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National Study of the Emergency Physician Workforce, 2020 - 20/11/20

Doi : 10.1016/j.annemergmed.2020.06.039 
Christopher L. Bennett, MD, MA a, Ashley F. Sullivan, MS, MPH a, Adit A. Ginde, MD, MPH b, John Rogers, MD c, Janice A. Espinola, MPH a, Carson E. Clay, BA a, Carlos A. Camargo, MD, DrPH a,
a Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 
b Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 
c Department of Emergency Medicine, Coliseum Northside Hospital, Macon, GA 

Corresponding Author.

Abstract

Study objective

We describe the current US emergency physician workforce.

Methods

We analyzed the 2020 American Medical Association Physician Masterfile data set. All physicians who designated emergency medicine as their primary or secondary specialty were included; nonactive physicians, residents, primarily research or teaching faculty, or those primarily involved in administration or nonclinical work were excluded. We calculated emergency physician population density, using 2018 Census Bureau estimates of the US population; urban-rural assignments were based on Urban Influence Codes. We compared 2020 results with our previous analysis of the 2008 emergency physician workforce. Again, we were unable to account for American Osteopathic Board of Emergency Medicine certification.

Results

There were 48,835 clinically active emergency physicians in 2020. The median age was 50 years (interquartile range [IQR] 41 to 62 years) and 28% were women. Overall density of emergency physicians per 100,000 population was 14.9. Most emergency physicians were in urban areas (92%), whereas 2,730 (6%) were in large rural areas and 1,197 (2%) in small rural areas. Urban emergency physicians were younger (median age 50 years; IQR 41 to 61 years) than those in large rural areas (median age 58 years; IQR 47 to 67 years) or small rural areas (median age 62 years; IQR 51 to 68 years), and more likely to be women (29%, 20%, and 19%, respectively). Most emergency physicians in small rural areas (71%) completed their medical training more than 20 years ago. Compared with 2008, the total number of clinically active emergency physicians has increased by 9,774, but, per 100,000 US population in 2020, emergency physician density decreased in both large rural (–0.4) and small rural (–3.7) areas.

Conclusion

Urban emergency physicians in 2020 remain substantially younger than rural emergency physicians, with many rural ones near the US retirement age. We did not observe a continued increase in the percentage of female physicians among emergency physicians. Given the ongoing demand for physicians in all US emergency departments, this analysis provides essential information for understanding the current emergency physician workforce and the challenges ahead.

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 Please see page 696 for the Editor’s Capsule Summary of this article.
 Supervising editor: Donald M. Yealy, MD. Specific detailed information about possible conflict of interest for individual editors is available at editors.
 Author contributions: CLB, AFS, and CAC conceived and designed the study. JAE and CAC provided statistical advice. CLB and JAE acquired the data. JAE performed the analysis. CEC created the maps. All authors contributed to data interpretation. CLB drafted the article. All authors contributed substantially to article revision and approved the final version. CAC take responsibility for the paper as a whole.
 All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.
 Readers: click on the link to go directly to a survey in which you can provide JXRLCMG to Annals on this particular article.
 A podcast for this article is available at www.annemergmed.com.


© 2020  American College of Emergency Physicians. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 76 - N° 6

P. 695-708 - décembre 2020 Retour au numéro
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