Reiter Mark, Wen Leana S, Allen Brady W
University of Tennessee-Murfreesboro, Murfreesboro, Tennessee; American Academy of Emergency Medicine, Milwaukee, Wisconsin; Emergency Excellence, LLC, Brentwood, Tennessee.
Patient-Centered Care Research, The George Washington University, Washington, DC; Department of Emergency Medicine, The George Washington University, Washington, DC.
J Emerg Med. 2016 Apr;50(4):690-3. doi: 10.1016/j.jemermed.2015.09.022. Epub 2016 Jan 25.
The landscape of the emergency medicine workforce has changed dramatically over the last few decades. The growth in emergency medicine residency programs has significantly increased the number of emergency medicine specialists now staffing emergency departments (EDs) throughout the country. Despite this increase in available providers, rising patient volumes, an aging population, ED overcrowding and inefficiency, increased regulation, and other factors have resulted in the continued need for additional emergency physicians.
To review current available data on patient volumes and characteristics, the overall physician workforce, the current emergency physician workforce, the impact of physician extenders and scribes on the practice of emergency medicine, and project emergency physician staffing needs into the future.
We project that within the next 5 to 10 years, there will be enough board-certified or -eligible emergency physicians to provide care to all patients in the U.S. EDs. However, low-volume rural EDs will continue to have difficulty attracting emergency medicine specialists without significant incentives.
There remains a shortage of board-certified emergency physicians, but it is decreasing every year. The use of physicians from other specialties to staff EDs has long been based on the theory that there is a long-standing shortage of available American Board of Emergency Medicine/American Osteopathic Board of Emergency Medicine physicians, both now and in the future. Our investigation shows that this is not supported by current data. Although there will always be regional and rural physician shortages, these are mirrored by all other specialties and are even more pressing in primary care.
在过去几十年里，急诊医学劳动力格局发生了巨大变化。急诊医学住院医师培训项目的增加显著提高了目前在美国各地急诊科工作的急诊医学专家数量。尽管可用的医疗服务提供者有所增加，但患者数量不断上升、人口老龄化、急诊科过度拥挤和效率低下、监管加强以及其他因素导致仍持续需要更多的急诊医生。
回顾关于患者数量和特征、整体医生劳动力、当前急诊医生劳动力、医生助理和抄写员对急诊医学实践的影响的现有数据，并预测未来急诊医生的人员配备需求。
我们预计在未来5至10年内，将有足够数量的获得委员会认证或具备认证资格的急诊医生为美国急诊科的所有患者提供治疗。然而，患者量少的农村急诊科在没有重大激励措施的情况下，仍将难以吸引急诊医学专家。
获得委员会认证的急诊医生仍然短缺，但短缺情况每年都在减少。长期以来，使用其他专科的医生来配备急诊科人员的依据是，美国急诊医学委员会/美国骨科急诊医学委员会的医生目前和未来一直存在长期短缺。我们的调查表明，目前的数据并不支持这一点。尽管总会存在地区和农村医生短缺的情况，但所有其他专科也都存在类似情况，且在初级保健领域更为紧迫。
