Staffing Models and the Role of the Emergency Department Medical Director

Originally approved April 2020

The American College of Emergency Physicians (ACEP) believes that it is the responsibility of the emergency department (ED) medical director to identify the most appropriate local staffing model to achieve operational efficiency while maintaining clinical quality and physician-directed or supervised care. 

Though multiple staffing models utilizing physicians and other clinicians exist, the needs of each individual ED are unique. The utilization and distribution of staff within the ED should be determined at the site level by local ED leadership, who are responsible for and/or have a role in staff hiring, training/onboarding, and supervision. 

The medical director and other local physician leaders should be responsible for establishing local processes and practices that ensure both sufficient physician training/onboarding and availability, as well as the opportunity for safe supervision of other clinicians to ensure clinical quality.