A study of the workforce in emergency medicine: 1999

Moorhead, John C.; Gallery, Michael E.; Hirshkorn, Colleen; Barnaby, Douglas P.; Barsan, William G.; Conrad, Lily; Dalsey, William C.; Fried, Michelle; Herman, Steven D.; Hogan, Paul; Mannle, Thomas E.; Packard, Dighton C.; Perina, Debra G.; Pollack, Charles V.; Rapp, Michael; Rorrie, Colin C.; Schafermeyer, Robert W.

doi:10.1067/mem.2002.124754

Cited by 85 publications

(55 citation statements)

References 5 publications

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“…33 However, we were able to capture a broad range of characteristics typical of U.S. EPs; compared to prior estimates of the demography of the U.S. EP workforce, our sample was similar, although not identical, in terms of age, sex, length of clinical practice, and proportion of board-certified respondents. [34][35][36][37] Because there is no reason to suspect our sample was extremely atypical, we believe that the sentiments expressed may resonate with, at the very least, a nontrivial amount of EPs.…”

Section: Limitationsmentioning

confidence: 99%

Emergency Physician Perceptions of Shared Decision‐making

Kanzaria

Brook

Probst

et al. 2015

Academic Emergency Medicine

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Objectives: Despite the potential benefits of shared decision-making (SDM), its integration into emergency care is challenging. Emergency physician (EP) perceptions about the frequency with which they use SDM, its potential to reduce medically unnecessary diagnostic testing, and the barriers to employing SDM in the emergency department (ED) were investigated.Methods: As part of a larger project examining beliefs on overtesting, questions were posed to EPs about SDM. Qualitative analysis of two multispecialty focus groups was done exploring decision-making around resource use to generate survey items. The survey was then pilot-tested and revised to focus on advanced diagnostic imaging and SDM. The final survey was administered to EPs recruited at four emergency medicine (EM) conferences and 15 ED group meetings. This report addresses responses regarding SDM.Results: A purposive sample of 478 EPs from 29 states were approached, of whom 435 (91%) completed the survey. EPs estimated that, on average, multiple reasonable management options exist in over 50% of their patients and reported employing SDM with 58% of such patients. Respondents perceived SDM as a promising solution to reduce overtesting. However, despite existing research to the contrary, respondents also commonly cited beliefs that 1) "many patients prefer that the physician decides," 2) "when offered a choice, many patients opt for more aggressive care than they need," and 3) "it is too complicated for patients to know how to choose."Conclusions: Most surveyed EPs believe SDM is a potential high-yield solution to overtesting, but many perceive patient-related barriers to its successful implementation.ACADEMIC EMERGENCY MEDICINE 2015;22:399-405

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Section: Limitationsmentioning

confidence: 99%

Emergency Physician Perceptions of Shared Decision‐making

Kanzaria

Brook

Probst

et al. 2015

Academic Emergency Medicine

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“…Moreover, based on the most recent workforce survey, a minimum of 5.35 full-time equivalents (FTEs) would be required to staff an ED with single coverage. 2 We also assumed that 3,548 visits will be seen annually by the average EP, based on 2.8 patients per hour 8 and working 40 hours per week, of which 34% spent on nonclinical requirements. 2 We…”

Section: Ep Demandmentioning

confidence: 99%

“…' Staffing EDs creates unique challenges due to the mandate to provide round-the-clock care and the inability to restrict patient demand for services. The most recent national EP workforce projection, based on 1999 data, 2 questioned the ability to supply an adequate number of emergency medicine (EM) residency-trained, board-certified EPs. Given the rising volume of ED visits, up to 115 million in 2005, 3 and changes in the political landscape, 4 a reassessment of EP workforce needs is warranted.…”

mentioning

confidence: 99%

Assessment of Emergency Physician Workforce Needs in the United States, 2005

Camargo

Ginde

Singer

et al. 2008

Academic Emergency Medicine

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Objectives: The objective was to estimate emergency physician (EP) workforce needs, taking into account the diversity of U.S. emergency departments (EDs) and various projections of EP supply and demand.Methods: The 2005 National ED Inventory-USA (http://www.emnet-usa.org/) provided annual visit volumes for 4,828 U.S. EDs. The authors calculated annual supply based on existing emergency medicine (EM) board-certified EPs, adding newly board-certified EPs, and subtracting board-certified EPs who died or retired. Demand was estimated at each ED by dividing the number of visits by the average EP volume (based on 2.8 patients ⁄ hour, 40 hours ⁄ week, and 34% nonclinical time). The models assumed that at least 1 EP should be present 24 ⁄ 7 in each ED, which would require at least 5.35 full-time equivalents (FTEs) per ED. Based on annual EP attrition estimates, results for best-case, worst-case, and intermediate scenarios were calculated.Results: In 2005, there were approximately 22,000 EM board-certified EPs, but 40,030 EPs would be needed to staff all 4,828 EDs (55% of demand met). A total of 2,492 (52%) EDs had a visit volume that required the minimum number (5.35) FTEs, of which 47% were rural. In the unrealistic (no attrition), best-case scenario, it would take until 2019 to staff all EDs with board-certified EPs. In the worst-case scenario (12% attrition), supply would never meet demand. Our intermediate scenario (2.5% attrition) suggested that board-certified EPs would satisfy workforce needs in 2038. The report states that ''although, ideally, all EDs [emergency departments] would be staffed by residency trained, board certified EPs, this is highly unlikely to occur in the near to middle term, if ever. Therefore alternative staffing models must be developed.'' Staffing EDs creates unique challenges due to the mandate to provide round-the-clock care and the inability to restrict patient demand for services. The most recent national EP workforce projection, based on 1999 data, 2 questioned the ability to supply an adequate number of emergency medicine (EM) residency-trained, board-certified EPs. Given the rising volume of ED visits, up to 115 million in 2005,3 and changes in the political landscape, 4 a reassessment of EP workforce needs is warranted.Our objective was to estimate EP workforce needs, taking into account the diversity of U.S. EDs and various projections of EP supply and demand. We hypothesized that the supply of EM residency-trained, board-certified EPs would be insufficient to meet demand for several decades.

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“…In contrast with the United States, 3 the demographics of EM providers in Canada has not been formally evaluated. The JANUS project, an initiative of the College of Family Physicians of Canada to collect information on the clinical activities of FPs, found that 24% of 13 088 FPs surveyed worked in the ED setting and 7% described the ED as their main practice setting.…”

Section: Introductionmentioning

confidence: 99%

Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments

Bhimani

Dickie²,

McLeod³

et al. 2007

CJEM

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Objectives:We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. Methods: A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. Results: Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. Conclusion:The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions. ORIGINAL RESEARCH • RECHERCHE ORIGINALE

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A study of the workforce in emergency medicine: 1999

Cited by 85 publications

References 5 publications

Emergency Physician Perceptions of Shared Decision‐making

Emergency Physician Perceptions of Shared Decision‐making

Assessment of Emergency Physician Workforce Needs in the United States, 2005

Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments

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