Mid-level providers and emergency care: let's not lose the force

Area of Science:

• Emergency Medicine
• Healthcare Workforce Studies
• Medical Education

Background:

• Global rise in emergency department (ED) visits strains healthcare systems.
• Shortages of emergency physicians, particularly in the US and Canada, necessitate alternative staffing solutions.
• Mid-level providers (MLPs) are increasingly utilized to supplement emergency care.

Purpose of the Study:

• To address the growing need for emergency care providers.
• To evaluate the role and training of mid-level providers in emergency medicine.
• To propose strategies for expanding the emergency care workforce.

Main Methods:

• Review of current literature on mid-level provider utilization in emergency medicine.
• Analysis of existing training pathways for nurse practitioners (NPs) and physician assistants (PAs).
• Identification of gaps in specialized emergency medicine training for MLPs.

Main Results:

• While many MLPs have established credentials, emergency medicine skills are often acquired through on-the-job training.
• There is a lack of formal, specialized training programs for NPs and PAs in emergency care.
• The physician manpower gap is projected to persist, highlighting the need for workforce innovation.

Conclusions:

• Mid-level providers are valuable additions to the emergency medicine workforce.
• Specialized training, akin to physician emergency medicine residency, is needed for NPs and PAs.
• Developing a strategic plan for training specialist NPs and PAs is essential for expanding emergency care capacity.