July 6, 2021

Letter from the Editor

Debbie Fletcher, MD


Hello Workforce section,

First of all, I want to thank our entire workforce for the dedication to patients during the COVID-19 pandemic. Hopefully, we are settling back into more normal routines, and we can focus on issues other than COVID! We had tremendous movement on EM Workforce (WF) issues this spring, with ACEP releasing their information and proposals during an April webinar. We have done the first thing we need to do to solve a problem: admit that the problem exists. We have a staggering projected oversupply of emergency medicine (EM) physicians, over 9,000, by year 2030. This is caused from many factors combining around this same time; increased number of residencies, and increased number of advance practice providers (APP) entering our EM workforce (WF). We have had lively discussions on the ACEP engagED community, along with social media pages like EM Docs and Reddit.

The ACEP WF report comes a year after Dr. Carlos Camargo’s National Study of the Emergency Physician Workforce 2020 came out, that shows a severe shortage of EM physicians in the rural areas of the country. EM docs are having difficulty finding jobs in their desired location. Rural EM does not appeal to many, but from personal experience it is very professionally satisfying. Dr. Richard Stennes has written an article for us discussing the benefits of rural EM practice, and I would hope that others would try it as well.

We stand by the ACEP Policy statement that a board-certified emergency physician is the gold standard for all emergency departments. We are planning to have our Emergency Medicine Workforce Section meeting via Zoom two weeks before the ACEP21 in Boston in October. Prior to that, we will send out the new proposed section objectives, call for officer nominations, and a few Operational Guidelines changes, then vote on these during the section zoom meeting. I have been posting often on EM Workforce section’s engagED community instead of writing the newsletter as it is more in real time of events - they are happening quickly! Make sure you are linked with our engagED page for timely updates, and feel free to post yourselves. Please work with us, our EM organizations, and your state medical societies to help swing the pendulum back to physician-led care for patients, and help doctors regain control of emergency medicine.

Final thoughts for now:

When my job was eliminated by our new CMG in 2019, I was appalled and confused. How could this happen? I googled “nurse practitioners replacing physicians” and really did not find much about this. In fact, I found more comments like “nurse practitioners will never replace doctors”, and “this would never happen”. Fast forward just two years later, and it is becoming reality for more of us, and with the trend projected to increase in our career future. We need to take emergency medicine back, for our patients and our fellow physicians.

Contact me at ddfletcher@mindspring.com, and join our section.

Debbie Fletcher, MD, FACEP, FAAEM