What happens when insurance companies and emergency physicians clash over fair payment, leaving patients caught in the middle? In this Echo Episode, part two of a two-part series, Dr. Andrea Austin talks with Dr. Jillian Schmitz about the pressing challenges in emergency medicine today.Dr. Schmitz explains the intricacies of surprise billing, where out-of-network emergency care leads to unexpected patient costs, and the No Surprises Act’s intent to protect patients by removing them from billing disputes. She highlights the implementation challenges, including insurance companies’ failure to follow regulations, skyrocketing arbitration fees, and delays in payments that threaten small practices. The conversation also explores ACEP’s advocacy efforts, the power of collective action, and an exciting initiative to accredit emergency departments to set standards for resources, staffing, and transparency.You’ll hear how they:<ul><li>Break down surprise billing and its impact on patients and emergency physicians</li><li>Expose flaws in the No Surprises Act’s implementation, including insurance companies’ manipulation of dispute processes</li><li>Advocate for collective action through ACEP membership, Political Action Committee (PAC) contributions, and sharing real-world stories</li><li>Propose accrediting emergency departments to ensure proper resources and fair practice environments</li><li>Challenge misconceptions about ACEP’s ties to corporate medicine and emphasize its physician-led advocacy</li></ul>If you’re an emergency physician feeling the weight of systemic challenges or seeking ways to drive change, this episode offers practical insights, advocacy strategies, and a hopeful vision for the future of emergency medicine.About the Guest:“Emergency physicians are resilient—we adapt to challenging situations with little information and make the best of it.” – Dr. Gillian SchmitzDr. Gillian Schmitz is a professor at the Uniformed Services University and an emergency physician at Brooke Army Medical Center in San Antonio, Texas. As the  past president and a member of the Board of Directors of the American College of Emergency Physicians (ACEP), she has been a leading voice in addressing workforce challenges, burnout, and policy reform in emergency medicine. A civilian working in military medicine, Gillian’s career blends clinical practice, academic teaching, and advocacy, inspired by her commitment to serving those who serve the country. Her work focuses on fostering resilience, improving team dynamics, and advocating for systemic changes to support emergency physicians.📍 Connect with GillianLinkedIn:<a href="https://www.linkedin.com/in/gillian-schmitz-md-facep-8a5b5b1a/"> </a>https://www.linkedin.com/in/gillian-schmitz-b88794302/Email:<a href="mailto:jillianmd@gmail.com"> jillianmd@gmail.com</a>📚 Resources + Mentions<a href="https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills">🔗 No Surprises Act</a>🔗 <a href="https://www.acep.org/life-as-a-physician/workforce">ACEP Workforce Report</a>🔗 <a href="https://www.acep.org/state-advocacy/guide-to-state-legislation/state-advocacy-issues-and-resources">ACEP Advocacy Resources</a>🔗 <a href="https://www.amazon.com/Dare-Lead-Brave-Conversations-Hearts/dp/0399592520">Dare to Lead by Brené Brown</a>🔗 <a href="https://www.amazon.com/Gifts-Imperfection-Think-Supposed-Embrace/dp/159285849X">The Gifts of Imperfection by Brené Brown</a>🔗 <a href="https://learn.coachingfordoctors.net.au/recalibrate-application">Recalibrate: Group Coaching for Physicians</a>🔑 Top 3 Key Takeaways<ul><li>Understand and fight surprise billing: The No Surprises Act aims to protect patients, but enforcement gaps allow insurance companies to delay payments and manipulate disputes, threatening small practices. Share your stories to fuel advocacy.</li><li>Join the collective: Support ACEP through membership or PAC contributions to amplify emergency physicians’ voices in Congress and drive policy changes like fair reimbursement and accreditation standards.