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Physician Staffing of Small Rural Hospital Emergency Departments

Rapid Change and Escalating Cost

Bibliographic Data

ID19431685
AuthorsHarold A Williamson (Washington University in St. Louis), Roger A Rosenblatt (University of Washington), L Gary Hart (University of Washington)
Year1992
Volume8
Issue3
Pages171-177
Publication date1992-06-01
Open AccessYes
TypeARTICLE
VenueThe Journal of Rural Health (JOURNAL)
Journal identifiersISSN: 0890-765X • E-ISSN: 1748-0361
PublisherWiley (PUBLISHER • GB)
DOI10.1111/j.1748-0361.1992.tb00349.x
PMID10121545
OpenAlexW2017512328
LanguageEN
Citations received4
References cited8

We surveyed all 37 rural Washington state hospitals with fewer than 100 beds to determine how rural emergency departments are staffed by physicians and to estimate rural hospital payments for emergency department physician services. Only five hospital emergency departments (14%) were still covered by the traditional rotation of local practitioners and billed on a fee‐for‐service basis. Ten hospitals (27%) paid local private practitioners to provide emergency department coverage. Twelve other hospitals (32%) hired visiting emergency department physicians to cover only weekends or evenings. The remaining 10 rural emergency departments (27%) were staffed entirely by external contract physicians. Thus, 86 percent of rural hospitals contracted for emergency department coverage, and 59 percent obtained some or all of this service from nonlocal physicians. Most of the 32 hospitals with some form of contracted services have changed to this emergency department coverage in the last few years. The cost of these services is high, particularly for the smallest hospitals that have fewer than eight emergency department visits per day and pay physician wages of nearly $100 per patient visit. Emergency staffing responsibility has shifted from local practitioners to the hospital administrators because of rural physician scarcity and a desire to improve quality and convenience. The cost of these changes may further undermine the economic viability of the smaller rural hospitals

Business · Emergency department · Family medicine · Medical emergency · Payment · Staffing · Emergency and Acute Care Studies · Global Health Workforce Issues · Healthcare Policy and Management · Medicine · Nursing · Emergency Medicine · Finance

  • Modeling the Mental Health Workforce in Washington State

    Open Access•Laura‐Mae Baldwin, Miriam M Patanian et al.•The Journal of Rural Health•2006

  • Rural Emergency Department Staffing and Participation in Emergency Certification and Training Programs

    Open Access•Michelle Casey, Michelle M Casey et al.•The Journal of Rural Health•2008

  • Educating Generalist Physicians for Rural Practice

    Open Access•John P Geyman, J J van Sante et al.•The Journal of Rural Health•2000

  • Nonemergency Medicine‐Trained Physician Coverage in Rural Emergency Departments

    Open Access•Lars E Peterson, Martey S Dodoo et al.•The Journal of Rural Health•2008

  • Is There a Role for the Small Rural Hospital

    Open Access•L Gay Hart, Bruce A Amundson et al.•The Journal of Rural Health•1990

Citations per year0.15
Citation span2000 - 2008 (9)
Highly citedNo

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