We need to expand our advocacy for procedural sedation, observation medicine, care coordination, and other skills that meet our patients’ demands.

We have to make sure that we offset quality and cost-containment measures with medical malpractice solutions.

We need to be given control of the resources we need to become the coordinators of patient care and allocators of acute health care resources. We are the most capable physicians to manage and care for patients with complex medical conditions and acute psychiatric problems. We have to make sure these patients are not just left to board in the emergency department.

Whether you are a partner in a democratic group or employed by a large medical group, hospital, or academic center, you deserve to be paid fairly. It is disheartening to hear of the burdensome amount of debt with which many of our recent graduates are leaving residency. Recruiting the best and brightest to our specialty requires us to be diligent in our methodology and to ensure fair payment for our services.

ACEP needs to vigorously advocate to ensure insurance companies pay fairly. We have to engage policymakers, the media, the public, and other decision makers on the value of the care we provide. We must ensure that there is a standard for what constitutes fair payment. We have to work with patient advocacy groups to make sure the high-deductible plans have affordable patient responsibilities and do not shift more health care dollars to insurance companies.

As states pass laws that “rate set” emergency physician payments, we need to take an aggressive legal and possibly even lead a Constitutional challenge to make sure that insurance companies, Medicare, and Medicaid pay their fair share. As Medicaid and Medicare numbers expand and the number of insured commercial patients decreases, we need to make sure that all pay fairly. This responsibility cannot be shifted to a decreasing number of commercially insured patients.

We need to protect graduate medical education funding. We need to assist with the American Board of Emergency Medicine/American Osteopathic Board of Emergency Medicine merger so that residency spots are not lost and advocate for increased funding to train the numbers of emergency physicians needed.

We need to be at the forefront of developing alternative payment modalities that demonstrate our value and create gain-sharing agreements so that emergency physicians are compensated for their conservation of resources and care coordination. We need to create win-win-win situations for payers, physicians, and, most important, patients.