Abstract and Introduction
Emergency medicine (EM) has advanced profoundly since its specialty recognition in 1979. As diagnosis and treatment changes, payment restructures and best practices evolve. We drive these changes, impacting hospital throughput and revenue to ensure quality emergency care. Our impact on the practice of medicine depends on a body of knowledge, the "biology" of emergency medicine. From 2000 to 2010 the number of emergency physicians (EP) increased more than in any other specialty. With estimates of over 48,000 EPs practicing in the United States currently and continued opening of new residency programs, multiple sources expect a 20–30% surplus of board-certified emergency physicians by 2030.[4,5] Presciently, a 1997 paper by Holliman et al predicted that the supply of emergency doctors would equal demand in about 2020.
In 2020, multiple EM organizations created a taskforce to study the projected EM workforce oversupply. The considerations address issues related to who practices emergency medicine (advanced practice providers, non-board-certified physicians) and who manages emergency clinicians (contract management groups, academic and hospital systems). Only two offer non-zero sum approaches: broaden the umbrella to expand emergency physician scope of practice and expand the reach of emergency medicine to ensure that no community is left behind. This review aims to provide context for the workforce dilemma by describing the evolution of the scope of EM and possible future directions.
Western J Emerg Med. 2022;23(3):418-423. © 2022 Western Journal of Emergency Medicine