</li><li>Envision a better future: ACEP’s push to accredit emergency departments could set standards for resources, staffing, and transparency, improving practice environments and patient care nationwide.</li></ul>🩺 About the HostDr. Andrea Austin is a board-certified emergency physician, educator, and passionate advocate for system-level change in healthcare. As the creator and host of Heartline: Changemaking in Healthcare, Dr. Austin brings curiosity, compassion, and bold honesty to conversations with leaders who are challenging the norms and reshaping medicine from the inside out.With decades of experience in high-pressure clinical environments, Andrea has seen firsthand the cracks in the system—and the people working to repair them. Whether she’s mentoring residents, speaking on national stages, or recording with a fellow disruptor, she centers one theme: change doesn’t happen in isolation. It happens heart to heart.💫 About the ShowHeartline: Changemaking in Healthcare isn’t just a podcast—it’s a pulse check on what’s possible.Hosted by emergency physician and educator Dr. Andrea Austin, Heartline features conversations with healthcare leaders, innovators, and quiet disruptors who are challenging the way things have always been done.Each episode explores real stories of change—from redefining leadership and communication, to reimagining systems built on burnout and hierarchy. This is a space for truth-telling, for asking better questions, and for reconnecting with the reason we all got into medicine in the first place: to make it better.This isn’t about perfection. It’s about progress—with heart.  🎓 Upcoming Events & Opportunities<ul><li>🔥 ⁠⁠Recalibrate: Group Coaching for Physicians⁠⁠</li></ul>Starting  2026, I’ll be co-leading Recalibrate with psychologist and coach Sharee Johnson. This 6-month group coaching program supports physicians in rediscovering mindfulness, meaning, and wholehearted practice. I'm an alum myself—this program transformed my career. Learn more and enroll here, and please share with colleagues who may benefit.<ul><li>⁠<a href="https://www.womeninmedicinesummit.org/">⁠⁠Women in Medicine Summit | Chicago, Sept 18–20, 2025⁠⁠</a></li><li>FemInEM is leading a full day on Women’s Health. The Gala will be a can't-miss celebration of leadership and community.</li><li> ⁠<a href="https://www.acep.org/aawep/">⁠⁠AAWEP St. Lucia Retreat | March 5–8, 2026⁠⁠</a></li><li>For women EM physicians. Sun, connection, and reflection in a stunning setting. Details coming soon via AAWEP.</li><li>⁠<a href="https://www.cmeriverconference.com/cme-rhine-river-cruise">⁠⁠Women Physicians European River Cruise | May 18–25, 2026⁠⁠</a></li><li>A scenic and soulful journey from Amsterdam to Basel with an inspiring community.</li></ul>—-------------------------------🎧 Thanks for tuning into Heartline: Changemaking in Healthcare!🌟 Learn more and book a free discovery call today at<a href="https://andreaaustinmd.com/coaching"> ⁠⁠andreaaustinmd.com/coaching⁠⁠</a>.Stay connected and keep making a difference:✅ Subscribe to the<a href="https://andrea-austin.mykajabi.com/newsletters/2147552842/subscribe"> ⁠⁠Heartline newsletter⁠⁠</a> for insights into reclaiming your well-being as a healthcare professional, improving teams around you, and transforming the system.📱 Follow us on social:<a href="https://www.instagram.com/andreaaustinmd/"> ⁠⁠Instagram⁠⁠</a>,<a href="https://www.linkedin.com/in/andreaaustinmd/"> ⁠⁠LinkedIn⁠⁠</a> &<a href="https://www.youtube.com/@andreaaustinmd"> ⁠⁠YouTube⁠⁠</a>📚 Discover Dr. Austin’s book Revitalized: A Guidebook to Following Your Healing Heartline on<a href="https://amzn.to/40QzgHS"> ⁠⁠Amazon⁠⁠</a> or<a href="https://shop.ingramspark.com/b/084?params=qpSaalqMqh8gY4Tldyk53hvMT3Ig2aOlN212acjobI1"> ⁠⁠Ingram⁠⁠</a>.Follow Your Heartline and transform healthcare today!

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