Written by Eriny Hanna
If current trends stay the same, emergency medicine will likely face an oversupply of physicians by 2030. We as a specialty need to work together to find ways to mitigate this and continue doing what we do best—save lives…and livelihoods.
?Why does this matter
The field of emergency medicine is relatively new, with historical shortages in EM-trained physicians. The number of providers in practice, including advanced practice providers (APPs), has boomed. ACEP assembled a task force to determine if projections point to a shortage or a surplus of EM physicians. There are specific factors we can address as a specialty to ensure supply-demand equilibrium.
Economics 101: Supply and Demand
We’re taking it back to high school econ 101. This study used estimates based on current data as well as a sensitivity analysis to project the future supply and demand. The study assumed that supply = demand in 2018, considered the “base year.” They determined that the most likely case assumes 2% annual growth in residents graduating and 3% annual attrition of practicing providers. 20% of encounters will be seen by APPs (compared to 15% in 2018), and emergency department visits will increase by 11.2%. These percentages were agreed upon by the task force using a modified Delphi approach. If true, there will be an excess of 7,845 EM doctors in 2030. However, if there is absolutely no growth in residency graduations, 4% attrition, no change in APP percentage of encounters, and no decline in demand, then there would actually be a shortage of 2,855 doctors.
This study is based on assumptions, meaning there is a degree of uncertainty of the data. We certainly need frequent crunching of the numbers to have precise projections. It didn’t account for variability in number of shifts providers work, nor did it account for non-clinical work, such as research, education and administration. Additionally, it didn’t account for the fact that staffing, desirability, and demand differs between practice settings, especially urban versus rural.
But it does provide important data that our specialty can use to ensure economic health. The study suggests that we should transition our focus to maintenance rather than growth of the workforce. The authors cite a few areas of consideration: number of providers entering EM, number of accredited EM residencies, role of APPs, attrition of non-EM trained physicians, and demand for EM physicians in other settings. Factors effecting demand include cost and access to patients, new models of care, and population growth.
To contribute to national efforts or get the latest updates, visit www.acep.org/life-as-a-physician/workforce.
The Emergency Medicine Physician Workforce: Projections for 2030. Ann Emerg Med. 2021 Aug 2;S0196-0644(21)00439-X. doi: 10.1016/j.annemergmed.2021.05.029. Online ahead of print.