Assessment of emergency physician workforce needs in the United States, 2005

Abstract

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.

Conclusions: Supply of EM residency-trained, board-certified EPs is not likely to meet demand in the near future. Alternative EP staffing arrangements merit further consideration.