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:
- Break down surprise billing and its impact on patients and emergency physicians
- Expose flaws in the No Surprises Act’s implementation, including insurance companies’ manipulation of dispute processes
- Advocate for collective action through ACEP membership, Political Action Committee (PAC) contributions, and sharing real-world stories
- Propose accrediting emergency departments to ensure proper resources and fair practice environments
- Challenge misconceptions about ACEP’s ties to corporate medicine and emphasize its physician-led advocacy
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 Schmitz
Dr. 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 Gillian
LinkedIn: https://www.linkedin.com/in/gillian-schmitz-b88794302/
Email: jillianmd@gmail.com
📚 Resources + Mentions
🔗 The Gifts of Imperfection by Brené Brown
🔗 Recalibrate: Group Coaching for Physicians
🔑 Top 3 Key Takeaways
- 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.
- 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.
- 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.
🩺 About the Host
Dr. 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
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Ruthie's Table 4
For more than 30 years The River Cafe in London, has been the home-from-home of artists, architects, designers, actors, collectors, writers, activists, and politicians. Michael Caine, Glenn Close, JJ Abrams, Steve McQueen, Victoria and David Beckham, and Lily Allen, are just some of the people who love to call The River Cafe home. On River Cafe Table 4, Rogers sits down with her customers—who have become friends—to talk about food memories. Table 4 explores how food impacts every aspect of our lives. “Foods is politics, food is cultural, food is how you express love, food is about your heritage, it defines who you and who you want to be,” says Rogers. Each week, Rogers invites her guest to reminisce about family suppers and first dates, what they cook, how they eat when performing, the restaurants they choose, and what food they seek when they need comfort. And to punctuate each episode of Table 4, guests such as Ralph Fiennes, Emily Blunt, and Alfonso Cuarón, read their favourite recipe from one of the best-selling River Cafe cookbooks. Table 4 itself, is situated near The River Cafe’s open kitchen, close to the bright pink wood-fired oven and next to the glossy yellow pass, where Ruthie oversees the restaurant. You are invited to take a seat at this intimate table and join the conversation. For more information, recipes, and ingredients, go to https://shoptherivercafe.co.uk/ Web: https://rivercafe.co.uk/ Instagram: www.instagram.com/therivercafelondon/ Facebook: https://en-gb.facebook.com/therivercafelondon/ For more podcasts from iHeartRadio, visit the iheartradio app, apple podcasts, or wherever you listen to your favorite shows. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.