• C J Holliman, R C Wuerz, D M Chapman, and A J Hirshberg.
• Pennsylvania State University, Milton S. Hershey Medical Center, Emergency Department, Hershey 17033-0850, USA.
• Acad Emerg Med. 1997 Jul 1;4(7):725-30.

ObjectiveTo mathematically model the supply of and demand for emergency physicians (EPs) under different workforce conditions.MethodsA computer spreadsheet model was used to project annual EP workforce supply and demand through the year 2035. The mathematical equations used were: supply = number of EPs at the beginning of the year plus annual residency graduates minus annual attrition; demand = 5 full-time equivalent positions/ED x the number of hospital EDs. The demand was empirically varied to account for ED census variation, administrative and teaching responsibilities, and the availability of physician extenders. A variety of possible scenarios were tested. These projections make the assumption that emergency medicine (EM) residency graduates will preferentially fill clinical positions currently filled by EPs without EM board certification.ResultsUnder most of the scenarios tested, there will be a large deficit of EM board-certified EPs well into the next century. Even in scenarios involving a decreasing "demand" for EPs (e.g., in the setting of hospital closures or the training of physician extenders), a significant deficit will remain for at least several decades.ConclusionsThe number of EM residency positions should not be decreased during any restructuring of the U.S. health care system. EM is likely to remain a specialty in which the supply of board-certified EPs will not meet the demand, even at present levels of EM residency output, for the next several decades.

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