“That said, NEMPAC is also transparent, and we welcome all questions, concerns, and feedback regarding candidates we’ve supported,” Dr. Corker said. “Get involved and help us make a difference!”

Opportunities for Interaction

“I support NEMPAC … and hope you will too.”

— Kristin M. Donaldson, MD, MPH, FACEP | Illinois

Kristin M. Donaldson, MD, MPH, FACEP, said NEMPAC has provided opportunities for leaders in Illinois to interact with national and state level legislators during the past year. These interactions led to discussions about issues facing emergency physicians, including boarding, violence, and reimbursement.

“NEMPAC has provided these opportunities to educate legislators about important issues impacting emergency medicine and patients,” she said.

Openness to Collaboration

“I feel lucky to have a resource like NEMPAC…”

— Lisa Maurer, MD, FACEP | Wisconsin

Lisa Maurer, MD, FACEP, cited how NEMPAC’s influence and reputation on Capitol Hill has made a positive impact on the No Surprises Act legislation, regulation, and subsequent legal action, “without which we could be facing disastrous market forces for my independent democratic group.”

She noted how NEMPAC supports candidates on both sides of the aisle based on policy positions and openness to collaboration, and heavily considers input from local docs.

“Leaders in my state have been asked often about our personal experience and opinions regarding federal candidates,” Dr. Maurer said. “Frankly, I feel lucky to have a resource like NEMPAC where staff and docs on the Board of Directors use my hard-earned dollars to support the expert opinion and research that I don’t have the experience or time to do myself.”

Mr. Scheid is ACEP’s Communications Director.