As emergency physicians age, how to we prepare?
Posted by CEP America on Wed, Jun 02, 2010 @ 11:30 AM
By Joel Stettner, MD
As a now-seasoned emergency physician, I started my emergency medicine practice in 1974, moving directly from a rotating internship and internal medicine residency to a community hospital emergency department.
The transition was easy, since I had done ER moonlighting during my residency (back in the day, I guess), and I really enjoyed the practice. As you might imagine, I have accumulated a few years since then, and I continue to see patients - although with reduced clinical hours. Not surprisingly, I have noticed that many practicing ED and community physicians' colleagues are also aging. In fact, in some specialties, including emergency medicine, there seems to be a developing shortage of younger doctors who will be there to take over what promises to be a growing workload.
When I first started, emergency medicine seemed to be a young person's game. Especially given the stress and shift work requirements that came with the job. Over time, emergency physicians found ways to continue practicing with the help of mid-levels and creative schedules. But as more and more physicians make the decision to retire, who will be there to step in and do the work?
Several developments are especially worrisome in this regard. Population growth in the United States continues its upward trend and health care reform legislation will add millions of newly insured patients who will be seeking care. A widely recognized lack of primary care physicians, coupled with a shortage of boarded-certified ED physicians - as well as retirement for many in these and other specialties over the next few years - portend a growing demand for services in the face of a declining ability to deliver. And new organizations, including ACOs, Medical Homes, and Foundations, will need to meet their health care service needs.
We can hope that technology (telemedicine, EHRs, Internet applications, etc.) will help, and that mid-levels can take on greater responsibility. But I think we need to take a careful look at how we train young physicians, and the environment in which they are expected to practice. Then perhaps we can develop a more comprehensive approach to what will happen as our physician population continues to age in emergency medicine and other specialties.
I look forward to hearing your thoughts on the topic!