Rep. McCormick: You go back to 74% of all physicians are now employed by hospital systems. Once you’re an employee, you are kind of cut out of the profit ideas, you don’t have a competition model anymore, you just have a survival. And maybe you get paid more because of RVUs, depends on what system you’re in. For an ER doctor, we’re paid entirely on RVUs. Most physicians now are paid on RVUs, which means that the more patients you see, the more money you make, but it also encourages you to hustle through patients as fast as possible.

I think AI is going to change some things, it’s going to make us more efficient. You’re not going to need scribes anymore, which means there’s another $20 per hour employee that goes away. Once we get good at [AI], your note will basically be written by the time you leave and you can modify it accordingly.

Now the problem is we have some insurance companies that literally have 40% denial from ER physicians.  We spend all that time with the patient, spend all that time with EMRs, we have a scribe, we have coders, and we stay up late trying to complete our notes after our shifts, and we’re still getting 40% denials. That’s almost half of our billing getting denied. Meanwhile, insurance companies are making record profits.

Why wouldn’t you invest in a company like that, where basically, you can deny people their reimbursements, you can deny people their pre-approvals, you can basically decide the fate of surprise billing, and have no accountability.

And look at what [Secretary Bacerra] has done in Texas. He’s been taken to court four times, and lost all four cases. That’s either a really bad lawyer or a guy who’s purposely doing the wrong thing to evade what Congress has outlined, taking it totally out of the purview of the intent of the legislation on surprise billing.

It shouldn’t be just PBMs and insurance companies making record profits, and hospitals trying to hang on for dear life, and physicians all becoming employees of hospitals, which, once again, increases the price. In the end, it should be about patients.

ACEP Now: Dr. Aisha Terry, has focused on the pipeline of leadership for the College this year. How would you encourage other physicians to follow in your footsteps, maybe if they’re feeling like they want to get away from the bedside and tackle issues, whether that’s in Congress, or a state legislature, or local level?