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Published on: April 7, 2023
Child Health Needs and the Pediatric Emergency Medicine Workforce: 2020-2040
Maya S Iyer1,2, Joshua Nagler3, Richard B Mink4
1Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
Insights
The number of pediatric emergency medicine (PEM) physicians is projected to increase nationally, improving child health. However, disparities in care may persist due to geographic maldistribution.
Area of Science:
- Pediatric Emergency Medicine
- Health Workforce Analysis
- Child Health Services
Background:
- Millions of children visit US emergency departments annually.
- Board-certified pediatric emergency medicine (PEM) physicians provide higher-quality care.
- PEM has grown significantly since the early 1990s, impacting child health.
Purpose of the Study:
- To project the future supply of PEM subspecialists through 2040.
- To analyze current PEM workforce status and utilization of emergency department (ED) services.
- To discuss implications for education, practice, policy, and research.
Main Methods:
- Utilized American Board of Pediatrics workforce data.
- Employed a microsimulation model for future pediatric subspecialty workforce supply.
- Projected PEM specialist numbers nationally, by region, and by division.
Main Results:
- The PEM workforce is anticipated to increase nationally, driven by fellowship program growth.
- Despite overall growth, physician maldistribution is likely to continue.
- Areas like New England and Mid-Atlantic may see the highest concentrations, while rural areas could face shortages ('PEM deserts').
Conclusions:
- Continued growth in PEM fellowship programs suggests a national increase in PEM physicians.
- Geographic disparities in PEM physician distribution are expected to persist.
- Addressing maldistribution is crucial for equitable access to pediatric emergency care.
Abstract:
Approximately 30 million ill and injured children annually visit emergency departments (EDs) in the United States. Data suggest that patients seen in pediatric EDs by board-certified pediatric emergency medicine (PEM) physicians receive higher-quality care than those cared for by non-PEM physicians. These benefits, coupled with the continued growth in PEM since its inception in the early 1990s, have impacted child health broadly. This article is part of a Pediatrics supplement focused on predicting the future pediatric subspecialty workforce supply by drawing on the American Board of Pediatrics workforce data and a microsimulation model of the future pediatric subspecialty workforce. The article discusses the utilization of acute care services in EDs, reviews the current state of the PEM subspecialty workforce, and presents projected numbers of PEM subspecialists at the national, census region, and census division on the basis of this pediatric subspecialty workforce supply model through 2040. Implications of this model on education and training, clinical practice, policy, and future workforce research are discussed. Findings suggest that, if the current growth in the field of PEM continues on the basis of the increasing number and size of fellowship programs, even with a potential reduction in percentage of clinical time and attrition of senior physicians, the PEM workforce is anticipated to increase nationally. However, the maldistribution of PEM physicians is likely to be perpetuated with the highest concentration in New England and Mid-Atlantic regions and "PEM deserts" in less populated areas.
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