"Everyone at ACEP is a CMG shill." Proof?

[turkeyjerky]

Is it not identity politics on your part to assume that this person was chosen because she "[ticked] the 'diversity?' box to be electable"?

How can someone who looks like her be chosen in a way that is palatable to you? After all, she can't change her physical characteristics.

Ugh. They could be chosen after running on a platform demonstrating that they will represent our interests.

As an analogy from politics, I'll offer this. It's sorta the difference between Alexandria Ocasio-Cortez and Kamala Harris. Both are minority female politicians, however one stands for something, and the other stands for herself.

Seems to me that supporting this person when Robert McNamara was on the ballot, is akin to supporting Hillary over Bernie.

The last thing this specialty needs is a corporate diversity office as its president. However, considering ACEP is basically the HR division of corporate medicine, I"m not surprised.

---

Members don't see this ad.

 

[Rekt]

Is it not identity politics on your part to assume that this person was chosen because she "[ticked] the 'diversity?' box to be electable"?

How can someone who looks like her be chosen in a way that is palatable to you? After all, she can't change her physical characteristics.

Your argument is so asinine and devoid of any intellectual thought it's hard to even formulate an appropriate response. You're essentially virtue signaling yourself to feel better.

The vast majority of em docs could give a damn about gender/looks/culture/identification/etc as long as that person wants to get **** done a that's actually favorable to EPs.

 

[Franzd'Epinay]

Ugh. They could be chosen after running on a platform demonstrating that they will represent our interests.

As an analogy from politics, I'll offer this. It's sorta the difference between Alexandria Ocasio-Cortez and Kamala Harris. Both are minority female politicians, however one stands for something, and the other stands for herself.

Seems to me that supporting this person when Robert McNamara was on the ballot, is akin to supporting Hillary over Bernie.

The last thing this specialty needs is a corporate diversity office as its president. However, considering ACEP is basically the HR division of corporate medicine, I"m not surprised.

I'm not quite seeing your point here. There are plenty of politicians of all races who one could say "stand for something" and plenty of politicians of all races who one could say "stand for themselves". What does their minority status have to do with it? Boring, duplicitous, or careerist politicians can and do exist in all races.

 

[Franzd'Epinay]

The vast majority of em docs could give a damn about gender/looks/culture/identification/etc as long as that person wants to get **** done a that's actually favorable to EPs.

Then why include a quip about the person being a '"diverse" appearing candidate' among other complaints about her policies?

Someone can be a CMG shill regardless of race. If you want to complain about someone's views on CMGs, then I don't see the point of bringing up their "diversity".

 

[bravotwozero]

How can someone who looks like her be chosen in a way that is palatable to you? After all, she can't change her physical characteristics.

she can change her policies you know….

 

[Franzd'Epinay]

she can change her policies you know….

Right, that would remove the complaint about her policies, but would not remove the complaint about her "diverse" appearance.

 

[RustedFox]

Is it not identity politics on your part to assume that this person was chosen because she "[ticked] the 'diversity?' box to be electable"?

How can someone who looks like her be chosen in a way that is palatable to you? After all, she can't change her physical characteristics.

Maybe, maybe not?
Truth be told, I don't know the candidate's name nor what she "looks like" because I pay less attention to ACEP than I do to a passing fart; but all I needed to do is read the above posts and I can make a guess that the party line is going to be: "See? Diversity good."

But really, what any thinking person wants out of an elected official is results and discussion of the relevant issues and the plan for action. Those are things that it seems like all political candidates and parties have forgotten these days in favor of: "See? Diversity good."

I expect the same from ACEP, because ACEP.

It's insulting.

 

[Franzd'Epinay]

Maybe, maybe not?
Truth be told, I don't know the candidate's name nor what she "looks like" because I pay less attention to ACEP than I do to a passing fart; but all I needed to do is read the above posts and I can make a guess that the party line is going to be: "See? Diversity good."

But really, what any thinking person wants out of an elected official is results and discussion of the relevant issues and the plan for action. Those are things that it seems like all political candidates and parties have forgotten these days in favor of: "See? Diversity good."

I expect the same from ACEP, because ACEP.

It's insulting.

I'm more or less on the same boat--I never renewed my ACEP membership after graduating residency, so I had to look up their leadership.

This board has been consistently critical of ACEP leadership for years. It just strikes me as odd that, to be a bit reductionist, the criticism from some people is as follows:

- Immediate past president: "CMG Shill"
- Current president: "CMG Shill"
- President-elect: "CMG Shill"
- President candidate: "CMG Shill and also diversity checkbox"

That doesn't strike you as odd too? This person can't be a regular CMG shill like the others who just so happens to look different?

I'll go back again to the earlier question I posed you: what can this specific candidate do so that your opinion changes from "CMG Shill and also diversity checkbox" to plain old "CMG Shill" (as it was for her predecessors)?

 

[RustedFox]

I'm more or less on the same boat--I never renewed my ACEP membership after graduating residency, so I had to look up their leadership.

