We also acknowledge that resident salaries have remained relatively flat despite increased academic indebtedness. We encourage research to determine if low salaries have contributed to program expansion and/or limited opportunity in emergency medicine for students from less well-off financial backgrounds.
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ACEP Now: Vol 40 – No 05 – May 2021- Support practicing physicians to encourage rewarding practice in all communities
A consistent EM workforce issue is the undersupply of residency-trained, board-certified physicians working in rural and underserved communities. ACEP’s report from the 2019–2020 Rural Emergency Medicine Task Force affirmed that rural emergency departments represent 53 percent of all hospitals in the United States and 24 percent of total ED patient volume, yet the number of EM residency–trained or EM board–certified physicians working in rural emergency departments has not changed over the past 10 years. ACEP is not saying that graduating residents should see working in a rural emergency departments as their only option. Instead, we invite the entire EM community to look to the objectives proposed and help identify ways that we can better support those who wish to choose a rural practice. One item to note is our commitment to engage further with the federal government or other non-governmental organizations to expand existing or create new rural, Indian Health Service, and public health scholarships to provide debt forgiveness and salary support for service in these areas.
ACEP remains dedicated to working together with those who share our commitment to identify data-driven solutions that promote both patient safety and emergency physician opportunities.
Support for practicing physicians is not limited to rural or urban location. It pertains to the many different employment models emergency physicians choose to practice in. ACEP continues to update and evolve our policies, many as directed by Council, to support all practicing emergency physicians. Most recently, this includes updates to our policies on Emergency Physician Rights and Responsibilities, Emergency Physician Contractual Relationships, and Compensation Arrangements for Emergency Physicians. ACEP policy statements can be found at www.acep.org/patient-care/policy-statements/. Work continues on other key Council resolutions that were approved or referred to the Board last October.
- Ensure appropriate use of nurse practitioners (NPs) and physician assistants (PAs) to protect the unique role of emergency physicians
Emergency medicine is a medical specialty that requires advanced education, training, orientation, credentials, continuing education, and certification. The emergency department is a unique environment with significant challenges of dynamic patient care, limited information about patient present and past illness or injury, and unpredictable patient acuity and volume. It is unacceptable to have an emergency department that is not led and staffed in real time by a board-certified emergency physician with sufficient time to oversee the department and engage with patients.
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3 Responses to “Workforce Considerations: ACEP’s Commitment to You and Emergency Medicine”
April 21, 2021
Johnny the EM guySo if I understand this correctly you want to restrict the pipeline (residency) of future EM physicians, restrict independent practice by mid-level providers, while simultaneously admitting there aren’t enough EM physicians in rural communities.
I am curious as to how you reconcile these obviously opposing goals?
You cannot force EM physicians into rural practices or hospitals. Nor can you force private corporate hospital system to pay rural EM physicians more in order to lure them there.
April 24, 2021
Eric sI don’t think that stopping the proliferation of emergency residencies is enough. All existing residencies will have to cut down on spots (perhaps 20-25%) because it is unreasonable to close some down. There are too many EM docs. The corporate jobs are already lowering pay because they can because there is a surplus. The only way to protect us and allowing us to work is to cut the surplus.
April 25, 2021
Robert McNamara, MDThis is an excellent document with great suggestions. To extend some of the themes above let me plead that the ACEP also endorse two items very closely aligned with the views stated here:
1) Ensure business interests are not superseding the needs of our patients.
2) Declare it unacceptable to have the contract for emergency services held by a lay for profit corporation. (this of course gives them the power to make staffing decisions)
Each of these goals can be obtained by advocating for enforcement of existing prohibitions on the corporate practice of medicine and by seeking such regulations where they do not exist or restoring those that have been weakened. It is for our patients after all.