3 Challenges Facing Emergency Physicians in the Next Decade

In most cases emergency physicians are the first health professionals a person will encounter when there is something wrong with their health. Therefore, it is extremely important that challenges facing emergency physicians are addressed and solutions are implemented by the Canadian Association of Emergency Physicians (CAEP) so that physicians are able to perform to the best of their abilities. Some of the challenges facing emergency medicine in the next decade are burnout, understaffing and patient overcrowding.

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Burnout

One of the most influential challenges emergency physicians face is burnout. Burnout is a state of emotional exhaustion and depersonalization usually caused by stress that can cause lower quality care for patients (Huang, 2020). In a pre-COVID-19 study in Canada comprised of 462 of 1011 emergency physicians, 86.1% of emergency physicians experienced burnout and 6% actively considered suicide in the past year (Huang, 2020). According to another study in the United States involving 333 emergency physicians, emergency doctors had a 3.18 times more likely chance to develop burnout than the average physician (Berger, 2013). In an additional study the main causes of burnout were reported as being “loss of autonomy and control over content of clinical work” and “unreasonable quantity of work and pace” (Moore, 2015). This makes sense as emergency physicians work in a very stressful high paced environment, have little time for breaks, have little control over the patients they see, often work long hours and commonly see patients on the worst day of their lives. The first wave of COVID-19 did not drastically change the rate of burnout of the emergency physician due to the community support, various wellness initiatives and less people coming into the hospital for non-COVID-19 related health problems (Huang, 2020). However, after the inevitable future COVID-19 waves and eventual return to normalcy sooner or later ER physicians will begin to feel the effects of burnout. For this reason, it is important that CAEP addresses this issue and implements solutions to lower the risk of burnout.

(Thompson, 2021)

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Understaffing

Another challenge for emergency physicians is being understaffed. According to a report from the Collaborative Working Group on the Future of Emergency Medicine in Canada, Canada has a shortcoming of 478 emergency doctors and is projected to reach 1518 by 2025 if no interventions occur (Collier, 2016). In the same report it was found that 40% of emergency departments in large urban centres have staff needs not fully covered and the issue is worse in rural areas where 62.5% of departments have staffing issues (Collier, 2016). As Canada’s population continues to age, more and more emergency physicians will retire creating an even larger shortage if the issue is not addressed. A shortage of emergency physicians is extremely dangerous as it causes emergency physicians to have to work more which could in turn lead to longer wait times, burnout and a lower quality of care. Therefore, Canada’s shortage of emergency physicians must be addressed to allow for the highest possible emergency department efficiency.

(Jones, 2017)

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Patient Overcrowding

The final main challenge faced by emergency physicians is the overcrowding of patients. Overcrowding increases the wait times and creates a more stressful environment for the emergency physicians where they feel pressure to work fast ultimately lowering the quality of care. Overcrowding mainly occurs because of family practice sensitive conditions (FPSCs) or conditions that can be treated by a family physician and do not require emergency care (CIHI, 2014). In a study performed by CIHI in 2013-2014, 1 in 5 of overall non-admitted emergency department visits and 1 in 3 visits by seniors in long term care homes were FPSCs (CIHI, 2014). Most of the reasons for these visits stem from a lack of access to primary care and family physicians (CIHI, 2014). With the aging population of the baby boomers the numbers of FPSCs will likely increase if no changes are made. Hence, to solve this predicament access to family physicians must be dealt with as well.

(Helman, 2019)

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In closing, the most glaring complications emergency physicians will face in the next decade are burnout, understaffing and overcrowding of patients. Thus, it is important that solutions to all of these difficulties are concentrated on to ensure emergency patients receive the quality care and emergency physicians remain healthy.

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References

Berger, E. (2013, March 1). Physician Burnout Emergency Physicians See Triple Risk of Career Affliction. Annals of Emergency Medicine, 61(3), 17-19. https://doi.org/10.1016/j.annemergmed.2013.01.001

Canadian Association of Emergency Physicians (CAEP). (n.d.). Accessed March 5, 2021, from https://caep.ca

CIHI. (2014, November). Sources of Potentially Avoidable Emergency Department Visits. https://secure.cihi.ca/free_products/ED_Report_ForWeb_EN_Final.pdf

Collier, R. (2016, August 9). Canada’s Emergency Medicine Shortfall. CMAJ, 188(11), 246.https://doi.org/10.1503/cmaj.109-5292

Dahle, J. M. (2018, October 16). 7 reasons why this physician works half-time. KevinMD. Accessed March 5, 2021, from https://www.kevinmd.com/blog/2018/10/7-reasons-why-this-physician-works-half-time.html

Helman, A. (2019). [Photograph of busy ER waiting room]. ACEP Now. https://www.acepnow.com/article/how-to-solve-emergency-department-overcrowding/

Huang, B. (2020, November 12). ‘That’s nuts, right?’ Burnout rates raise concerns among ER doctors. Healthy Debate. Accessed March 5, 2021, from https://healthydebate.ca/2020/11/topic/burnout-rates-among-er-doctors/

Jones, C. (2017). [Photograph of nurse being overworked]. Hospital recruiting. https://www.hospitalrecruiting.com/blog/4137/how-to-survive-at-work-when-you-are-understaffed-and-overworked/

Moore, J. D. (2015, December 2). Burnout: Emergency Medicine Hit Hardest. Health Leaders Media. Accessed March 5, 2021, from https://www.healthleadersmedia.com/strategy/burnout-emergency-medicine-hit-hardest

Thompson, A. (2021). [Photograph of distraught doctor]. Yahoo!Finance. https://finance.yahoo.com/news/doctor-describes-working-coronavirus-pandemic-150901084.html