Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH.
Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, TX.
Ann Emerg Med. 2021 Dec;78(6):726-737. doi: 10.1016/j.annemergmed.2021.05.029. Epub 2021 Aug 2.
The goals of this study were to determine the current and projected supply in 2030 of contributors to emergency care, including emergency residency-trained and board-certified physicians, other physicians, nurse practitioners, and physician assistants. In addition, this study was designed to determine the current and projected demand for residency-trained, board-certified emergency physicians.
To forecast future workforce supply and demand, sources of existing data were used, assumptions based on past and potential future trends were determined, and a sensitivity analysis was conducted to determine how the final forecast would be subject to variance in the baseline inputs and assumptions. Methods included: (1) estimates of the baseline workforce supply of physicians, nurse practitioners, and physician assistants; (2) estimates of future changes in the raw numbers of persons entering and leaving that workforce; (3) estimates of the productivity of the workforce; and (4) estimates of the demand for emergency care services. The methodology assumes supply equals demand in the base year and estimates the change between the base year and 2030; it then compares supply and demand in 2030 under different scenarios.
The task force consensus was that the most likely future scenario is described by: 2% annual graduate medical education growth, 3% annual emergency physician attrition, 20% encounters seen by a nurse practitioner or physician assistant, and 11% increase in emergency department visits relative to 2018. This scenario would result in a surplus of 7,845 emergency physicians in 2030.
The specialty of emergency medicine is facing the likely oversupply of emergency physicians in 2030. The factors leading to this include the increasing supply of and changing demand for emergency physicians. An organized, collective approach to a balanced workforce by the specialty of emergency medicine is imperative.
本研究旨在确定目前以及到 2030 年对急诊医学有贡献的人员（包括急诊住院医师培训和委员会认证的医生、其他医生、执业护士和医师助理）的供应情况和预计供应量。此外，本研究旨在确定目前以及到 2030 年对住院医师培训和委员会认证的急诊医生的需求情况。
为了预测未来的劳动力供应和需求，利用了现有数据来源，根据过去和潜在的未来趋势确定了假设，并进行了敏感性分析，以确定最终预测将如何受到基线投入和假设变化的影响。方法包括：（1）医生、执业护士和医师助理的基本劳动力供应估计；（2）进入和离开该劳动力的人数的未来变化估计；（3）劳动力的生产力估计；（4）急诊护理服务的需求估计。该方法假设基础年的供应等于需求，并估计基础年和 2030 年之间的变化；然后在不同情景下比较 2030 年的供应和需求。
工作组达成共识，最有可能的未来情景是：每年的住院医师培训增长率为 2%，每年的急诊医生流失率为 3%，执业护士或医师助理可处理的就诊量为 20%，急诊就诊量相对于 2018 年增长 11%。这种情况下，到 2030 年将有 7845 名急诊医生过剩。
急诊医学专业正面临到 2030 年急诊医生可能过剩的局面。导致这种情况的因素包括急诊医生供应量的增加和需求的变化。急诊医学专业必须采取有组织、集体的方法来实现劳动力的平衡。
