WORKFORCE PROJECTIONS FOR EMERGENCY-MEDICINE - HOW MANY EMERGENCY PHYSICIANS DOES THE UNITED-STATES NEED

Objective: To mathematically model the supply of and demand for emerge ncy physicians (EPs) under different workforce conditions. Methods: A computer spreadsheet model was used to project annual EP workforce sup ply and demand through the year 2035. The mathematical equations used were: supply = number of EPs at the beginning of the year plus annual residency graduates minus annual attrition; demand = 5 full-time equiv alent positions/ED X the number of hospital EDs. The demand was empiri cally varied to account for ED census variation, administrative and te aching responsibilities, and the availability of physician extenders. A variety of possible scenarios were tested. These projections make th e assumption that emergency medicine (EM) residency graduates will pre ferentially fill clinical positions currently filled by EPs without EM board certification. Results: Under most of the scenarios tested, the re will be a large deficit of EM board-certified EPs well into the nex t century. Even in scenarios involving a decreasing ''demand'' for EPs (e.g., in the setting of hospital closures or the training of physici an extenders), a significant deficit will remain for at least several decades. Conclusions: The number of EM residency positions should not be decreased during any restructuring of the U.S. health care system. EM is likely to remain a specialty in which the supply of board-certif ied EPs will not meet the demand, even at present levels of EM residen cy output, for the next several decades.