HighYield Emergency Medicine Advocacy

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High-Yield Emergency Medicine Advocacy

• What everyone interested in EM should know!
• Brought to you by the AAEM/RSA Medical Student
  Council

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Objectives

• What is advocacy?
• The issues that face physicians
• The issues unique to emergency medicine
• What you can do!

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Advocacy 101

• To Advocate - to speak or write in favor of
  support or urge by argument recommend publicly
• Advocacy - the act of promoting a particular
  issue, belief, individual, organization

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Advocacy 101

• Sometimes known as lobbying
• Lobbying is not synonymous with bribery and
  scandal

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Advocacy 101

• Lobbyists or advocates fight for important
  issues
• human rights animal rights child advocacy
  community practice social work consumer
  protection environmental protection
• Anything YOU believe in!

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Advocacy 101

• A few issues that matter to all physicians
• Medical liability reform
• Medicare physician payment reform
• Voice for the uninsured
• Improving public health
• Patient safety
• Managed care reform
• Research funding
• Medical education

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Advocacy 101

• A few issues that are unique to emergency
  physicians
• Corporate Practice of Medicine
• Due process in contract negotiations
• Restrictive covenants
• Open books
• Board certification
• Partnership and physician group dynamics

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Advocacy 101 - Corporate Practice of Medicine

• 38 states have statutes that limit or prohibit
  lay corporations from practicing medicine
• This prevents a conflict of interest
  corporations have a fiduciary duty to their
  shareholders, not to patients!
• Medicine is a profession, not a business

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Advocacy 101 - Due Process

• Legal definition - fundamental fairness and the
  right to a hearing when ones rights are
  threatened
• Why this matters? - rights to due process are
  well established in legal literature dating back
  to the Constitution of the United States

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Advocacy 101 - Due Process

• Why this matters? - Federal courts decided that
  physicians have a property interest in their
  medical staff privileges, therefore requiring a
  pre-deprivation hearing before any adverse action
  is taken against their medical staff privileges

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Advocacy 101 - Due Process

• Why this matters? - MDs in nongovernmental
  hospitals derive their due process rights from
  the Health Care Quality Improvement Act of 1986
  and from Joint Commission standards

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Advocacy 101 - Due Process

• Why this matters? - A hospital contracts with a
  business group that in turn hires physicians.
  They hire using contracts that often restrict
  physician due process in termination disputes -
  without due process, a physician can be fired
  without explanation

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Advocacy 101 - Due Process

• Why this matters? - Physicians should also have
  due process in order to advocate for their
  patients to hospital administration. Emergency
  physicians take care of uninsured and indigent
  populations - without due process, there is no
  formal way to advocate for their health and
  well-being

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Advocacy 101 - Restrictive Covenants

• Legal definition - an obligation imposed in a
  deed or contract by a contractor on to an
  employer to do or not do something
• Why this matters? - upon termination of a
  professional contract, some employers have a
  restrictive covenant stating a physician may not
  work in a defined geographical location for a
  specific period of time

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Advocacy 101 - Restrictive Covenants

• Why this matters? - worst-case scenario, if a
  contract is terminated, the physician may have to
  sell their home and move their family to find a
  new job
• The use of restrictive covenants are a
  controversial way the employer limits competition
  from physicians who leave their group

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Advocacy 101 - Open Books

• Legal definition - an accounting term used to
  describe a way of tracking financial information
  that is shared with employees
• Why this matters? - every emergency physician
  should access the information summarizing what
  fees have been billed and collected on his/her
  behalf

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Advocacy 101 - Open Books

• Why this matters? - contract management companies
  often hide this information from its working EPs,
  keeping them in the dark about their true
  monetary value to the practice and the amount of
  profit their employer is skimming off the top

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Advocacy 101 - Open Books

• Why this matters? - additionally, MDs have
  primary liability for billing errors and
  resultant fraud allegations, as all billing is
  submitted in physicians names and their provider
  numbers

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Advocacy 101 - Board Certification

• Legal definition - Board certification in the
  United States is overseen by the American Board
  of Medical Specialties, a non-profit umbrella
  organization
• Why this matters? - there are numerous studies
  implicating improved outcomes associated with
  emergency medicine residency trained physicians

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Advocacy 101 - Board Certification

• Why this matters? - there are organizations that
  are fighting to allow non-EM trained physicians
  to sit for the EM Boards. This would reduce the
  value of an EM residency and put downward
  pressure on EP salaries

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Advocacy 101 - Board Certification

• Why this matters? - untrained emergency
  physicians working in EDs attack the very
  integrity of our specialty. It undermines EM as
  a legitimate specialty. Our residency teaches a
  unique body of knowledge and cannot be learned
  through trial and error

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Advocacy 101 - Make Action Happen!

• Ten steps to grassroots advocacy
• Appoint a leader - YOU!
• Visit local leaders - professors, deans, local
  representatives, mayors
• Create and distribute education materials - THIS
  PRESENTATION!
• Invite policymakers to visit YOU
• Make contacts with other organizations - local
  physician leaders in your community

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Advocacy 101 - Make Action Happen

• Ten steps to grassroots advocacy
• Join larger organizations - AAEM, ACEP, SAEM, AMA
• Make donations to campaigns and Political Action
  Committees
• Volunteer to help campaigns that support your
  issues
• Team up with businesses
• Come to Washington, DC and meet with national
  leaders!

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Advocacy 101 - Make Action Happen

• Stay up-to-date -
• Visit the legislative action center
• http//capwiz.com/aaem/home/
• Capwiz will help you easily send letters to your
  representatives
• Forward the AAEM Advocacy Quick Hits to friends
  and family
• Let us know about important issues that matter to
  you and your community

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Advocacy 101 - Make Action Happen!

• For more information
• www.aaem.org
• www.aaemrsa.org/membership/
• www.ama-assn.org
• http//capwiz.com/aaem/home/