But at the same time, the more I grew as a physician, the more I was able to step back from the basics of my EM training and see the bigger picture. I became keenly aware of the systems issues that prevent our patients from accessing the care they need and impede us in providing the care we want to give. After being elected as the president-elect of EMRA in October, I soon found myself at the ACEP Board of Directors retreat, ACEP’s Media Training, and the Emergency Department Practice Management Association (EDPMA) annual conference, learning time and again the ins and outs of some of the more complex issues facing our specialty—from balanced billing and surprise coverage to inpatient boarding in the ED and EMTALA limitations. While still frustrated with our nation’s politics, the importance of being informed and involved resurfaced in my everyday experiences in the ED, but I wasn’t sure what to do about it.

Dr. Cosgrove and Dr. Kurtz:

Despite the differences in our backgrounds with politics and government affairs, the Leadership & Advocacy Conference in Washington, D.C., was unlike anything either of us had ever experienced. We would even go as far as saying that it was life altering. The quality of speakers, the content of their inspirational and informative messages, and the intimacy of being in the same room as people who truly care about the future of emergency medicine convinced us that we, too, want a seat at the table. As first-timers, even with our experiences in EMRA these past six months, we had very limited knowledge of many of the issues (and the acronyms—oh the acronyms!) affecting our daily practices in the ED. We talked about payment delivery reform (and how physician reimbursement is running full steam ahead into a fee-for-value instead of a fee-for-service model), the opioid epidemic (and Dr. Steven Stack’s passionate and very direct letter to physicians), mental health care reform, and ACEP’s unprecedented lawsuit against the federal government to contest a regulation that impedes fair coverage for patients who present to out-of-network emergency departments for emergency services. We were shown how to contact our representatives in effective ways regarding our viewpoints on bills that would affect patient care.

The preparation leading into ACEP Lobby Day was excellent. With our extremely limited experience lobbying legislators, we were both terrified and excited. Yet walking through the Senate and House office buildings, seeing “Nancy Pelosi” and “John McCain” written on office doors (not to mention a surprise showing by Marco Rubio), and meeting with our own federal legislators about issues that truly matter to our patients were almost as exciting as running a successful code or putting in a crash chest tube.