Since the passage of the ACA in 2010, ACEP members have focused on quantifying and advocating for the value of emergency medicine and the emergency physician. With the Supreme Court decisions that upheld key portions of the ACA, along with recent passage of the SGR repeal (Medicare Access and CHIP Reauthorization Act, or MACRA), the importance of advocating for the value of emergency physicians is now paramount.

With the MACRA-mandated reform, we know our Medicare pay is stable. We also know our pay will be tied to quality measures and alternative payment models (APMs). Now is the time to secure our place within the chorus of voices working together to implement health care reform.

First, we must finish creating our specialty’s first quality registry (Clinical Emergency Data Registry, or CEDR) and follow it with an economic registry. With these registries, we can create clinically relevant quality measures, improve the care we deliver, and quantitatively prove our value while fighting insurer misbehavior. Second, we’ll develop APMs by sharing our members’ innovative approaches. We need to bring together these pilot models to create APMs, such as accountable care organizations, to be the collaborative physician leaders in the new acute care continuum. The only way we can practice the medicine we want is to create the practice we want.

Another top issue is workforce stability, which includes growth and diversity.

Workforce stability starts with job satisfaction. We need scribes to help with burdensome electronic medical records and advance practice providers so we can focus on the sickest patients. We need to address graduate medical education funding gaps by advocating for the new Congressional funding proposals, create alternative-funding models, and maximize the business plans of our current programs. And finally, we need to support our current and future emergency physicians by ensuring their health and helping them fulfill their mission of helping people.

For the first time, America has four generations in the workforce. Those with many years of service look for alternative practice options and new ways to contribute. The new generation of emergency physicians strive to find their home and their voice as they begin their journey. As a mid-career physician, I have the benefit of following the trails of my mentors and blazing new trails for my mentees.

Our residents are more diverse every year. For example, nearly 40 percent of emergency medicine residents are women, and our women attending physicians will climb beyond the current 25 percent. We must account for all types of diversity when creating the practice model of the future.