This board has been consistently critical of ACEP leadership for years. It just strikes me as odd that, to be a bit reductionist, the criticism from some people is as follows:

- Immediate past president: "CMG Shill"
- Current president: "CMG Shill"
- President-elect: "CMG Shill"
- President candidate: "CMG Shill and also diversity checkbox"

That doesn't strike you as odd too? This person can't be a regular CMG shill like the others who just so happens to look different?

I'll go back again to the earlier question I posed you: what can this specific candidate do so that your opinion changes from "CMG Shill and also diversity checkbox" to plain old "CMG Shill" (as it was for her predecessors)?

Wrong question to ask.

How about: "What can this person do to not be a CMG shill?"

But, the predictable sequence here is, instead:

"Hello physician, ACEP really listened to what you had to say about the things that are important."

"Diversity is like, so important."

"So we did a diversity!"

"Nevermind those other pesky things. Here's what's REALLY important. If you disagree, then you're a racist and here is your Swastika."

Somebody count the number of logical fallacies in there for me.

- and we all know that there is a SIGNIFICANT likelihood that this is *exactly* what they'll say.

 

[Franzd'Epinay]

Wrong question to ask.

How about: "What can this person do to not be a CMG shill?"

But, the predictable sequence here is, instead:

"Hello physician, ACEP really listened to what you had to say about the things that are important."

"Diversity is like, so important."

"So we did a diversity!"

"Nevermind those other pesky things. Here's what's REALLY important. If you disagree, then you're a racist and here is your Swastika."

Somebody count the number of logical fallacies in there for me.

- and we all know that there is a SIGNIFICANT likelihood that this is *exactly* what they'll say.

This whole back and forth started because criticism was levied at this person that was "this individual is X and Y". This board has, for years, been critical about X, but I don't think it's the "wrong question" to also ask about this new criticism of Y (in addition to asking about X).

I thought we could talk and chew gum at the same time (i.e. "why do we keep getting CMG Shills?" and also "Is it fair to say that this person was hired due to their 'diversity' appearance?"), but it seems you don't think that's the case--as long as one criticizes this person for being a CMG shill, it's also fair game to call them anything else.

I think we will just have to agree to disagree there.

 

[RustedFox]

This whole back and forth started because criticism was levied at this person that was "this individual is X and Y". This board has, for years, been critical about X, but I don't think it's the "wrong question" to also ask about this new criticism of Y (in addition to asking about X).

I thought we could talk and chew gum at the same time (i.e. "why do we keep getting CMG Shills?" and also "Is it fair to say that this person was hired due to their 'diversity' appearance?"), but it seems you don't think that's the case--as long as one criticizes this person for being a CMG shill, it's also fair game to call them anything else.

I think we will just have to agree to disagree there.

You're mischaracterizing my argument, and you know it.

Let me try again. This time, less Tolkien (as is my way) and more direct.

Instead of actually fixing the problems that we have (CMG evil overlords) we fully expect ACEP to move the goalposts and pat themselves on the back for addressing "diversity!" by "electing" (don't buy that) someone that checks the boxes. If anyone dissents, they can easily be shushed by declaring that the dissenter doesn't care about "diversity!" and is therefore a member of a hate group, thereby disqualifying their opinion.

So you see, the complaint is not directed at the person and their innate biologic qualities, but rather at ACEP and their insultingly transparent fallacies.

 

[Franzd'Epinay]

If anyone dissents, they can easily be shushed by declaring that the dissenter doesn't care about "diversity!" and is therefore a member of a hate group, thereby disqualifying their opinion.

So you see, the complaint is not directed at the person and their innate biologic qualities, but rather at ACEP and their insultingly transparent fallacies.

But this hasn't happened. No one has called you a racist for saying this woman is a CMG shill.

All I'm saying is that you are very welcome to say "this president is terrible for the specialty and working closely with CMGs" if you believe that to be the case. If someone calls you racist for that I agree that it would be ridiculous.

What seems rather unnecessary is to say "this president is terrible for the specialty, working closely with CMGs and, ugh, and I hate that her "diversity" means I can't say that because then I'll be called a racist". That seems like an unnecessary logical leap. If you're preemptively getting angry at ACEP hypothetically calling you racist for criticisng someone's CMG views, then it's likely you're getting in your head a bit too much.

Again, I think we're talking past each other now, so I'll leave it there.

 

[AlmostAnMD]

The full focus of any EM organization should be protecting EM, specifically SDGs. I'll support any organization that prioritizes protection for small groups and pursuing corporate practice of medicine infractions like in cali right now.

AAEM is as close as it gets for me.

I called my old PD. They still send the residents once a year to ACEP. When I suggested he stop and try to turn the tide a different direction he responded like I asked him to change all their code status.

ACEP is ingrained so, so hard in us. It starts in residency and gets presented like the the only way to do anything.

I love how they advocate for better billing, etc...but that's just to get more money to private equity, it has nothing to do with me. What I care about is the eradication of corporate medicine.

I don't think we're being completely passive here. These discussions need to be public and out in the open and frequent as hell. People will see this topic, students that turn to residents that one day turn to leaders. If not this one then hopefully one of many others. Eventually, I hope, people will get it.

