Academic emergency medicine staffing nonacademic emergency department sites: A national survey

Changing health care markets have threatened academic health centers and th eir traditional focus on teaching and research. Objectives: To determine th e number of academic emergency medicine departments (AEMDs) that staff addi tional nonacademic ED sites and to determine whether clinical reimbursement monies from those ED sites are used for academic purposes. Methods: A two- part sun ey of all 119 academic EM programs listed in the 1997-1998 Graduat e Medical Education Directory was conducted. Questionnaires were addressed to each AEMD chair. AEMDs and ED sites were characterized. Hiring difficult ies, EM faculty academic productivity, and use of ED site reimbursement mon ies for academic activities were assessed. Results: Ninety-nine of 119 (83% ) AEMDs responded. Twenty three (23%) AEMDs staffed 28 added ED sites. Thes e sites tended to be urban (65%), with moderate volumes (25,000-35,000 pati ents/year), and had an equal or better reimbursement rate than the AEMD (89 %). ED sites were commonly staffed by academic EM faculty (79%) and EM resi dents (29%). Ninety-six percent of the AEMDs had hired additional faculty; hiring new faculty was considered easy. Academic productivity at AEMDs with added ED sites was reported as unchanged. Reimbursement monies from these ED sites were commonly used for faculty salary support, faculty development , and EM research and residency activities. Conclusions: Academic EM depart ments are often affiliated with nonacademic ED sites. These additional site s are commonly staffed by academic EM faculty and EM residents. Academic pr oductivity does not appear to decrease when additional ED sites are added. Reimbursement monies from these ED sites commonly supports academic activit ies.