Supply of board-certified emergency physicians unlikely to meet projected needs

December 17, 2008

The number of physicians with board certification in emergency medicine is unlikely to meet the staffing needs of U.S. emergency departments in the foreseeable future, if ever; according to a study from a research team based at Massachusetts General Hospital (MGH). In the December issue of Academic Emergency Medicine, the investigators report finding that staffing every emergency department with board-certified emergency physicians does not appear to be feasible, given their projections for the field.

"Thousands of emergency departments are not currently staffed by physicians with this type of training," explains Carlos Camargo, MD, DrPH, of the MGH Department of Emergency Medicine, who led the study. "We questioned whether staffing every department with residency-trained, board-certified emergency physicians - which some individuals have advocated for decades - was a realistic goal. So we set out to estimate emergency physician workforce needs, taking into account the diversity of hospitals across the country and projections about the future physician supply and demand."

The researchers analyzed data from the 2005 National Emergency Department Inventories-USA database to determine the number of emergency departments in the country and their patient volumes. Based on the approximately 22,000 board-certified emergency physicians in practice and the 1,350 who became newly certified during 2005, the team developed three scenarios for physician supply, all of which assumed the same number of new board-certified physicians each year. The best-case scenario, which was intentionally unrealistic, assumed that no board-certified emergency physician died or retired; the worst case assumed an annual attrition rate of 12 percent; and the intermediate scenario assumed 2.5 percent attrition each year.

Having at least one board-certified emergency physician present in all U.S. hospital emergency departments at all times would require 40,000 physicians with such training, indicating that only 55 percent of 2005 demand was being met. Under the intermediate-scenario projection, it would not be possible to meet the goal until 2038, and under the worst-case scenario, the goal could never be met. Even if no board-certified emergency physician ever died or retired, 100 percent staffing of all emergency departments with board-certified emergency physicians would not happen for more than a decade.

"The mismatch between the supply and demand for residency-trained, board-certified emergency physicians is a longstanding problem," Camargo says. "The need for emergency services is large and growing; and even if existing programs graduated more physicians, there is little reason to think more of those graduates would move to the rural areas that are particularly short on physicians with this specialized training. We probably should explore alternatives, such as giving the family physicians who currently staff many U.S. emergency departments extra training in key emergency procedures. We might also increase our reliance on nurse practitioners and physicians assistants, who can help emergency physicians of any training background better handle the continually rising number of patients." Camargo is an associate professor of Emergency Medicine at Harvard Medical School.
-end-
Co-authors of the Academic Emergency Medicine report are Janice Espinola, MPH; Ashley Sullivan, MS, MPH, and John Pearson, MGH Department of Emergency Medicine; Adit Ginde, MD, MPH, University of Colorado Denver School of Medicine; and Ayellete Singer, MA, and Adam Singer, MD, Stony Brook University Medical Center, New York.

Massachusetts General Hospital (www.massgeneral.org), established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $500 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.

Massachusetts General Hospital

Related Emergency Department Articles from Brightsurf:

Deep learning in the emergency department
Harnessing the power of deep learning leads to better predictions of patient admissions and flow in emergency departments

Checklist for emergency department team's COVID-19 surge
After reviewing the literature on COVID-19 scientific publications the authors developed a checklist to guide emergency departments.

Why is appendicitis not always diagnosed in the emergency department?
A new study examines the factors associated with a potentially missed diagnosis of appendicitis in children and adults in the emergency department.

Providing contraceptive care in the pediatric emergency department
A new study found that two-thirds of female adolescents ages 16-21 seen in a pediatric Emergency Department (ED) were interested in discussing contraception, despite having a high rate of recent visits to a primary care provider.

Low back pain accounts for a third of new emergency department imaging in the US
The use of imaging for the initial evaluation of patients with low back pain in the emergency department (ED) continues to occur at a high rate -- one in three new emergency visits for low back pain in the United States -- according to the American Journal of Roentgenology (AJR).

Emergency department admissions of children for sexual abuse
This study analyzed emergency department admissions of children for sexual abuse between 2010 and 2016 using a nationwide database of emergency visits and US Census Bureau data.

30-day death rates after emergency department visits
Researchers used Medicare data from 2009 to 2016 to see how 30-day death rates associated with emergency department visits have changed.

Preventing smoking -- evidence from urban emergency department patients
A new study from the Prevention Research Center of the Pacific Institute for Research and Evaluation offers a more in-depth understanding of smoking among patients in an urban emergency department.

When a freestanding emergency department comes to town, costs go up
Rather than functioning as substitutes for hospital-based emergency departments, freestanding emergency departments have increased local market spending on emergency care in three of four states' markets where they have entered, according to a new paper by experts at Rice University.

Emoji buttons gauge emergency department sentiments in real time
Simple button terminals stationed around emergency departments featuring 'emoji' reflecting a range of emotions are effective in monitoring doctor and patient sentiments in real time.

Read More: Emergency Department News and Emergency Department Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.