Or, private equity just takes us all. Merger by merger, hospital by hospital.

 

[RustedFox]

But this hasn't happened. No one has called you a racist for saying this woman is a CMG shill.

All I'm saying is that you are very welcome to say "this president is terrible for the specialty and working closely with CMGs" if you believe that to be the case. If someone calls you racist for that I agree that it would be ridiculous.

What seems rather unnecessary is to say "this president is terrible for the specialty, working closely with CMGs and, ugh, and I hate that her "diversity" means I can't say that because then I'll be called a racist". That seems like an unnecessary logical leap. If you're preemptively getting angry at ACEP hypothetically calling you racist for criticisng someone's CMG views, then it's likely you're getting in your head a bit too much.

Again, I think we're talking past each other now, so I'll leave it there.

Not really talking past each other.

You seem to have this idea that the candidate is running for office because they want to bring something new to the table and solve problems and move the state of EM forward.

But what we all suspect (and rightfully so) is that the candidate is just another CMG shill in the ACEP inner party, and was chosen by the inner party to pacify the proles (us) under the guise of "diversity!"

Oh, and haven't you heard? The gin rations have gone up 20%! Or is it down 20%?

 

[RuralEDDoc]

Current ACEP president: Army physician
President elect: Army physician
Unopposed president elect candidate: Academic

This aren’t the CMG shill droids you’re looking for.

 

[Rekt]

Current ACEP president: Army physician
President elect: Army physician
Unopposed president elect candidate: Academic

This aren’t the CMG shill droids you’re looking for.

No action against CMGs.
No action against CMGs.
100% chance no action against CMGs.

If they aren't fighting it, they're supporting it.

 

[AlmostAnMD]

No action against CMGs.
No action against CMGs.
100% chance no action against CMGs.

If they aren't fighting it, they're supporting it.

Ya rly

All three would be highly unmotivated to care about SDGs whatsoever. They're in an insular bubble unaffected by everything else. If not a shill then something just worthless, which is probably why they're in leadership positions to begin with.

 

[RuralEDDoc]

Ya rly

All three would be highly unmotivated to care about SDGs whatsoever. They're in an insular bubble unaffected by everything else. If not a shill then something just worthless, which is probably why they're in leadership positions to begin with.

It’s easy to lob bombs from the sidelines without getting involved in the process. What have you done to fight the problem, other than post ad hominems? It’s a rhetorical question for anyone that complains about acep and is not involved in fixing the perceived problems.

 

[GonnaBeADoc2222]

It’s easy to lob bombs from the sidelines without getting involved in the process. What have you done to fight the problem, other than post ad hominems? It’s a rhetorical question for anyone that complains about acep and is not involved in fixing the perceived problems.

Ya sure. Next thing you'll say is "every vote matters" in American elections.

 

[alpinism]

ACEP is like a corrupt city government taking payoffs from cartels to do nothing while they destroy their city with drugs.

You don't fix the problem by getting involved with corrupt officials you fix the problem by removing them from office.

 

[Kryptocoin]

CMGs are thriving today because some doctors sold out other doctors. Corporate practice of medicine is illegal in most states, yet CMGs get around this by having some doctors act as "paper owners". Why aren't we naming and shaming these enablers?

ACEP is just a symptom. If ACEP dissolves tomorrow, the problem will still be there.

 

[GonnaBeADoc2222]

CMGs are thriving today because some doctors sold out other doctors. Corporate practice of medicine is illegal in most states, yet CMGs get around this by having some doctors act as "paper owners". Why aren't we naming and shaming these enablers?

ACEP is just a symptom. If ACEP dissolves tomorrow, the problem will still be there.

To be fair, we all wpuld have sold out

 

[RuralEDDoc]

Just reading the above posts, it seems that a key reason that this field is doomed is that its physicians have no interest in working to fix it.
Hate ACEP? Join AAEM and contribute something - time, ideas, money, whatever you like. Think AAEM is powerless? You’re wrong.
Don’t just fiddle while Rome burns.

 

[GonnaBeADoc2222]

I have my money to ABEM this year.

Guess what? Blackrock has more.

 

[sylvanthus]

Just reading the above posts, it seems that a key reason that this field is doomed is that its physicians have no interest in working to fix it.
Hate ACEP? Join AAEM and contribute something - time, ideas, money, whatever you like. Think AAEM is powerless? You’re wrong.
Don’t just fiddle while Rome burns.

While I like and applaud the optimism I just cant bring myself to have hope for this field or for medicine in general. If I saw ONE significant thing improving, not just “not getting worse” maybe maybe Id have some hope.

I spent too much time and energy in ACEP, AAEM, MSSNY AMA etc that woulda been better spent on hobbies. My freetime in residency and med school were wasted for a decade. Now, I enjoy my freetime too much to waste anymore time on fruitless endeavors. I gotta get my hobbies back and become more of a well rounded person. Medicine has stolen enough. Now Im gonna watch it burn from the sidelines while drinking a beer.

 

[BoardingDoc]

gotta get my hobbies back and become more of a well rounded person

I just got into woodworking a couple of months ago. Highly recommend it.

