One in Fifteen Family Physicians Principally Provide Emergency or Urgent Care

• Critical Care
• Emergency Medicine
• Health Policy
• Primary Health Care
• Rural Health

Family physicians adapt their care depending on the rurality, market conditions, and needs in their community. Most family physicians provide comprehensive primary care associated with the profession's traditional “basket of services,”¹ but some adapt their work to meet needs in other important settings, including emergency departments and urgent care centers.²

We used data routinely collected from all family physicians during their Maintenance of Certification for Family Physicians examination application between 2008 and 2012 (n = 22,192); we restricted our analysis to those who passed the examination to avoid double-counting physicians. We used rural urban commuting area codes to classify rurality.³

We found that about 1 in 15 respondents (6.7%) devoted ≥80% of their time to either emergency (3.6%) or urgent care (3.1%). As expected, increasing rurality was associated with greater proportions of family physicians working principally in emergency care.⁴ More male family physicians work in emergency care, whereas more female physicians work in urgent care.

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Figure 1.

Percentage of family physicians passing the Maintenance of Certification–Family Physician examination from 2008 to 2012 who report devoting at least 80% of their time to either emergency care or urgent care.

With the growing national consensus regarding the need to maintain and expand the primary care pipeline, it is important that workforce planners and policymakers be able to accurately assess the availability of primary care. This ability relies on being able to identify primary care physicians serving in clinical roles other than primary care. A small but important percentage of family physicians are serving as emergency and urgent care physicians, particularly in rural areas.