American College of Emergency Physicians
Emergency physicians from across the nation are visiting Capitol Hill on April 16 during ACEP's 2024 Leadership and Advocacy Conference to speak with their legislators about
- Solving the Emergency Department Boarding Crisis
- Protecting Emergency Physicians from Violence in the ED
- Guaranteeing Emergency Physician Due Process Rights
- Fulfilling Medicare’s Promise for Physicians and Patients
Learn more below about these four pivotal issues facing emergency medicine.
Solving the Emergency Department Boarding Crisis
Hospital emergency departments (EDs) have reached a breaking point due to a long-standing problem known as “boarding,” where patients are held in the ED following stabilization and care awaiting an inpatient bed or space in a tertiary facility.
Boarding has significantly increased nationwide and become a public health emergency. ACEP collected more than 140 personal stories from emergency physicians across the country. Nearly all respondents (97%) cited boarding times of more than 24 hours, with one-third stating they had patients stay more than one week, and 28% citing they had patients boarding more than two weeks. Patients with behavioral health needs wait on average three times longer than medical patients. Research has shown that 75 percent of psychiatric emergency patients, if promptly evaluated and treated in an appropriate location – away from the active and disruptive ED setting – have their symptoms resolved to the point they can be discharged in less than 24 hours.
How Can Congress Help?
There is no one-size-fits-all solution to ED boarding, but there are legislative efforts that will help alleviate the strain.
To help alleviate psychiatric patient boarding, ACEP urges legislators to cosponsor the bipartisan “Improving Mental Health Access from the Emergency Department Act” (H.R. 5414/S. 1346) to ensure appropriate treatment and follow-up care for our patients with acute psychiatric needs.
Resources:
Improving Mental Health Access from the Emergency Department (Issue Paper)
Why Boarding Happens, and How it Worsens (Infographic)
Protecting Emergency Physicians from Violence in the ED
Violence in the emergency department is a serious and growing concern. More than 91% of emergency physicians reported that they or a colleague had been attacked or threatened on the job within the past year, according to a January 2024 ACEP poll of its members. Nearly three-quarters (71%) said that violence in their ED is worse than last year. In addition to the immediate physical threat to emergency physicians and other ED personnel, workplace violence causes significant stress for health care providers and patients seeking treatment in the ED and contributes to job dissatisfaction and burnout.
As Congress has looked at ways to address broader issues of increased violence in our communities, we ask legislators to establish important, common-sense procedures to protect emergency physicians, health care workers, and patients from violence in the health care workplace.
How Can Congress Help?
ACEP urges legislators to cosponsor bi-partisan legislation to address this problem - the “Workplace Violence Prevention for Health Care and Social Service Workers Act” (H.R. 2663/S. 1176) and the “SAVE Act” (H.R. 2584/S.2768). Congress needs to swiftly consider these bills to help protect emergency physicians and our colleagues in the emergency department.
Resources:
Protecting Emergency Physicians and Health Care Workers from Violence (Issue Paper)
Guaranteeing Emergency Physician Due Process Rights
The best interests of all patients are served when emergency physicians practice in a fair, equitable, and supportive environment. The right to due process provides the foundation for this supportive environment, ensuring that emergency physicians can fully advocate for their patients without the fear of retribution or termination by employers.
Safeguarding the right to due process for emergency physicians helps sustain and advance quality patient care and safety. All emergency physician contracts should include a due process clause.
How Can Congress Help?
ACEP urges legislators to cosponsor the “Physician and Patient Safety Act,” bipartisan legislation sponsored by Senators Roger Marshall, MD (R-KS) and Elizabeth Warren (D-MA) and Representatives Raul Ruiz, MD (D-CA) and John Joyce, MD (R-PA), to guarantee due process protections for emergency physicians, ensuring that those who provide our nation’s health care safety net can effectively advocate for all patients without fear of retaliation or termination.
Resources:
Guaranteeing Emergency Physician Due Process Rights (Issue Paper)
Fulfilling Medicare’s Promise for Physicians and Patients
For decades, Medicare physician reimbursements have failed to keep up with inflation, despite other Medicare participants receiving annual inflationary updates. Further, the yearly threat – and implementation – of significant cuts to Medicare physician payments continues to destabilize our nation’s health care safety net. Rather than face a yearly scramble to address steep payment cuts, emergency physicians welcome the opportunity to work with Congress to identify policy solutions that will provide long-term stability for Medicare beneficiaries and the physicians who manage and provide their health care.
How Can Congress Help?
ACEP urges Congress to work with emergency physicians to provide long-term stability for Medicare and to support and contribute to ongoing bipartisan efforts to stabilize the Medicare physician payment system.
Resources:
Ensuring Stable and Fair Medicare Physician Payment (Issue Paper)
