Staffing in small rural hospital emergency rooms: dependence on community family physicians

This study describes the characteristics of emergency room staffing at rural hospitals in Kansas.

Administrators at 84 rural hospitals in communities of less than 5,000 were surveyed by telephone using a scripted interview.

Seventy-seven hospitals provided physician-staffed emergency room services. Their average daily emergency room census was 4.4. The average hospital medical staff consisted of 2.9 physicians. Eighty-six percent of all hospital staff physicians were family physicians. Ninety-six percent of all hospital emergency room staffing was provided by the local medical staff. Fee-for-service was the only method of reimbursement to physicians in 44 hospitals. Alternatives to emergency room staffing by local physicians included contracted part-time emergency room physicians, locum tenens physicians, mid-level practitioners, or emergency room closure.

Rural family physicians have considerable responsibility for providing emergency care. Physicians must have adequate training in emergency medical care to practice in communities such as these.