Summer 2013: National Advocacy at ACEP Leadership & Advocacy Conference 2013 Timothy J. Koboldt, M.D. Chief Resident, Emergency Medicine Washington University in St. Louis School of Medicine

POSTED: September 6th, 2013
POSTED IN: Summer 2013,

The American College of Emergency Physicians’ yearly Leadership and Advocacy Conference (LAC)  is one of the smallest but arguably one of the most important meetings for Emergency Medicine. Occurring every May in Washington D.C., it is an important time for physicians from Missouri and all over the country to learn the issues, advocate for EM, and get more involved in ACEP and organized medicine.

This year there was a strong showing from the MoCEP Board as M0CEP President Dr. Larry Slaughter, board members Dr. Douglas Char, Dr. Evan Schwarz, and Dr. Jonathan Heidt were in attendance along with resident board members Dr. Kene Chukwuanu and Dr. Timothy Koboldt. Dr. Sarah Hoper, resident from Washington University in St. Louis, and current Legislative Advisor for the Emergency Medicine Resident Association (EMRA), was in charge of the first day’s resident programming and gave a keynote address on the Affordable Care Act and Medicaid expansion. The following day commenced with learning the current issues and legislation for the legislative session as well as skills sessions for advocacy and building relationships with elected officials. Of particular interest was HR 36 the “Health Care Safety Net Enhancement Act of 2013” which would allow providers to have federal liability protection for all EMTALA-related care. The companion bill S 961 was introduced to the Senate by Missouri’s own Senator Roy Blunt.

Also among the topics discussed with legislators was HR 351/S. 351 “Protecting Seniors Access to Medicare Act of 2013” which would repeal the Independent Payment Advisory Board (IPAB) provision of the ACA. Since hospitals and nursing homes (Medicare Part A) are not subject to IPAB’s cost-cutting recommendations until FY 2020, it was felt that physicians and other outpatient services would unequally bear the brunt of any cuts.

Other issues included cuts to GME funding and a permanent Sustainable Growth Rate (SGR) fix. While medical schools have responded to the AAMC’s mandate to increase class sizes, the number of funded GME spots has remained static since 1997. Coupled with this are proposed cuts to GME funding in both the Republican and President Obama’s budgets. This could lead to a situation where there are more US medical school graduates than there are residency spots – leaving US medical grads without the specialty training they need to help the looming doctor shortage. In slightly more positive news, we learned that the projected 10-year cost of a permanent SGR fix has decreased from an estimated to $244 billion to $138 billion, which is felt by some lawmakers to be within the realm of possibility to prevent a 24.4% cut in reimbursement due to take effect in January 2014.

With these issues in mind, we were able to meet personally with Senator Roy Blunt, Representative Lacy Clay, and legislative advisors for Senator Claire McCaskill and numerous other representatives from Missouri. While these ideas were not universally met with open arms, we were able to ask our representatives to co-sponsor these bills, communicate ACEP’s position on the issues, and provide personal accounts and education about Emergency Medicine and the impact that these issues have on providers and our patients.

What would a Leadership and Advocacy Conference be without discussion of leadership, namely within ACEP? Due to the smaller size of this conference (~500 attendees), it is much more possible to have personal conversations and get to know the current leaders within the ACEP and those who will be running for office in October in Seattle. This proved to be a valuable way to hear the vision for the future from the current leadership in EM as well as to network and get to know the next generation of leaders within ACEP.

Overall, LAC is a great opportunity to learn the issues, advocate for our patients and our specialty, and to become more involved in organized medicine. Next year’s conference will again be at the Washington D.C. Omni Shoreham Hotel on May 18-21, 2014, and I hope you will strongly consider attending.