1st project:

2nd project.

Gonna build a workbench next, to help facilitate building bigger things.

 

[sylvanthus]

I just got into woodworking a couple of months ago. Highly recommend it.

1st project:
View attachment 358298

2nd project.

View attachment 358300

View attachment 358299


Gonna build a workbench next, to help facilitate building bigger things.

Nice work! I lack the required skills for that sorta thing but can appreciate those that have the skills.

 

[EctopicFetus]

Is it not identity politics on your part to assume that this person was chosen because she "[ticked] the 'diversity?' box to be electable"?

How can someone who looks like her be chosen in a way that is palatable to you? After all, she can't change her physical characteristics.

I think it is a dude

 

[RustedFox]

I think it is a dude

Makes my point even more salient.
I know *nothing* demographically about the "candidate", but fully expect to be insulted by the shell game and excuses.

 

[EctopicFetus]

In related news. A white woman is the acep diversity champion. TeamHealth Leader Dr. Becky Parker Named Champion of Diversity and Inclusion by ACEP

 

[bravotwozero]

Can AAEM do something to make their annual conferences NOT suck? If they succeed, May win over more converts, I hate to say it.

 

[EctopicFetus]

Can AAEM do something to make their annual conferences NOT suck? If they succeed, May win over more converts, I hate to say it.

Agreed. I don’t go. They blow. For education I do essentials. It’s imo actually useful. AAEMs conference sucks. ACEP’s does too but great networking. I’m not gonna support a crap ass organization just to socialize with people.

 

[sum dude]

It's hilarious the misinformation and just blatantly incorrect things posted on this forum by people who either don't know or gave up on understanding or doing anything about the current state of EM long ago

OP - good post, you're actually thinking with your brain than just repeating social medial drivel. As above, the majority of the board isn't (Burns voice) "CMG owned." The majority is actually academic, and has been for years, with this board multiple military/education types in charge.

ACEP sure has its problems, but they still helped hold off the 20% NSA EM paycuts we were facing. These evil CMG owned ACEPers are also working with the demonic AMA to hold off 10% cuts we all face in Medicare in a few months. You think AAEM's $40k PC donations (to mostly R's) are moving the needle in DC? Nope..ACEP's PAC is 20x bigger than AAEM's. AAEM has its place, particularly if you want to try to sue the CMG's out of existence (good luck matching KKR's legal team), but if you want any hope of doing anything in Washington (which controls US healthcare), you're going to need ACEP and AMA.

Truth is, you need organizations like ACEP and AMA b/c they're the only ones swinging enough weight to counter the Blue Cross/United Healths of the world who otherwise tell congress what to do. We'd all be making 30% less if there weren't groups like TMA & AMA (suing federal government), ACEP (one of most successful lobbying groups in medicine who basically made Congress re-write the NSA to include arbitration) and whatever other group you all want to rail about being "CMG" owned, even when they're not.

For all you whining about "what has ACEP done?" to combat CMG's...what do you want them to do, start a coup and overthrow capitalism? We're a capitalist society and Wallstreet figured out healthcare is big time money. Wallstreet is better at money than you are. None of the groups or hospitals selling out to CMG's or wallstreet firms were held at gunpoint...they took the money and ran. ACEP actually has programs for small groups to more successfully compete against CMG's...which is much more helpful to my group than suing people in the other side of the country. Like any organization, they have their problems, but if you want to actually fix things, you're going to have to get involved with one of these organizations to change our current health system.

That said, I'm sure it's easier and more cathartic to post anonymously on forums and yell Grandpa Simpson style at the sky..."ACEP what have you done to stop CMG's!"

 

[AlmostAnMD]

I had a much longer reply typed up but deleted it. I'll just summarize and say what holds me back from appreciating acep for helping to avoid paycuts is motivation. Its not to help us. Its to line pocketbooks of PE, back to the glory of capitalism you mentioned. Notably absent from their efforts is preventing residency expansion and protection from midlevels because those things drive costs down further. Except unlike the paycut issue these last two hurt physicians while helping PE.

As much as I want to get involved, I'm probably just going to take the easy road and get out. Wife has a biomed startup company that is on the up and up and already makes half what I do with zero debt as is from her day job.

Happy to give my money to aaem, the only organization that I think truly cares about docs and only docs.

Here's my fantasy that will never happen:

Corporate practice lawsuits continue from California now to everywhere

All CMG are disbanded, regional ownership only due to above. Like Bell in the 60s/70s. Collectively they can bill as a single group to give leverage to insurance companies (ala ohio independent hospital association getting group discount rates on supplies despite having no official affiliation, for more information "the hospital " about CHWC in Bryan Ohio is a great book)

Require residencies to have 7-10k patients/resident and minimal away rotations (trauma/picu). If it can't do that, axe it

It's all possible but too many people back the wrong horse. I'm hopeful some distant day the majority of docs switch to aaem and then the gears might start to turn.

 

[EctopicFetus]

It's hilarious the misinformation and just blatantly incorrect things posted on this forum by people who either don't know or gave up on understanding or doing anything about the current state of EM long ago

OP - good post, you're actually thinking with your brain than just repeating social medial drivel. As above, the majority of the board isn't (Burns voice) "CMG owned." The majority is actually academic, and has been for years, with this board multiple military/education types in charge.

