Thanks to a newly constituted board, the generosity of members, and the prospect of a new presidential administration and Congress focused on health care reform, ACEP’s political action committee, the National Emergency Medicine Political Action Committee, has seen a record-breaking level of fundraising success in 2008.

For the first time ever, NEMPAC exceeded the goal of $1 million set by the ACEP Board of Directors, with a total 2008 donation tally of $1,045,136.

“We’ve been very active in fundraising activities,” said Dr. Bruce S. Auerbach, chairman of the NEMPAC Board of Trustees. “We constituted our board to ensure that we had people who were large donors themselves and had ideas for innovative approaches and were comfortable talking to colleagues. So, the board has been instrumental in facilitating contributions this year.”

ACEP President Nick Jouriles, M.D., said one reason the 2008 fundraising campaign was so successful is that “ACEP members are overachievers.”

“Despite the sour economy, our members made record contributions to NEMPAC in 2008, which shows that we are committed to being a very strong voice for our patients in Washington, D.C.,” he said.

At the 2008 Scientific Assembly in Chicago, Dr. Jouriles called on every ACEP member to contribute $250 a year to NEMPAC, hoping to build a “war chest” of $6 million and the largest medical PAC in the country.

During the 2-day 2008 Council meeting before Scientific Assembly, NEMPAC raised more than $259,440, doubling the previous record.

Why Members Pitched in

The fact that NEMPAC is, as Dr. Auerbach calls it, “party-blind” enhanced the success of its efforts: NEMPAC contributions are “based on emergency medicine and ACEP priorities,” rather than on whether a candidate belongs to a certain political party, Dr. Auerbach said.

Emergency physician groups also played a major role in NEMPAC’s 2008 success, with unprecedented contributions to the campaign. The group approach began in 2007, with CEP America leading the way.

NEMPAC support from CEP America in Laguna Hills, Calif., evolved from a state-level group plan.

“For several years, CEP America has been the anchor contributor to the California Emergency Medicine Advocacy Fund (CEMAF),” said Dr. Wesley Fields, chairman of the Emergency Medicine Political Action Committee of the California Chapter of ACEP (CAL ACEP), and a member of the CEP America board of directors.

“CEMAF was designed as a group-level campaign, with like-minded groups pledging 20 cents per ED visit in support of emergency medicine in Sacramento,” he explained. “This program has been a huge success.”

CEP America has begun to grow outside the state of California, which has meant supporting efforts at the federal level, Dr. Fields noted.

“Nearly 1,000 of my partners in Arizona, Illinois, Georgia, Oregon, and Texas, as well as California, are proud to be providing leadership in their specialty’s advocacy at the federal level via NEMPAC,” he said.

Emergency Medicine Physicians (EMP) also developed a NEMPAC donation campaign this year. During the Council meeting, the group presented NEMPAC with a total of $102,420 from their partners.

“As leaders in emergency medicine, none of us should be looking over our shoulders to see who will step up first. What’s right is right. Plainly and simply, giving to NEMPAC is just the right thing to do,” said Dr. Dominic Bagnoli, chief executive officer of EMP.

“ ‘Giving a Shift’ for us, while making an investment in our future and that of our specialty, was merely giving a small token of appreciation back to NEMPAC for the tens of thousands of dollars NEMPAC has put back into each and every one of our pockets through countless successful initiatives,” Dr. Bagnoli said.

Other EM groups chose a different way to participate. In 2008, Florida Emergency Physicians had 30 members who donated $1,000 each to NEMPAC.

“It took a couple years of trying, but basically, I convinced my fellow group members that NEMPAC is an investment in our business, and that the return on investment was pretty obvious,” said Dr. Vidor Friedman, a member of Florida Emergency Physicians. “Especially given what’s going on with Medicare reimbursement, I thought we would see results. I was able to show that NEMPAC was helpful in protecting physician pay from Medicare reductions,” he added.

Dr. Friedman found success with the argument that a physician might invest about $2,500 a year in continuing education after residency, but that if every ACEP member invested even just $250 in NEMPAC, emergency medicine could have the largest medical PAC—resulting in a greater presence and strength in the political and legislative process for members’ practices and patients.

“An important way to ensure that we have a seat at the table when decisions are made about our profession and our patients is if we have access to policymakers,” Dr. Friedman said. “NEMPAC provides us with a means to educate lawmakers through the political process.”

In North Carolina, NEMPAC support also evolved from a state-level PAC model.

“A few years ago, when group physicians were trying to get more politically involved, we figured out how to create a practice PAC and fund it through payroll deductions,” said Michael W. Icenhour, chief operating officer of Mid-Atlantic Emergency Medical Associates (MEMA) in Charlotte. “We thought that we could take a little out of every paycheck, and no one would miss it.”

When the group wanted to get involved at the national level, Mr. Icenhour found that state-level PACs can give funds to other state PACs, but not to federal ones.

“We checked into becoming a federal PAC, but it didn’t make sense—there was more reporting, funding limits, and so forth,” he said. A better solution for their group, he added, was to make payroll-deduction contributions to NEMPAC.

The suggested amount is “about $21 a month—no doctor will miss that,” Mr. Icenhour said. The success of the group’s state-level effort suggests that this national one, which began in October 2008, will see similar results.

While it can be difficult to persuade doctors to participate in the political process, it is worth it, Mr. Icenhour noted.

“This is an opportunity to provide information so politicians understand our issues. The PAC gives us some ability to get in front of politicians,” he explained.

Funding Decisions

NEMPAC examines incumbents’ voting records and their willingness to cosponsor bills or sign on to legislation supporting emergency medicine and ACEP initiatives, Dr. Auerbach said. If a candidate runs for office with no legislative record to follow, ACEP’s Washington office staff will meet the candidate to understand his or her position on ACEP’s concerns. They will also contact the state chapter office and leadership in the candidate’s state to see if there is a history of involvement with the state chapter and to ascertain the candidate’s support of emergency medicine issues at the state level.

NEMPAC uses its funds to support the campaigns of congressional candidates. “We constantly gear up for the ‘next election’—one-third of the Senate is up every 2 years, and all House members are up every 2 years,” said Jeanne Slade, ACEP’s political action director. “We raise money continually and keep a healthy reserve so we’re always ready.” NEMPAC already has been asked to support campaigns for 2010, she said.

Why the ongoing cycle? “For members who are already elected, starting to raise money early discourages challengers,” Ms. Slade explained. “We like to have the opportunity to participate early, and candidates appreciate if we show faith in them. It builds friendship and long-term working relationships.” Early support also helps hold candidates accountable to the issues of importance to ACEP members and their patients.

NEMPAC also works with ACEP members “back home” to encourage them to deliver NEMPAC contributions at local fundraising events and to take extra steps to develop relationships with their national representatives, including volunteering for campaigns and hosting fundraisers in their own communities.

NEMPAC in the Future

Because of NEMPAC’s strong fundraising efforts in 2008, ACEP will have more opportunities to educate new and returning legislators in the new 111th Congress.

“NEMPAC will continue to do what it has been doing, in an expanded manner,” Dr. Auerbach said. “In 2009, we are increasing our goal, because we believe that all emergency physicians should be able to contribute at least at a moderate level. We will continue to work with larger physician groups to see if they can reach 100% participation in NEMPAC.”

A key concern will be ensuring that the issues of importance to emergency physicians and their patients are heard when Congress and the Obama administration move to improve health care access and affordability.

“We must make sure that other initiatives don’t harm emergency physicians or interfere with our ability to care for our patients,” Dr. Auerbach said, “and that we have a prominent place in any discussions of health care reform.”