EMPRN, the Emergency Medicine Practice Research Network, recently completed its first survey and presented some of the results at ACEP’s Scientific Assembly. The Network was designed to provide a means of assessing the real-life practice of emergency medicine. Too often, research studies are performed within urban, academic centers whose patients and providers are not representative of the real practice setting.

Using EMPRN, we can examine a more typical population. Several years ago the ACEP Board of Directors decided to limit the number of surveys sent to members. Any survey “blasted” out to the membership must first be approved by the Board. While this limits surveys sent to individuals, it also prevents individuals who would willingly complete surveys from having their voice heard. By becoming part of EMPRN, individuals agree to participate in 3-4 short (less than 5 minute) surveys each year. Participation will help provide information important to our advocacy, planning and practice.

To date, more than 1,200 emergency physicians have joined. We have limited the membership at this time to those active members living in the United States (sorry, no residents at this time). The current membership is representative of the active membership of ACEP. Males represent 72% of ACEP and 75% of EMPRN. The age distribution is similar. The geographic distribution is similar to ACEP, with 23% of members living in the Northeast, 23% in the Midwest, 32% in the South, and 22% in the West.

Interestingly, ACEP and EMPRN members live in urban zip codes (92% ACEP, 90% EMPRN). Overall, 80% of EMPRN members are boarded by ABEM or AOBEM. Geographically, urban physicians are more likely to be boarded (81%) than those living in large rural areas (78%), small rural areas (72%) or in isolated rural areas (56%).

Overall, 25% of participants stated they were considering leaving the practice of emergency medicine within the next five years. This varied by age but also by area, with the greatest number in small rural (44%) and isolated rural (38%) areas. This has significant potential impact for our future workforce, as recent graduates are less inclined to look for jobs in these areas.

We have heard much about the growing problem with opioids. Emergency physicians tend to write more prescriptions for opioids, although many of these are for small quantities. More of our prescriptions are diverted for illicit use. Part of the reason we dispense so many opioids is that we see so many patients with chronic pain. We asked the network participants to estimate the percentage of patients seen for chronic pain. The percentage seen with chronic pain was higher in rural areas.

Patients with chronic pain should be managed by their primary care physician, not the emergency department. Our finding suggests that patients with chronic pain present in large numbers to our emergency departments. Primary care physicians should be encouraged to provide the appropriate management that would reduce the number of patients seen in EDs for their chronic pain.

We also learned a little more about ourselves. Almost 7% of EMPRN members do not see pediatric patients. This is obviously more common in urban areas. About 56% participate in Physician Quality Reporting; 80% receive patient satisfaction scores on the patients they see, and 27% have some part of their compensation tied to their performance/quality measures.

If you are not a member of EMPRN and have 20 minutes a year to volunteer to your specialty, please go to ACEP.org/emprn and join today. Your voice is crucial to a better understanding of our practice. If you are a member of EMPRN, thank you. The new survey is available. All of the questions come from your suggestions.

Dr. Schneider and Dr. Sklar are project leaders for the EMPRN.