Three-Fourths Of Emergency Department Directors Report Shortages Of Medical Specialists

From the American College of Emergency Physicians:

Three-fourths of emergency department medical directors responding to a survey reported inadequate on-call specialist coverage, compared with two-thirds in 2004, according to a new report released by the American College of Emergency Physicians (ACEP), in conjunction with researchers from Johns Hopkins University and funded by a grant from the Robert Wood Johnson Foundation.

The findings indicate that on-call coverage in the nation's emergency departments has deteriorated significantly since 2004. Both surveys were conducted to assess the effects and potential unintended consequences of changes made to the regulations governing the Emergency Medical Treatment and Labor Act (EMTALA). The changes include permitting specialists to be on-call at more than one hospital at the same time and limiting the amounts of call time.

"The availability of specialists has spiraled downward in just one year and confirms what was reported in the National Report Card on the State of Emergency Medicine, released in January by ACEP," said Frederick Blum, MD, President of ACEP. "These survey findings are evidence of further strain on an already frayed health care system, which coupled with the growing demands for emergency services, means patients could be at risk. If emergency departments can't handle the day-to-day emergencies, how will we ever be able to save lives and respond effectively to acts of terrorism and other disasters?"

The top five shortages were among the specialties of orthopedics; plastic surgery; neurosurgery; ear, nose and throat; and hand surgery. Seventy-three percent of emergency department directors reported problems with inadequate specialist coverage, compared with 67 percent in 2004. More specialists were negotiating for fewer on-call duty hours in 2005 - 42 percent compared with 18 percent in 2004. Forty-five percent of directors reported patients were leaving without being seen, compared with 29 percent in 2004. The percent of hospitals paying stipends to specialists, whether or not they see patients, more than quadrupled to 36 percent, compared with 8 percent in 2004.