ACEP sure has its problems, but they still helped hold off the 20% NSA EM paycuts we were facing. These evil CMG owned ACEPers are also working with the demonic AMA to hold off 10% cuts we all face in Medicare in a few months. You think AAEM's $40k PC donations (to mostly R's) are moving the needle in DC? Nope..ACEP's PAC is 20x bigger than AAEM's. AAEM has its place, particularly if you want to try to sue the CMG's out of existence (good luck matching KKR's legal team), but if you want any hope of doing anything in Washington (which controls US healthcare), you're going to need ACEP and AMA.

Truth is, you need organizations like ACEP and AMA b/c they're the only ones swinging enough weight to counter the Blue Cross/United Healths of the world who otherwise tell congress what to do. We'd all be making 30% less if there weren't groups like TMA & AMA (suing federal government), ACEP (one of most successful lobbying groups in medicine who basically made Congress re-write the NSA to include arbitration) and whatever other group you all want to rail about being "CMG" owned, even when they're not.

For all you whining about "what has ACEP done?" to combat CMG's...what do you want them to do, start a coup and overthrow capitalism? We're a capitalist society and Wallstreet figured out healthcare is big time money. Wallstreet is better at money than you are. None of the groups or hospitals selling out to CMG's or wallstreet firms were held at gunpoint...they took the money and ran. ACEP actually has programs for small groups to more successfully compete against CMG's...which is much more helpful to my group than suing people in the other side of the country. Like any organization, they have their problems, but if you want to actually fix things, you're going to have to get involved with one of these organizations to change our current health system.

That said, I'm sure it's easier and more cathartic to post anonymously on forums and yell Grandpa Simpson style at the sky..."ACEP what have you done to stop CMG's!"

Good lord. This post. It’s every acep post. I’ll summarize. ACEP is awesome. Everything good that happened to EM is because of acep. Everything bad well “how do you expect us to control that”. Reality the field is burning to the ground. ACEP is the self imposed king of EM. The end.
acep Apologists can go back to braiding Dominic bagnolis back hair and slicking the hair of bill jaquis.
please leave this nonsense off this forum. F ACEP.

 

[thegenius]

It's hilarious the misinformation and just blatantly incorrect things posted on this forum by people who either don't know or gave up on understanding or doing anything about the current state of EM long ago

OP - good post, you're actually thinking with your brain than just repeating social medial drivel. As above, the majority of the board isn't (Burns voice) "CMG owned." The majority is actually academic, and has been for years, with this board multiple military/education types in charge.

ACEP sure has its problems, but they still helped hold off the 20% NSA EM paycuts we were facing. These evil CMG owned ACEPers are also working with the demonic AMA to hold off 10% cuts we all face in Medicare in a few months. You think AAEM's $40k PC donations (to mostly R's) are moving the needle in DC? Nope..ACEP's PAC is 20x bigger than AAEM's. AAEM has its place, particularly if you want to try to sue the CMG's out of existence (good luck matching KKR's legal team), but if you want any hope of doing anything in Washington (which controls US healthcare), you're going to need ACEP and AMA.

Truth is, you need organizations like ACEP and AMA b/c they're the only ones swinging enough weight to counter the Blue Cross/United Healths of the world who otherwise tell congress what to do. We'd all be making 30% less if there weren't groups like TMA & AMA (suing federal government), ACEP (one of most successful lobbying groups in medicine who basically made Congress re-write the NSA to include arbitration) and whatever other group you all want to rail about being "CMG" owned, even when they're not.

For all you whining about "what has ACEP done?" to combat CMG's...what do you want them to do, start a coup and overthrow capitalism? We're a capitalist society and Wallstreet figured out healthcare is big time money. Wallstreet is better at money than you are. None of the groups or hospitals selling out to CMG's or wallstreet firms were held at gunpoint...they took the money and ran. ACEP actually has programs for small groups to more successfully compete against CMG's...which is much more helpful to my group than suing people in the other side of the country. Like any organization, they have their problems, but if you want to actually fix things, you're going to have to get involved with one of these organizations to change our current health system.

That said, I'm sure it's easier and more cathartic to post anonymously on forums and yell Grandpa Simpson style at the sky..."ACEP what have you done to stop CMG's!"

So what has ACEP done to increase my pay, reduce residencies from opening up, increasing job security, imposing PPH limits, reducing midlevel encroachment?

Just curious.

 

[old_boy]

So what has ACEP done to increase my pay, reduce residencies from opening up, increasing job security, imposing PPH limits, reducing midlevel encroachment?

Just curious.

Increase pay: They've worked to prevent CMS pay cuts and generally increase physician reimbursement. CMGs, ACEP, and frontline physicians are all aligned on negotiating for higher reimbursement rates. ACEP has welcomed corporate money, which in the long term may hurt your pay as it increases corporate medicine profits. Verdict: mixed

Reduce residencies: Nothing that I've seen. They've taken a hands-off approach, deferring to ACGME, claiming it's not their role. Of course, ACEP's corporate boosters benefit from more residencies and indirectly ACEP does as well with more members. Verdict: ACEP is failing the frontline doc

Increasing job security: Not much, but I'm not sure this is their role given the nuances and complexity in "job security". Labor market regulation often has unintended consequences.

