ACEP Now: What obstacles exist in Congress to address hospital boarding? What would be your recommendations on how to address them?

U.S. SENATE CANDIDATE RAUL GARCIA, DO, FACEP (R-WA) is challenging incumbent Maria Cantwell (D-WA) in Washington State. Dr. Garcia has been a successful small business owner of his own medical practice, one of the founding Deans of two medical schools, and the Medical Director of two hospitals. He is currently the Medical Director of Astria ToppenishHospital in Toppenish, Washington. Dr. Garcia founded “Opportunity for Washington” as a non-profit, nonpartisan effort promoting education and change. He helped found the Partnership for Food Security in 2020 to promote COVID-19 education, particularly in the Latino community. Dr. Garcia earned his DO at the New York Institute of Technology College of Osteopathic Medicine and trained at SBH Health System Bronx. A native of Pinar del Rio, Cuba, Dr. Garcia escaped Cuba with his mother at age 11 and later gained asylum in the U.S. and settled in Miami, where he attended college and earned a Bachelor of Science degree in Microbiology/Immunology.

Dr. Garcia: I was on the ACEP board for six years here in Washington, so having a physician in Congress who understands our perspective is going to be a breath of fresh air. I support the public reporting of boarding issues to raise awareness. There’s a role for government in educating the public, so they can become advocates for our goals. The biggest issue comes down to reimbursements, which have been declining annually. This lack of funding impacts hospitals’ ability to hire staff, and often, the boarding problems in Washington aren’t due to lack of beds but rather a lack of personnel. We need increased reimbursements across the board to resolve this and encourage more people to join health care professions.

Increasing funding for community primary care and public education would also help reduce ED traffic for non-emergency cases. Half the patients I see could likely be managed in primary care, but we lack the resources to support that system or educate the public about alternatives. I intend to advocate for CMS policies that allow more flexibility in discharging patients when ERs are at capacity. Boarding patients in EDs makes it hard to meet metrics, especially with a single provider managing a full ED. I experience this daily, and Washington, unfortunately, ranks 50th in medical bed availability, leading us to board patients for days at a time. I look forward to finding better solutions.