Regionalization of Emergency Care Future Directions and Research: Workforce Issues

Abstract

The provision of emergency care in the United States, regionalized or not, depends on an adequate workforce. Adequate must be defined both qualitatively and quantitatively. There is currently a shortage of emergency care providers, one that will exist for the foreseeable future. This article discusses what is known about the current emergency medicine (EM) and non-EM workforce, future trends, and research opportunities.ACADEMIC EMERGENCY MEDICINE 2010; 17:1286-1296 ª 2010 by the Society for Academic Emergency Medicine A well-trained, efficiently distributed workforce is critical to provide for the nations' emergency care needs. This includes any regionalized system of emergency care. The cognitive and technical skills of emergency care providers are vital resources in ensuring delivery of timely, high-quality emergency care to all Americans. Currently, 120 million patients go to our nation's emergency departments (EDs) each year. Historic trends have shown that the demand for emergency care continues to rise, 1 even with health care reform and a push toward universal insurance coverage.2 This reflects a growing, aging population with many chronic diseases. This rising demand is likely to increase the need for emergency care providers. There is currently a shortage and mal-distribution of emergency medicine (EM) residency-trained and board-certified physicians (emergency physicians [EPs]). 3-7The 2010 Academic Emergency Medicine consensus conference on regionalization of emergency care focused on getting the right care to the right patient at the right time. We describe the current state of the emergency care workforce, potential solutions, and a vision for the future. Our discussion looks at EPs, non-EM-trained physician providers, and nonphysician providers. We identify gaps in knowledge that form the basis of an emergency care workforce research agenda. Our discussion focuses on the goal of improved access to high-quality emergency care for all acutely ill or injured patients across the entire United States. Under any regionalization plan, an efficiently distributed, qualified workforce will ensure a sufficient number of providers with appropriate training for their practice environments and will be distributed according to patient need throughout the system.

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