Imposing PPH Limits: Do you really want to be this minutely managed?

Reducing midlevel encroachment: They've championed the concept of board certification for physicians and successfully helped to legitimize our specialty, but they seem to have no problem with an anesthesia-type model of one physician supervising multiple PA/NPs. Verdict: Mixed

Don't hate ACEP - just realize that organizations generally function exactly as they should to maximize their own incentives. And ACEP's incentives don't always benefit the front line ED physician.

 

[AlmostAnMD]

Reducing midlevel encroachment: They've championed the concept of board certification for physicians

That's a really generous description of "finding ways to suck more money out of physician CME"

lifetime certification --> 10 year certification --> 5 year certification --> Future??? Yearly? daily? Each "enhancement" is going to double our costs for your championship legitimacy.

I'm sorry, "board certification" is just another cash cow now for ABEM in cahoots with ACEP. What was that party they threw with all our money? Some 500k spent on a tropical island for an ABEM meeting? Someone here posted a link to it a while ago.

Let's not derail this topic and discuss the overt corruption of "board certification."

"Champion"..............lol

great descriptor

 

[EctopicFetus]

Increase pay: They've worked to prevent CMS pay cuts and generally increase physician reimbursement. CMGs, ACEP, and frontline physicians are all aligned on negotiating for higher reimbursement rates. ACEP has welcomed corporate money, which in the long term may hurt your pay as it increases corporate medicine profits. Verdict: mixed

Reduce residencies: Nothing that I've seen. They've taken a hands-off approach, deferring to ACGME, claiming it's not their role. Of course, ACEP's corporate boosters benefit from more residencies and indirectly ACEP does as well with more members. Verdict: ACEP is failing the frontline doc

Increasing job security: Not much, but I'm not sure this is their role given the nuances and complexity in "job security". Labor market regulation often has unintended consequences.

Imposing PPH Limits: Do you really want to be this minutely managed?

Reducing midlevel encroachment: They've championed the concept of board certification for physicians and successfully helped to legitimize our specialty, but they seem to have no problem with an anesthesia-type model of one physician supervising multiple PA/NPs. Verdict: Mixed

Don't hate ACEP - just realize that organizations generally function exactly as they should to maximize their own incentives. And ACEP's incentives don't always benefit the front line ED physician.

It’s the biggest lie going cms reimbursement has 0 impact on what cmgs and hospitals pay docs. It’s purely supply and demand. Why is Denver pay terrible? Is cms ignoring the people of Colorado? Or is it because usacs has a monopoly and there are more people who want to work there then there and jobs and supply and demand take hold?

Under 15% of em docs have their pay tied to cms reimbursement. That’s true sdgs with open books.

That’s where Acep has shown some value to a small sliver of docs. Failures everywhere else.

 

[turkeyjerky]

Reading over that diversion thread has me thinking, where the F is ACEP in lobbying CMS on interpreting EMTALA in such a ridiculous, schizophrenic manner? Isn’t that ish something they should be all over? (I’m not referring to some sort of complicated legislative effort. The actual statute, imho, is quite reasonable. It’s the interpretation that is irrationa— leading to all sorts of catch 22’s, but which also should be more amenable to lobbying)

Wait, I know why. It’s doctors and patients who are affected by this, not the CMGs (in fact they are literally indemnified against it in most cases). So why would ACEP give a flying F

 

[EctopicFetus]

Reading over that diversion thread has me thinking, where the F is ACEP in lobbying CMS on interpreting EMTALA in such a ridiculous, schizophrenic manner? Isn’t that ish something they should be all over? (I’m not referring to some sort of complicated legislative effort. The actual statute, imho, is quite reasonable. It’s the interpretation that is irrationa— leading to all sorts of catch 22’s, but which also should be more amenable to lobbying)

Wait, I know why. It’s doctors and patients who are affected by this, not the CMGs (in fact they are literally indemnified against it in most cases). So why would ACEP give a flying F

Acep is happy certifying eds as geriatric eds. $$ maker. Stupid stuff those guys come up with.

 

[VA Hopeful Dr]

Reading over that diversion thread has me thinking, where the F is ACEP in lobbying CMS on interpreting EMTALA in such a ridiculous, schizophrenic manner? Isn’t that ish something they should be all over? (I’m not referring to some sort of complicated legislative effort. The actual statute, imho, is quite reasonable. It’s the interpretation that is irrationa— leading to all sorts of catch 22’s, but which also should be more amenable to lobbying)

Wait, I know why. It’s doctors and patients who are affected by this, not the CMGs (in fact they are literally indemnified against it in most cases). So why would ACEP give a flying F

Would a hospital getting hit with an EMTALA violation because of a CMG-employed physician get pretty damned angry at the CMG? Like mad enough to replace them.

