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Emergency Medicine Challenges in Ecuador.

Andrés M Patiño1, Santiago Cantillo-Campos2, Alexis S Kearney3

  • 1Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia.

The Western Journal of Emergency Medicine
|November 18, 2020
PubMed
Summary

Emergency medicine in Ecuador faces challenges despite its 30-year history. Key issues include medical supply shortages, need for better medico-legal protection, and limited residency training outside the capital, impacting emergency care quality.

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Area of Science:

  • Medical Specialties
  • Public Health
  • Healthcare Systems

Background:

  • Emergency medicine (EM) in Ecuador was established as a specialty in 1993.
  • The country currently has two EM residency programs and approximately 300 trained emergency physicians.
  • This study aims to identify and describe the current challenges facing EM in Ecuador.

Purpose of the Study:

  • To explore the multifaceted challenges in emergency medicine within Ecuador.
  • To gather insights from various healthcare professionals regarding emergency care delivery and physician working conditions.
  • To inform strategies for strengthening the specialty and improving emergency medical services.

Main Methods:

  • Conducted 25 semi-structured, in-person interviews with a diverse group of healthcare professionals.
  • Interviewees included emergency physicians, general practitioners, public health specialists, prehospital personnel, and other medical specialists.
  • Data analysis focused on identifying and quantifying the frequency of reported challenges across key areas of emergency medicine.

Main Results:

  • The most frequently cited challenges were medical supply shortages, need for improved medico-legal protection, limited EM residencies outside Quito, and a desire for more bedside teaching (each 44%).
  • Other significant challenges included inadequate access to ultrasound equipment and limited EM presence outside the capital (38%).
  • Additional issues raised were low demand for emergency physicians in private practice, lack of pay differentials for night/weekend shifts, and insufficient administrative/leadership training.

Conclusions:

  • Emergency medicine in Ecuador has progressed with established residencies and a national society but continues to face significant obstacles.
  • Persistent challenges in medical care, working conditions, education, leadership, and prehospital services require attention.
  • Enhanced collaboration and advocacy among emergency physicians are crucial for advancing the specialty and improving patient care outcomes.