National study of the emergency physician workforce, 2008

We describe the characteristics of the US emergency physician workforce.

We performed a cross-sectional analysis of the 2008 American Medical Association Physician Masterfile, which includes data on all physicians who have ever obtained a medical license in at least 1 US state. We included all physicians who designated emergency medicine as their primary or secondary specialty.

There were 39,061 clinically active emergency physicians, of which 57% were emergency medicine board certified and 69% were emergency medicine trained or emergency medicine board certified. Family medicine (31%) and internal medicine (23%) were the most common backgrounds for non-emergency medicine-trained/emergency medicine board certified emergency physicians, and most (75%) graduated from residency greater than or equal to 20 years ago. Nearly all (98%) emergency physicians who graduated within the past 5 years were emergency medicine trained or emergency medicine board certified. Rural emergency physicians were much less likely than urban emergency physicians to have emergency medicine training (31% versus 57%), emergency medicine board certified (43% versus 59%), and to have graduated in the past 5 years (8% versus 19%). The density of all emergency physicians per 100,000 population was highest in New England (16.0) and in urban areas (14.5). The lowest emergency physician densities were in West South Central (10.2) and rural areas (10.3). Density of emergency medicine-trained or emergency medicine board certified emergency physicians was 10.3 in urban, 5.3 in large rural, and 2.5 in small rural areas.

Although newer emergency physicians are almost all emergency medicine trained or emergency medicine board certified, many non-emergency medicine-trained/emergency medicine board certified emergency physicians still provide clinical coverage of EDs. Demand for all emergency physicians will likely continue for several decades and the shortage may even increase in rural areas.