 

[bravotwozero]

Would a hospital getting hit with an EMTALA violation because of a CMG-employed physician get pretty damned angry at the CMG? Like mad enough to replace them.

They'll just tell the CMG to fire the said doc, if they're upset enough, who will be the scapegoat.

 

[Arcan57]

Don't hate ACEP - just realize that organizations generally function exactly as they should to maximize their own incentives. And ACEP's incentives don't always benefit the front line ED physician.

I think hating on ACEP is reasonable. I've donated a fair amount of money to them over the years and watched them turn into an AMA like organization that feels like it's coasting off it's triumphs in the 00s and early teens.

 

[EctopicFetus]

I think hating on ACEP is reasonable. I've donated a fair amount of money to them over the years and watched them turn into an AMA like organization that feels like it's coasting off it's triumphs in the 00s and early teens.

So are you done spending money and supporting an org that is destroying our specialty?

 

[Arcan57]

So are you done spending money and supporting an org that is destroying our specialty?

Good question. Haven’t donated to NEMPAC in years. Not sure about giving up being FACEP. Probably will but have some professional things taking up my bandwidth at moment in terms of weighing pros/cons.

 

[sum dude]

So what has ACEP done to increase my pay, reduce residencies from opening up, increasing job security, imposing PPH limits, reducing midlevel encroachment?

Just curious.

ACEP (and AMA and all the specialty societies who lobbied Congress) have absolutely increased your pay, b/c we were staring at average $68,000/year paycuts (20% cuts) per EM doctor over next decade w/o shifting NSA language. Believe it, don't believe it, doesn't matter, b/c that's what absolutely happened.

Increasing job security - pretty much everyone is re-hiring post-covid. Everyone wigged out over one workforce prediction model, but it hasn't materialized yet. Is it hard to get a job paying $500k in and SDG in San Diego -- yeah, unicorns by definition are hard to find. ACEP, AAEM, SAEM, etc drafted a workforce which is sending rec's to ACGME and RUC to increase standards for residencies.

Reducing midlevel encroachment- literally in my state, FL ACEP and FMA stopped Florida from expanding FPA to midlevels accross all specialities. Primary care got screwed, but FMA literally met with the House Speaker, governor, and Senate President multiple times to hold off midlevels taking your ER jobs. Again, believe it or don't, but that's what happened. Without a lobbying body, EM is dead in the water.

For better or worse, AMA/State AMA and ACEP/state ACEP are the most powerful EM MD lobbying bodies in US/your state.

 

[sum dude]

It’s the biggest lie going cms reimbursement has 0 impact on what cmgs and hospitals pay docs. It’s purely supply and demand. Why is Denver pay terrible? Is cms ignoring the people of Colorado? Or is it because usacs has a monopoly and there are more people who want to work there then there and jobs and supply and demand take hold?

Under 15% of em docs have their pay tied to cms reimbursement. That’s true sdgs with open books.

That’s where Acep has shown some value to a small sliver of docs. Failures everywhere else.

This tells me you have no idea how reimbursement works and have never negotiated an insurance contract. You're confusing medicare reimbursement, which is usually about breakeven, with the real way commercial payers negotiate contracts.

We make all our money off of Commercial payors, who base their reimbursement on Medicare rates. It's a well known secret that Medicare rates drives insurance reimbursement, and it's why initially during NSA commercial payers wanted to tie OON pay to Medicare rates. It's also why every stupid balance billing article mentions "doctors making 400% of Medicare" instead of saying doctors making $800 on life-saving work. Every freaking doctor taking insurance has their pay related to CMS reimbursement--it's the rudder of our reimbursement ship. Not to mention if Medicare, which makes up about 30-40% of your groups total revenue (on average) drops 10%, you're all taking a bath on reimbursement, particularly if you are a SDG that revenue shares. Telling people CMS reimbursement affecting your pay is "a lie" is ignorant at best and dishonest at worst--I really hope people on here are smart enough to learn how revenue cycle management in EM really works and how you get paid...if not, we all deserve to get bought out by Wall Street.

 

[EctopicFetus]

This tells me you have no idea how reimbursement works and have never negotiated an insurance contract. You're confusing medicare reimbursement, which is usually about breakeven, with the real way commercial payers negotiate contracts.

We make all our money off of Commercial payors, who base their reimbursement on Medicare rates. It's a well known secret that Medicare rates drives insurance reimbursement, and it's why initially during NSA commercial payers wanted to tie OON pay to Medicare rates. It's also why every stupid balance billing article mentions "doctors making 400% of Medicare" instead of saying doctors making $800 on life-saving work. Every freaking doctor taking insurance has their pay related to CMS reimbursement--it's the rudder of our reimbursement ship. Not to mention if Medicare, which makes up about 30-40% of your groups total revenue (on average) drops 10%, you're all taking a bath on reimbursement, particularly if you are a SDG that revenue shares. Telling people CMS reimbursement affecting your pay is "a lie" is ignorant at best and dishonest at worst--I really hope people on here are smart enough to learn how revenue cycle management in EM really works and how you get paid...if not, we all deserve to get bought out by Wall Street.

