Emergency department coverage by primary care physicians in a rural practice-based research network: incentives, confidence, and training.
BACKGROUND
In rural areas of the United States, emergency departments (EDs) are often staffed by primary care physicians, as contrasted to urban and suburban hospitals where ED coverage is usually provided by physicians who are residency-trained in emergency medicine.


OBJECTIVE
This study examines the reasons and incentives for rural Oregon primary care physicians to cover the ED and their reported measures of confidence and priorities for additional training.


METHODS
We conducted a cross-sectional survey of primary care physicians in rural Oregon who are members of the Oregon Rural Practice-Based Research Network (ORPRN). The survey was sent to 70 primary care physicians in 27 rural Oregon practices.


RESULTS
Fifty-two of 70 (74%) ORPRN physicians representing 24 practices returned the questionnaire. Nineteen of the 52 responding physicians reported covering the ED. The majority (75%) of physicians covering the ED did so as a requirement for practice employment and/or hospital privileges. Physicians covering the ED reported low confidence in pediatric emergencies and expressed the need for additional training in pediatric emergencies as their top priority.


CONCLUSIONS
Almost two fifths of surveyed primary care physicians in a rural practice-based research network provide ED coverage. Based on these physicians' low levels of confidence and desire for additional training in pediatric emergencies, effective education models are needed for physicians covering the ED at their rural hospitals.
Creighton University School of Medicine, Omaha, Neb.
Edward
E
Lew
Lyle J
LJ
Fagnan
Nora
N
Mattek
Jo
J
Mahler
Robert A
RA
Lowe
D002983:Clinical Competence; D004636:Emergency Service, Hospital; D019538:Health Care Surveys; D006780:Hospitals, Rural; D009922:Oregon; D010821:Physicians, Family / Q000193:education; D012424:Rural Population; D000078329:Workforce