By Debra Wood, RN, contributor Jan 21, 2019
departments remain prime places for patients to obtain medical attention,
making emergency medicine physicians critically important in their care.
is still a good market for emergency medicine physicians in the current and
near future,” said William Jaquis, MD, FACEP, president-elect of the American College
of Emergency Physicians (ACEP). In fact,
opportunities for emergency physicians and advanced practitioners are
likely to feel the impact from a number of emerging trends in the field.
10 Key Trends in
1. Growth in patient volume
of emergency department (ED) visits, reported in JAMA Internal Medicine in December 2018, found an 18.4 percent
increase from 2006 through 2014. ED visits increased more than population
growth, and the authors predicted ED visits will continue to increase as care
shifts from inpatient to outpatient settings.
A 2017 study by researchers at
the University of Maryland School of Medicine in Baltimore found that nearly
half of U.S. medical care is delivered in EDs. And in recent years, the
percentage of care delivered by EDs has grown.
As long as patient use of EDs
remains strong, emergency
medicine jobs will remain in demand.
With the need for emergency
medicine physicians strong, salaries remain high. ACEP reported in September
2018 that the national average salary for ED physicians increased 3.5 percent
from 2017, but that reflects a 34.5 percent increase from 11 years ago. Sign-on
bonuses are growing as well, with $50,000 being the norm.
Similarly, Merritt Hawkins’
latest annual review
of recruiting incentives found that average starting salaries for emergency
physicians increased from $349,000 in 2016/2017 to $358,000 in 2017/2018, not
including bonuses and benefits.
Emergency medicine also offers opportunities for locum
tenens assignments across the country, and is one of the most in-demand
specialties. ACEP reported locum tenens offers are some of the most lucrative
in terms of average
3. Care in alternative settings
reported retail and urgent care clinics and longer physician office hours are
reducing the number of lower-acuity patients seeking ED care.However, many hospitals offer
fast-track options. Toward the end of 2018, the Mount Sinai Health System
opened a new Express Care location, for minor injuries and illnesses on the
hospital’s New York campus. Emergency medicine physicians staff the location,
creating another opportunity for those seeking emergency medicine jobs.
Additionally, some urgent care
centers, such as GuideWell Emergency Doctors in Central Florida, employ emergency
physicians. As Florida Blue expands those centers, it will open up more emergency
4. More older adult patients
emergency medicine physicians are trained to care for patients of all ages, a
growing number of their patients are aging baby boomers. Patients age 65 and
older have higher utilization of the emergency department for care, Jaquis
specializing in the care of older adults are opening across the country. UC San
Diego Health opened California’s first accredited senior emergency care unit in
January 2019. This creates opportunities for emergency medicine physicians who
want to work with older adults.
GeriED is an exciting trend,” said Jaquis, suggesting an opportunity to enhance
older adults’ care.
5. Freestanding emergency
health systems are building freestanding EDs, depending on state laws.
provide a way to extend emergency care to areas that otherwise would not have
access to high-quality emergency care,” Jaquis said.
freestanding locations create opportunities for emergency medicine physicians
wanting to “cut down on the frustrations of working in a bigger hospital and to
focus on the patient,” Jaquis said.
6. Consolidation of emergency
medicine physician groups
number of emergency medicine practice groups are consolidating, Jaquis
reported. Smaller groups are joining larger groups, making them even bigger.
Swearingen, co-founder of Edgemont Capital Partners in New York, wrote in Emergency Physicians Monthly about the
trend in emergency practice consolidation, citing “regulatory uncertainty,
cost-containment and negotiating leverage pressures” as reasons.
7. Revenue concerns
concerns exist with an increase in high-deductible health plans, out-of-network
providers, and balanced billing leaving patients with more of their bills to
pay themselves, Jaquis said.
may go to a hospital in their plan’s network, only to find that the physicians
that treat them may not be in the network, leaving the patient to pay the
charges or whatever the insurer denied.
comes from a shift of cost to the patient who is caught in the middle,” Jaquis
said. This leaves some physicians wondering if they are going to get paid.
8. Rural shortages of emergency
is always a trend of not enough emergency physicians in rural markets,” Jaquis
A 2018 study
from the University of Iowa found that rural EDs using telemedicine saves money
and makes it easier to recruit new physicians. ED physicians in rural areas can
to consult with specialists in larger facilities, which may let the patient be
treated in place or be transferred to the appropriate facility. Reimbursement,
however, remains a challenge, Jaquis said.
hospitals across the country continue to be shuttered, access to care is a
growing necessity for many, especially those in rural areas,” said Heather
Dumas, senior vice president of human resources at Air Methods in Englewood,
Colorado. “Today, more than one-quarter of the American population, 85 million
residents, can only access a Level 1 or 2 Trauma Care facility within one hour
if they are flown by air medical missions. Collectively, this means that our
services are more necessary than ever before.”
9. Concerns about violence
in the ED remains a problem. At Mercy Hospital in Chicago in November 2018,
emergency department physician Tamara O'Neal, MD, and two other people were
killed by a gunman in the ED.
is considerable concern for violence, whether workplace, domestic or gun
violence,” Jaquis said.
10. Access to care
medicine physicians remain concerned about the ability of patients to access
care, an ongoing challenge.
broadly work for access in all settings including emergency care,” Jaquis said.
“We have to make sure of the ability of patients to continue to access the care
Jobs for Emergency Physicians
Medicine Jobs Post-residency: Are You Ready?
Key Health Care Trends to Watch in 2019
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