Holliman C J, Wuerz R C, Chapman D M, Hirshberg A J
Pennsylvania State University, Milton S. Hershey Medical Center, Emergency Department, Hershey 17033-0850, USA.
Acad Emerg Med. 1997 Jul;4(7):725-30. doi: 10.1111/j.1553-2712.1997.tb03768.x.
To mathematically model the supply of and demand for emergency physicians (EPs) under different workforce conditions.
A computer spreadsheet model was used to project annual EP workforce supply and demand through the year 2035. The mathematical equations used were: supply = number of EPs at the beginning of the year plus annual residency graduates minus annual attrition; demand = 5 full-time equivalent positions/ED x the number of hospital EDs. The demand was empirically varied to account for ED census variation, administrative and teaching responsibilities, and the availability of physician extenders. A variety of possible scenarios were tested. These projections make the assumption that emergency medicine (EM) residency graduates will preferentially fill clinical positions currently filled by EPs without EM board certification.
Under most of the scenarios tested, there will be a large deficit of EM board-certified EPs well into the next century. Even in scenarios involving a decreasing "demand" for EPs (e.g., in the setting of hospital closures or the training of physician extenders), a significant deficit will remain for at least several decades.
The number of EM residency positions should not be decreased during any restructuring of the U.S. health care system. EM is likely to remain a specialty in which the supply of board-certified EPs will not meet the demand, even at present levels of EM residency output, for the next several decades.
对不同劳动力条件下急诊医生（EP）的供需情况进行数学建模。
使用计算机电子表格模型预测到2035年每年EP劳动力的供需情况。所使用的数学方程为：供给 = 年初EP数量 + 年度住院医师毕业生数量 - 年度人员损耗；需求 = 每个急诊科5个全职等效岗位×医院急诊科数量。根据急诊科人口普查变化、行政和教学职责以及医师助理的可用性，对需求进行实证调整。测试了各种可能的情景。这些预测假设急诊医学（EM）住院医师毕业生将优先填补目前由无EM委员会认证的EP担任的临床职位。
在测试的大多数情景下，到下个世纪，EM委员会认证的EP将出现大量短缺。即使在涉及对EP“需求”下降的情景中（例如，在医院关闭或医师助理培训的情况下），至少几十年内仍将存在显著短缺。
在美国医疗保健系统的任何重组过程中，EM住院医师职位数量都不应减少。即使按照目前EM住院医师培养规模，在未来几十年内，EM可能仍将是一个委员会认证的EP供应无法满足需求的专业。
