Emergency Physician Shortages Worsening in Rural America, Report Says

Of the 48,835 active emergency physicians in the United States, 92% practice in urban areas with just 8% practicing in rural communities.

Large swaths of rural America are enduring shortages of emergency physicians, and the problem is expected to worsen as a generation of rural doctors retires with no one to replace them, a new emergency medicine workforce analysis has found.

"The number of emergency physicians is increasing but there is a clear unmet need for emergency physicians in rural areas," said Christopher Bennett, MD, MA, assistant professor of emergency medicine at Stanford University School of Medicine and lead study author, which was published this week in Annals of Emergency Medicine.

"Policymakers and health leaders should prioritize opportunities to make sure that emergency departments across the country are led by appropriately trained and certified emergency physicians," he said.

According to the "National Study of the Emergency Physician Workforce, 2020," the nation's rural emergency physician shortage is expected to worsen in the coming years.

Of the 48,835 clinically active emergency physicians in the United States, 92% (44,908) practice in urban areas with just 8% (3,927) practicing in rural communities, down from 10% in 2008, the study found.

"Demand for emergency care in rural areas will remain high while emergency physician shortages in these communities continues to pose significant challenges for health systems and patients," Bennett said.

The analysis also shows that the rural emergency physician workforce is closing in on mid-career or retirement, with more than 70% having completed their medical training more than 20 years ago.

The median age for urban emergency physicians is 50 years old, while the median age in large rural communities is 58 years old, and 62 years old in smaller rural communities, the study found.

Relief does not appear to be coming any time soon, as the study found that 96% of the emergency medicine residency or fellowship graduates within the past four years practiced in more urban areas.  

On a brighter note, residency programs continue to expand, and that could help alleviate the shortage.

There were 4,565 residents in 145 programs in 2008, and in 2020 there are 7,940 residents in 247 programs.

"There are reasons to be optimistic about the pipeline of residents and trainees, however; we need to encourage a larger percentage of these individuals to work in rural America," Bennett said.

The study also found that women comprise 28% of emergency physicians, up from 22% in 2008.