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Brief ReportBrief Report

National Study on the Contribution of Family Physicians to the US Emergency Physician Workforce in 2020

Christopher L. Bennett, W. Anthony Gerard, John S. Cullen, Janice A. Espinola, Ashley F. Sullivan, Carson E. Clay and Carlos A. Camargo
The Journal of the American Board of Family Medicine November 2021, 34 (6) 1221-1228; DOI: https://doi.org/10.3122/jabfm.2021.06.210166
Christopher L. Bennett
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
MD, MA
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W. Anthony Gerard
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
MD
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John S. Cullen
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
MD
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Janice A. Espinola
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
MPH
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Ashley F. Sullivan
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
MS, MPH
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Carson E. Clay
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
BA
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Carlos A. Camargo Jr.
From Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA (CLB); Staff Emergency Physician, Lebanon, PA (WAG); Providence Valdez Medical Center, Valdez, AK (JSC); Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (JAE, AFS, CEC, CAC).
MD, DrPH
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  • Article
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  • Info & Metrics
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Article Figures & Data

Figures

  • Tables
  • Figure 1.
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    Figure 1.

    Family medicine emergency physician density per 100,000 population by county.

  • Figure 2.
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    Figure 2.

    Family medicine emergency physician percent among all clinically active emergency physicians by county.

Tables

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    Table 1.

    Comparison of Family Medicine Trained and/or Board Certified Emergency Physicians by Board Certification

    CharacteristicsAll Family Medicine EPs, n = 4354Family Medicine Board Certification, n = 3596General Emergency Medicine Board Certification, n = 388Neither Family Medicine nor Emergency Medicine Board Certification, n = 51No Board Certification, n = 319
    n%n%n%n%n%P Value*
    Demographics
    Age, y (median [IQR])435465 (59 to 69)359664 (59 to 69)38866 (58 to 70)5167 (62 to 71)31965 (60 to 71)<0.001
    Age categories, y<0.001
        25 to 441383110314412134
        45 to 6419914617014713535214113442
        ≥6522255117855023962295717254
    Female sex5311242912561451041130.48
    International medical graduate70116589163398167122<0.001
    Geography
    US Census division<0.001
        New England175414941542493
        Mid Atlantic3418281834948227
        East North Central59014496143699184916
        West North Central39193491019524217
        South Atlantic9032172820100268166722
        East South Central41510341102875104113
        West South Central586144911433910205217
        Mountain366830594010510165
        Pacific561134411280216123411
    MSA population size<0.001
        ≥1,000,00017224013673820352265112640
        250,000 to 999,999939228012274199185517
        100,000 to 249,99947411398113810483411
        <100,000651542412452
        Unknown11542797627691810209931
    Urban influence<0.001
        Urban34027927817834088407824176
        Large rural56013479133397144113
        Small rural37293229123483411
    Training
        Residency<0.001
        Emergency medicine403917652005236248
        Family medicine36468431818816242214128288
        Internal medicine662290.8144193741
        Pediatrics110.360.230.82400
        Surgery6213819261293
        Internship only581582000000
        Other residency130.3130.4000000
    None952953000000
    Years since completed medical training0.006
        <544134110.31283
        5 to 99827921330062
        10 to 1952012415126617483511
        ≥2035978429738530879469027085
    Primary specialty of emergency medicine2563592004563639491818759<0.001
    • EPs, emergency physicians; IQR, interquartile range; MSA, metropolitan statistical area.

    • ↵* Bivariate comparisons were tested using Kruskal-Wallis, χ2, and Fisher's exact tests, as appropriate.

    • View popup
    Table 2.

