Access To Emergency Medicine Board Certified Physicians in South Dakota

South Dakota ranks among the top states for healthcare affordability and quality, with low emergency department (ED) wait times and heavy presence of urgent cares. However, the state is composed of a majority rural population who faces significant disparities in access to emergency care, specifically board-certified emergency medicine (BCEM) physicians. This research evaluates the distribution of EDs and BCEM physicians across South Dakota, highlighting urban-rural disparities and proposing solutions to improve access to high-quality emergency care.

Data were collected through direct contact with all EDs in South Dakota to confirm the number and distribution of BCEM physicians. Additional data from the South Dakota Board of Medical Examiners and the Office of Rural Health were analyzed. Geographic mapping identified ED locations and counties without EDs.

The majority (82%) of BCEM practice East River, and 57% are in the Sioux Falls metro area. Twenty-one of 88 BCEM physicians are over 60 years old, and approximately 20% plan to retire by 2030. Many rural EDs rely on non-BCEM physicians, nurse practitioners, or physician assistants, often without physician oversight. Several counties lack an ED, and some South Dakota residents must travel over 30 miles for emergency care.

South Dakota's emergency healthcare system exhibits significant urban-rural disparities, with limited BCEM physician presence in rural areas. The establishment of a new Emergency Medicine residency aims to increase the supply of BCEM physicians in underserved areas. Expanded telemedicine, legislative support, and workforce retention strategies are critical to ensuring equitable access to high-quality emergency care across the state.