Our specialty has been working for decades to create, evolve, and sustain a workforce that meets the growing emergency medicine needs of our country. Over the past two years, eight organizations—American Board of Emergency Medicine, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American Osteopathic Board of Emergency Medicine, Association of Academic Chairs of Emergency Medicine, Council of Emergency Medicine Residency Directors, Emergency Medicine Residents’ Association, and Society for Academic Emergency Medicine—came together with the common goal of taking a data-driven, forward-looking approach to studying the emergency medicine workforce. The findings from the Emergency Medicine Physician Workforce: Projections for 2030 research, from which a manuscript is currently under independent peer review, show that for the first time in history we are headed toward an oversupply of emergency physicians in the next decade.
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ACEP Now: Vol 40 – No 05 – May 2021During an April 9, 2021, webinar, the eight stakeholders plus additional thought leaders furthered the process by proposing several ideas for consideration and discussion. We encourage you to watch the webinar and download a PDF of the slides used in the webinar at acep.org/workforce.
In an all-member email sent on April 15, ACEP identified eight key considerations we are committed to addressing. In this article, we, the ACEP Board, want to explain in greater detail what we mean by that.
To start, we firmly believe there is not one ideal, holistic solution to address market-driven industry instability. Shifting health care economics and evolving practice models affect each of you in different ways. Change will take time and precision, yet we must forge ahead as there are no quick fixes for the challenges we face. Furthermore, the implementation of the ideas discussed will require the coordinated involvement of the entire specialty, with each stakeholder playing an integral role in the process.
To that spirit, we are committed to continuing the multi-organizational task force that conducted the study to discuss feedback received from you and your colleagues, establish working groups, and begin advancing solutions. For our part, ACEP has taken steps to schedule needed engagements, is collating feedback, and is already investigating options. We developed toolkits and assisted in generating feedback and solutions from stakeholder groups—including other organizations, state chapters, ACEP sections and committees, and your local practice or programs. Where there is opportunity for meaningful change, ACEP is committed to developing new approaches that the entire emergency medicine community can support and champion.
Eight Key Considerations
- Stop the proliferation of emergency medicine residents and residency programs
We believe the entire emergency medicine community must come together to discuss all reasonable, realistic, and legal means to stem the growth of EM residencies and residency positions. Even though the Accreditation Council for Graduate Medical Education at this time continues to make decisions based exclusively on educational concerns and not workforce variables, all EM stakeholders as well as those in the EM industry—including hospital organizations, for-profit and non-profit physician staffing organizations, and academic healthcare organizations—should take a hard look at workforce projections, along with market and financial drivers of the past decade, and take the prudent steps to protect the integrity of emergency medicine.
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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.