    Comparison of Family Medicine Emergency Physicians by Sex, n = 4354

    All Family Medicine EPs,
    Male (n = 3823)Female (n = 531)
    Characteristicsn%n%P Value*
    Demographics
    Age, y (median [IQR])382365 (59 to 69)53162 (54 to 67)<0.001
    Age categories, y<0.001
        25 to 441013377
        45 to 6416914430057
        ≥6520315319437
    International medical graduate6301671130.07
    Geography
    US Census division0.87
        New England1484275
        Mid Atlantic3028397
        East North Central519147113
        West North Central34095110
        South Atlantic7892111422
        East South Central37110448
        West South Central512137414
        Mountain3218459
        Pacific498136312
    MSA population size0.03
        ≥1,000,00015033921941
        250,000 to 999,9998152112423
        100,000 to 249,99943311418
        <100,000521132
        Unknown10202713425
    Urban influence0.77
        Urban29937940977
        Large rural487137314
        Small rural3259479
    Training
    Residency<0.001
        Emergency medicine32288115
        Family medicine32328541478
        Internal medicine59271
        Pediatrics80.230.6
        Surgery57150.9
        Internship only57110.2
        Other residency120.310.2
        None762194
    Years since completed medical training<0.001
        <5290.8153
        5 to 9762224
        10 to 19421119919
        ≥2032218637673
    Primary specialty of emergency medicine224459319600.55
    • EPs, emergency physicians; IQR, interquartile range; MSA, metropolitan statistical area.

    • ↵* Bivariate comparisons were tested using Kruskal-Wallis, χ2, and Fisher's exact tests, as appropriate.

    • View popup
    Appendix Table 1.

    Comparison of Family Medicine Emergency Physicians with Isolated Family Medicine or Dual Family Medicine and Emergency Medicine Board Certification, n = 3596

    Isolated FM Board Certification (n = 2860)Dual FM and EM Board Certification (n = 736)
    Characteristicsn%n%P Value*
    Demographics
    Age, y (median [IQR])286063 (58 to 67)73669 (66 to 72)<0.001
    Age categories, y<0.001
        25 to 44933172
        45 to 6415735512817
        ≥6511944259180
    Female sex364136590.004
    International medical graduate512187710<0.001
    Geography
    US Census division<0.001
        New England1084416
        Mid Atlantic2168659
        East North Central3951410114
        West North Central30311466
        South Atlantic5832014520
        East South Central29510466
        West South Central42615659
        Mountain21688912
        Pacific3061113518
    MSA population size<0.001
        ≥1,000,00010363633145
        250,000 to 999,9996172218425
        100,000 to 249,999310118812
        <100,000421122
        Unknown8553012116
    Urban influence<0.001
        Urban21427563987
        Large rural409147010
        Small rural29710253
    Training
    Residency<0.001
        Emergency medicine29114720
        Family medicine26659351670
        Internal medicine140.5152
        Pediatrics30.130.4
        Surgery260.9122
        Internship only351233
        Other residency60.271
        None823132
    Years since completed medical training0.002
        <529150.7
        5 to 9532264
        10 to 1935013659
        ≥2023468462787
    Primary specialty of emergency medicine14024960282<0.001
    • EM, emergency medicine; FM, family medicine; IQR, interquartile range; MSA, metropolitan statistical area.

    • ↵* Bivariate comparisons were tested using Kruskal-Wallis, χ2, and Fisher's exact tests, as appropriate.

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The Journal of the American Board of Family   Medicine: 34 (6)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 6
November/December 2021
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National Study on the Contribution of Family Physicians to the US Emergency Physician Workforce in 2020
Christopher L. Bennett, W. Anthony Gerard, John S. Cullen, Janice A. Espinola, Ashley F. Sullivan, Carson E. Clay, Carlos A. Camargo
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1221-1228; DOI: 10.3122/jabfm.2021.06.210166

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National Study on the Contribution of Family Physicians to the US Emergency Physician Workforce in 2020
Christopher L. Bennett, W. Anthony Gerard, John S. Cullen, Janice A. Espinola, Ashley F. Sullivan, Carson E. Clay, Carlos A. Camargo
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1221-1228; DOI: 10.3122/jabfm.2021.06.210166
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