Physician Staffing in Emergency Departments: Results of a Texas Survey

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Abstract of Journal Article - September 2006  

By Join Y. Luh, MD; Tandace L. McDill, RN, MA; Bernard M. Karnath, MD; Daniel H. Freeman, PhD; Debbie L. Speegle, BA, MPAS, PA-C;  and Susan E. Keeney, MD

We obtained information on characteristics of emergency departments (EDs) in Level 1, 2, and 3 trauma centers in Texas; the residency training backgrounds of physicians practicing emergency medicine in these EDs; the training backgrounds of the directors of these EDs; and the presence of differences in clinical responsibilities based on training background. Data were gathered from a survey of 58 EDs in Level 1, 2, and 3 trauma centers in Texas. The survey instrument addressed items such as descriptive data on the hospital or department, the number of physicians in the ED, and the training background and board certification of these physicians from January 2002 to April 2004. All 58 EDs were contacted by phone and eventually responded. Of the 546 physicians the EDs reported as practicing emergency medicine, 58% had residency training in emergency medicine; 21% in family medicine; 12% in internal medicine; 5% in pediatrics; and 3% in general surgery. Physicians trained in family medicine were significantly more likely to work in Level 3 trauma centers and less likely to work in Level 1 centers. Those trained in emergency medicine were significantly more likely to work in Level 2 trauma centers and least likely to be in Level 3 centers; those trained in internal medicine were more likely to work in Level 1 and 3 centers than in Level 2. Only 9% of all the EDs surveyed had any differences in clinical responsibilities based on training background between physicians trained in emergency medicine and those trained in other specialties. We found that slightly more emergency medicine-trained physicians are practicing emergency medicine in Texas than nationwide. However, a significant workforce of physicians who received residency training in family medicine, internal medicine, pediatrics, and general surgery are practicing emergency medicine. 

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