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Emergency Physician Shortages Worsening in Rural America

Emergency Physician Shortages Worsening in Rural America

The number of emergency medicine physicians in the United States has increased in the past few years. But for rural areas, the reality is quite the opposite. Rural communities have experienced ER staffing shortages for several years now, and the problem is expected to worsen as a generation of rural doctors retires. According to a recent study published in the Annals of Emergency Medicine, of the 48,835 clinically active emergency physicians in the United States, 92% (44,908) practice in urban areas with just 8% (3,927) practicing in rural communities. That’s down from 10% in 2008.

The study further found that the median age for urban emergency physicians is 50 years old, while the median age in large rural communities is 58 years old, and 62 years old in smaller rural communities. Unfortunately, without a viable workforce solution, staffing shortages in rural ERs may continue as the analysis also shows that 96% of the emergency medicine residency or fellowship graduates within the past four years practice in more urban areas.

“Demand for emergency care in rural areas will remain high while emergency physician shortages in these communities continues to pose significant challenges for health systems and patients,” said Christopher Bennett, MD, MA, assistant professor of emergency medicine at Stanford University School of Medicine and lead study author.

Rural Emergency Medicine Needs Qualified Primary Care Physicians

To fill the workplace gap, rural emergency departments have long relied on the services of primary care trained doctors. Though not residency-trained in emergency medicine, primary care doctors who have spent significant time in the ER have proven to be highly qualified at delivering safe and effective emergency care. One such program that gives cause for optimism is the Monroe Clinic Emergency Medicine Fellowship in Monroe, WI, which is recognized by the American Academy of Emergency Physicians (AAEP). The AAEP recognizes teaching hospitals and medical schools that offer distinguished emergency medicine fellowships for primary care physicians. Completion of an AAEP-approved program enables graduate fellows to apply for certification with the Board of Certification in Emergency Medicine (BCEM).

How BCEM Certification Can Help Solve the Emergency Physician Shortage

If you are a rural emergency physician who is certified in a primary care specialty, you can apply for BCEM certification in one of two ways. Either complete an AAEP-approved emergency medicine fellowship or apply through the “practice track,” which requires five years of emergency medicine practice with at least 7,000 hours of emergency department coverage, letters of support, and case reports. To earn BCEM certification, candidates in either pathway must pass both a written and oral examination.

According to the Monroe Clinic, “The breadth of training in primary care medicine makes the family physician a nearly ideal provider of emergency services in rural areas, where the ER is often the only access to health care. In fact, family physicians and other primary care doctors provide a wide spectrum of medical care in rural ERs, including most of the emergency care. That’s why we feel strongly that some type of advanced training/fellowship or certification is needed to ensure rural hospitals have access to well-trained EM physicians.”

The Importance of BCEM Certification

A Member Board of the American Board of Physician Specialties® (ABPS), the BCEM has been responding to the certification and recertification needs of emergency department doctors since 1989. Certification with the BCEM, a Member Board of the ABPS, recognizes physicians as eminently qualified EM professionals, positions them as leaders in the healthcare community, and broadens their opportunities for career advancement. BCEM certification demonstrates to current and prospective employers alike that a physician has talent and skills that are on par with residency-trained ER specialists.

Primary care physicians with at least five years of full-time practice in EM and at least 7,000 hours practicing the specialty are also encouraged to apply for certification with the BCEM. Primary care physicians with at least five years of full-time practice in EM and at least 7,000 hours practicing the specialty are also encouraged to apply for certification with the BCEM. You can find more information about the BCEM’s eligibility requirements here.

If you would like more information about AAEP-approved fellowship programs or the eligibility requirements for BCEM certification, contact the ABPS today.

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Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine
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