Rural Emergency Medicine: patient volume and training opportunities

Area of Science:

• Emergency Medicine
• Rural Health
• Medical Education

Background:

• A significant shortage of board-certified Emergency Physicians exists in rural Emergency Departments (EDs).
• Training Emergency Medicine (EM) residents in rural EDs is proposed to encourage future rural practice.
• Concerns exist regarding whether rural EDs provide sufficient patient volume for effective EM resident training.

Purpose of the Study:

• To compare per-physician patient volumes in rural versus urban hospital EDs in Oklahoma.
• To assess the proportion of board-certified EM physicians in rural and urban Oklahoma EDs.

Main Methods:

• A 21-question survey was sent to Oklahoma hospital ED directors.
• Analysis included non-military hospitals with EDs seeing over 15,000 annual patient visits.
• Data were compared between rural and urban ED settings.

Main Results:

• 37 hospitals were analyzed; urban EDs had a higher percentage of board-certified EM physicians (80% vs. 28%).
• Patient volumes per full-time equivalent (FTE) physician were similar in rural (4359) and urban (4470) EDs (p = 0.84).

Conclusions:

• Rural and urban EDs in Oklahoma demonstrate comparable patient volumes per physician FTE.
• Adequate patient volumes in rural EDs support the feasibility of EM resident education.
• Fewer board-certified Emergency Physicians practice in rural EDs, necessitating exploration of increased rural EM resident training programs.