Utsav Nandi, MD MSCI FACEP
“…for the first time in history we are headed toward a likely oversupply of emergency physicians in the next decade.”
As I shared with you in my last post via engagED, the conclusion above from the workforce report finally put numbers and data on a problem that many were predicting for a while. Whether it was the increasing number of residency programs and residents across the country, or that of NPs and PAs, many of whom are now lobbying for independent practice, the future of our workforce does not look as promising as it once did. While the task force did a great job in analyzing a number of issues, many also viewed it critically in rural states where there is still a shortage of board-certified physicians in a lot of EDs. While I personally would love for all ED’s to be staffed by, and all patients have 24/7 access to, board-certified EM docs, I also realize that I may not be looking pragmatically at the economics of the current situation. As one of our experienced board members put it, we, as board certified EM physicians, valued ourselves and our time to the point that we may have priced ourselves out of the limited resource departments in states like ours. I valued this perspective as it helped me look at this more critically, locally.
This was put more starkly in focus for me as I saw some of my best residents, doctors who I would trust taking care of me or my family members, still looking for jobs as late as last month. I remember from just a few years ago when most seniors started their final years with contracts in hand. And here were some of the brightest, young EM docs having their contracts cancelled a few months from graduation.
To me, advocacy and informing policy decisions for important issues such as this is one of the most important roles of national EM groups, like ACEP and others. While I am happy to say that most of my residents have signed or are in the process of finalizing their contracts, I know that this is not the last we will hear about this. We, at ACEP, have been fighting scope of practice expansion for a while. After the taskforce report, ACEP identified the following key areas that they plan to address:
- Stem the growth of emergency medicine residents and residency programs
- Raise the bar and ensure consistency across emergency medicine residency training
- Ensure business interests are not superseding the needs of educating the workforce
- Support practicing physicians to encourage rewarding practice in all communities
- Ensure appropriate use of NPs and PAs to protect the unique role of emergency physicians
- Set the standards for emergency medicine so every patient has access to a board-certified emergency physician
- Broaden the umbrella to expand emergency medicine physician scope of practice
- Expand the reach of emergency medicine to ensure that no community is left behind
This is also one of the priority issues for ACEP’s leadership and President-Elect, and we will be discussing this in more detail with them, along with other state chapter leaders over the next few months. I will keep you updated on any major issues that come up in our discussions.
In light of the discussion surrounding our workforce, I thought it was important to actually hear from our workforce in Mississippi. A new intern just entering the EM workforce in a new program, a graduating senior making the transition from chief resident to independent practice and a past president who is in the process of transitioning from the workforce have been kind enough to share their stories and experiences over the past year with me. I hope you will appreciate their honesty and enjoy reading about their experiences as much as I did. Drs. Davis, Bratton and Levin, thank you!
Our Workforce: An Intern’s Perspective
by Bennett Davis, MD
Our Workforce: A Senior Resident’s Perspective
by Dustin Bratton, MD
View from a Retiring E.R. Doctor
by Philip L Levin, MD, FACEP