Earlier this week, ACEP responded to a congressional request for information (RFI) from the Senate Health, Education, Labor, and Pensions (HELP) Committee leaders Chair Bernie Sanders (I-VT) and Ranking Member Bill Cassidy, MD (R-LA), regarding the drivers of and potential solutions to ongoing health care workforce shortages.
Here's a brief summary of the key points we hit on the factors affecting emergency medicine as a profession and emergency physicians individually. We also addressed some challenging issues head on, not least of which is acknowledgment and consideration of the 2023 Match results for EM.
- ED Boarding, Stress, and Burnout: We echoed many of our points from the recent sign on letter we led to the White House, and suggested several solutions—such as creating a dashboard of available ICU beds and load balancing plans, enacting the bipartisan and bicameral "Improving Mental Health Access from the Emergency Department Act" that we have supported, full repeal of the Medicaid IMD exclusion, prohibiting MA plans from requiring prior authorization for transfers to post-acute facilities, making permanent telehealth waivers, supporting development of alternative acute psychiatric care models (e.g., EmPATH, PES units, BHERs, etc.), and creating more robust metrics.
- ED Violence: ACEP highlighted the results of our workplace violence survey and pushed for consideration of the two bills we've supported: Rep. Joe Courtney's (D-CT) "Workplace Violence Prevention for Health Care and Social Service Workers Act" and Reps. Madeleine Dean and Larry Bucshon, MD's "Safety from Violence for Healthcare Employees (SAVE) Act."
- Financial Stability and Economic Prospects: We relayed growing feelings that compensation does not match the demands of the specialty; issues regarding the growing corporatization of medicine, diminishing individual autonomy, and lowest rates of practice ownership of all specialties; continued issues with private payers that have gotten worse in the wake of the NSA implementation; and continued Medicare payment cuts.
Scope of Practice: ACEP urged Congress not to try to solve workforce shortages by expanding independent practice for APPs—which data shows doesn't solve the problem, doesn't increase access, and leads to worse outcomes and higher spending. The gold standard of emergency care is emergency physician-led, team-based care.
- Rural shortages: We highlighted issues regarding ED staffing, recruitment, and retention challenges for rural emergency care; shared our policy suggestions on establishing new incentives to mitigate some of this; and urged Congress to modify the Rural Emergency Hospital (REH) designation to include add-on physician payments.
Health workforce shortages are one of HELP's big priorities, but there are a number of congressional committees and members who are concerned and looking into this as well, so we will continue advancing our priorities and getting our message across.
Find out more about ACEP's workforce efforts.