Rural EDs Trail Other Areas in Number of Available EPs

By Jonathan Springston, Editor, Relias Media

An analysis of the nation’s emergency physician (EP) population released this week revealed a major staffing gap between urban and rural communities, as well as an overall aging workforce.

In sum, there are 48,835 clinically active EPs in the United States. Of those, 44,908 work in urban areas, while only 3,927 practice in rural facilities. Importantly, the total number of clinically active EPs has increased by 9,774 over the last decade; however, per 100,000 U.S. population in 2020, EP density is down in large rural areas (-0.4) and small rural areas (-3.7).

“The number of emergency physicians is increasing, but there is a clear unmet need for emergency physicians in rural areas,” Christopher Bennett, MD, MA, lead study author and assistant professor of emergency medicine at Stanford, said in a statement. “Policymakers and health leaders should prioritize opportunities to make sure that emergency departments across the country are led by appropriately trained and certified emergency physicians.”

The median age of all active EPs is 50 years, but that number climbs to 58 years in large rural communities and to 62 years in small rural areas. Most EPs who completed residency within the last four years work in urban areas. In rural communities, 70% of those EPs completed their training more than 20 years ago, indicating those workers may be closer to retirement than their urban brethren.

Nonetheless, the analysis shows the training pipeline to be robust. There are 7,940 residents in 247 programs today, up from 4,565 residents in 145 programs in 2008. The key is where these new EPs will choose to work.

“Demand for emergency care in rural areas will remain high while emergency physician shortages in these communities continues to pose significant challenges for health systems and patients,” Bennett said. “There are reasons to be optimistic about the pipeline of residents and trainees; however, we need to encourage a larger percentage of these individuals to work in rural America.”

For more on this analysis, be sure to read the October issue of ED Management, which will be available soon. Meanwhile, for even more useful information about rural facilities, check out this article from the February 2020 issue of ED Management about delivering telemedicine services for patients who live in those communities. Telemedicine has become an indispensable tool during the COVID-19 pandemic.

Also, this article from the March 2020 issue of ED Management describes how small emergency departments in sparsely populated regions can initiate medication-assisted treatment without additional resources, a vital tactic for all providers engaged in battle against opioid addiction.