WASHINGTON, June 13, 2018 /PRNewswire-USNewswire/
-- Emergency departments are strained by physician shortages,
predominantly in rural areas, according to "State of the National
Emergency Department Workforce: Who Provides Care Where?," a new
study in Annals of Emergency Medicine.
"Emergency departments are an especially vital safety net for
patients in rural settings," said M. Kennedy Hall, MD, MHS, Assistant Professor in
the Department of Emergency Medicine at the University of Washington School of Medicine and
lead study author. "This study shows that there is an opportunity
to address emergency medicine workforce challenges and narrow any
potential gaps in training for those providing emergency care.
Staffing differences between rural and urban communities should
factor into optimal care delivery decisions and sound
policymaking."
Of 58,641 emergency medicine clinicians identified by the
analysis, 61 percent (35,856) were classified as emergency
physicians. Qualified health professionals who work under physician
supervision, known as advanced practice providers (APP) made up
24.5 percent (14,360) and non-emergency physicians made up 14.3
percent (8,397).
Among APPs, physician assistants (68.4 percent) and nurse
practitioners (31.5%) were most common. Among non-emergency
physicians, family practice (41.7 percent) and internal medicine
(19.9 percent) physicians were most represented.
In rural areas, clinicians are often trained in other
specialties and APPs provide disproportionately more emergency
care, especially where there may not be an emergency physician
available, the authors note.
More emergency physicians were mapped to urban counties (63.9
percent) than their rural counterparts (44.8 percent). More than
one-quarter of counties (27.1 percent) had no emergency clinicians
of any kind and 44.9 percent of counties had no emergency
physicians reimbursed by Medicare Part B.
The highest proportion of emergency physicians can be found
bi-coastally and in the Mountain Time Zone. The lowest proportions
can be found in the southern United
States and in the Central Time Zone.
"Our analysis revealed that more than one third of emergency
department clinicians are someone other than an emergency
physician," said Dr. Hall. "This points to the need for a broader
approach to emergency care training. Health systems have unique
needs and hospitals, particularly in rural areas, and will continue
to be challenged to harness the provider mix in their regions."
"Our EM workforce is broad-based with a variety of ambulatory
care skillsets in addition to emergency medicine experience. It is
important to provide additional emergency medicine specific
training when needed, as well as examine standards for APPs and
non-emergency physicians, especially in locations where access to
trained emergency physicians is limited," said Dr. Hall.
The analysis was based on the 2014 Medicare Public Use Files
(MPUF) dataset of 932,243 physicians, which includes 58,641 (6
percent) unique emergency medicine clinicians. The study found at
least 20,000 more emergency physicians than the previously
published workforce analysis from a decade ago.
Annals of Emergency Medicine is the peer-reviewed
scientific journal for the American College of Emergency
Physicians, the national medical society representing emergency
medicine. ACEP is committed to advancing emergency care through
continuing education, research, and public education. Headquartered
in Dallas, Texas, ACEP has 53
chapters representing each state, as well as Puerto
Rico and the District of Columbia. A Government Services
Chapter represents emergency physicians employed by military
branches and other government agencies. For more information,
visit www.acep.org.
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SOURCE American College of Emergency Physicians (ACEP)