California ED doctors ante up to boost on-call coverage

Just how serious is the on-call panel coverage situation in California? Serious enough that this fall, the state’s emergency physicians put up nearly $2 million of their own money in support of a ballot initiative that would have added $600 million a year to pay for uncompensated emergency care. The initiative did not pass.

"This is exactly an indication of how serious it is," says Paul Kivela, MD, MBA, FACEP, president of the California Chapter of the American College of Emergency Physicians (CAL/ACEP) and an attending physician at Queen of the Valley hospital in Napa, CA. The funding for the initiative fell on providers, he says. "The total was about $3.5 million to $4 million, and we raised close to $1.8 million among the emergency physicians," Kivela explains.

CAL/ACEP launched the initiative because, "We tried to find other ways to solve this problem, but it kept snowballing," he adds. So, the organization asked every emergency physician in California to donate $500 a year for two consecutive years to support the effort.

"About 50% of them gave, and some gave a lot more than $500," Kivela continues.

He contends the initiative, along with other recent events in California, will spur more people to try to come up with a solution. "This is more than an imminent crisis; we’re there right now," Kivela asserts. "The past election has been a big wake-up call; outgoing Gov. Grey Davis signed a bill requiring all mid-sized and large employers to offer insurance to their employees, but it was narrowly defeated."

Nor has he given up on his own efforts. "We failed because the proposed source of our funding was a surcharge on phones," Kivela observes. "We did not receive appropriate counsel on the reaches of the phone company." Will CAL/ACEP try again? "If that’s what it takes, we will try to do it again," he adds.