Cool. You say have no idea how reimbursement works but you have no concept of what running a business looks like. Let me help you with some basic economics. Lets say you "sum dude" is gifted an In N out burger franchise. Its already operational and oddly all the employees come trained to you. There are lemmings who are trained to work in your burger joint as a burger flipper and oddly this is their only option. A few will go off and open up a food truck serving burgers (DPC) or move elsewhere along the burger supply chain some may only serve premium beef (ICU) but for the most part you know there is no shortage of labor and in case of emergency you can hire some burger flippers who couldnt cut it at In N out U and went to krystal U (MLPs) and are inferior but most of your customers wont notice.

Now your business is fine you make a profit of $1M a year on this franchise. You have no rent costs cause the strip mall is so excited to have you there they cover all your NNN costs. Your labor costs $20/hr per burger flipper. Your customers pay you on average of $15 per order. Things are humming along but you gather that all of a sudden In N out U and Krystal U is pumping out fresh lemmings at 2x the needed rate (I took some liberty here). Then you hear that the customers (insurance companies) might be willing to only pay $14/order. You are nervous cause with the 100k orders a year this will hurt your profits by 100k. On the other hand you studied Adam Smith and The Theory of Moral sentiments. Suddenly you realize your labor has no choice so you lower wages and make up that 100k with a cut where you end up net positive.

Simply put CMGs and hospitals pay not based on collections but rather supply and demand of 'providers". Why is it that people make $500-1k picking up last minute shifts? Did those patients suddenly promise to pay more or have better insurance?

FWIW I have intimately known 2 SDGs and have done consulting for 15-20 groups and seen their books and helped with insurance negotiating and hospital negotiating but yeah dude Im the one who has no idea.

A simpler example. If I ran a business and my revenue and profit went up 25% do you think suddenly I would pay my people more if the market said I was paying at market or slightly above market rates? Perhaps your logic needs to be applied to USACS in colorado? Why do they pay $140/hr? Is something broken in colorado or is it the obvious supply and demand curves of that (and other markets). You dont have to agree with me by 2030 this reality will smack you in the face if you arent in an SDG.

While you are right that commercial contracts are tied to medicare only an idiot would negotiate it without tying it to a specific year of medicare. I have done this with each contract I negotiated. As I said above ACEP did a tiny bit to help SDGs, it helped the CMGs way more. The NSA is gonna hurt us all no doubt about that. Why was the NSA necessary cause ACEP stood by as the CMGs screwed people and ACEP was on its knees doing what ACEP shills do best for their PE masters.

 

[RustedFox]

Cool. You say have no idea how reimbursement works but you have no concept of what running a business looks like. Let me help you with some basic economics. Lets say you "sum dude" is gifted an In N out burger franchise. Its already operational and oddly all the employees come trained to you. There are lemmings who are trained to work in your burger joint as a burger flipper and oddly this is their only option. A few will go off and open up a food truck serving burgers (DPC) or move elsewhere along the burger supply chain some may only serve premium beef (ICU) but for the most part you know there is no shortage of labor and in case of emergency you can hire some burger flippers who couldnt cut it at In N out U and went to krystal U (MLPs) and are inferior but most of your customers wont notice.

Now your business is fine you make a profit of $1M a year on this franchise. You have no rent costs cause the strip mall is so excited to have you there they cover all your NNN costs. Your labor costs $20/hr per burger flipper. Your customers pay you on average of $15 per order. Things are humming along but you gather that all of a sudden In N out U and Krystal U is pumping out fresh lemmings at 2x the needed rate (I took some liberty here). Then you hear that the customers (insurance companies) might be willing to only pay $14/order. You are nervous cause with the 100k orders a year this will hurt your profits by 100k. On the other hand you studied Adam Smith and The Theory of Moral sentiments. Suddenly you realize your labor has no choice so you lower wages and make up that 100k with a cut where you end up net positive.

Simply put CMGs and hospitals pay not based on collections but rather supply and demand of 'providers". Why is it that people make $500-1k picking up last minute shifts? Did those patients suddenly promise to pay more or have better insurance?

FWIW I have intimately known 2 SDGs and have done consulting for 15-20 groups and seen their books and helped with insurance negotiating and hospital negotiating but yeah dude Im the one who has no idea.

A simpler example. If I ran a business and my revenue and profit went up 25% do you think suddenly I would pay my people more if the market said I was paying at market or slightly above market rates? Perhaps your logic needs to be applied to USACS in colorado? Why do they pay $140/hr? Is something broken in colorado or is it the obvious supply and demand curves of that (and other markets). You dont have to agree with me by 2030 this reality will smack you in the face if you arent in an SDG.

While you are right that commercial contracts are tied to medicare only an idiot would negotiate it without tying it to a specific year of medicare. I have done this with each contract I negotiated. As I said above ACEP did a tiny bit to help SDGs, it helped the CMGs way more. The NSA is gonna hurt us all no doubt about that. Why was the NSA necessary cause ACEP stood by as the CMGs screwed people and ACEP was on its knees doing what ACEP shills do best for their PE masters.

Paging the burn unit.