Evaluating West Virginia's Emergency Medicine Workforce: A Longitudinal Observational Study

Area of Science:

• Healthcare workforce analysis
• Rural health disparities
• Emergency medicine physician distribution

Background:

• Urban emergency departments are well-researched, but rural emergency healthcare settings remain less understood.
• Previous studies on the West Virginia (WV) healthcare workforce provide a foundation for further investigation.
• Understanding the unique challenges and resources of rural emergency departments is crucial for improving healthcare access.

Purpose of the Study:

• To define the healthcare landscape in rural West Virginia.
• To expand upon existing knowledge of the WV emergency medicine workforce.
• To analyze the characteristics and coverage of physicians in rural vs. urban emergency departments.

Main Methods:

• Anonymous surveys were distributed electronically and via hard copy to medical directors in Q2 2019.
• Hospitals were stratified by annual census and rural classification for data aggregation.
• Descriptive analysis was used to interpret survey responses from 53 departments (55% response rate).

Main Results:

• Fifteen of the 29 responding hospitals were classified as rural, exhibiting smaller patient census and less specialized physician coverage.
• Board-certified emergency medicine (EM)-trained physicians covered 67% of shifts statewide, averaging 29,500 annual visits.
• Full-time physicians demonstrated strong ties to WV (65% educated or raised in-state); rural areas had limited access to specialists beyond basic surgical and primary care.

Conclusions:

• Board-certified EM physicians offer some coverage in most WV emergency departments, but rural areas face underrepresentation.
• Specialized physician coverage in WV emergency departments has seen a 20% increase over the past 15 years.
• Rural WV hospitals predominantly offer basic consulting services, with limited access to other specialists.