title: [Quo vadis, preclinical emergency physician?: results of a survey of emergency medical services in Rhineland-Palatinate (Germany)].
abstract: BACKGROUND
  The provision of physician-staffed emergency medical services (EMS) has become difficult in German territorial states. However, the precise details are so far unknown.
  
  
  METHODS
  On behalf of the State Government of Rhineland-Palatinate (4 million inhabitants), in 2012 a written survey investigating personnel and structural settings was conducted at all emergency medical services (EMS) stations. The questionnaire comprised 53 items (14 open and 39 multiple choice questions).
  
  
  RESULTS
  Of the 78 stations 74 responded (94.8 %), 87.8 % of the responders were affiliated to a hospital, 62 % reported problems in recruiting physicians for the EMS, 92 % expected problems to further increase and 43 % have to hire external fee-based physicians. Women are considerably underrepresented (28.4 %), while anesthetists are overrepresented (56.1 %). The main reasons for the shortage of doctors were given as low salaries (59.5 %), increased demand for doctors (56.8 %), disinterest of other hospital departments (50 %), lack of opportunity for career advancement (45.9 %) and demographic factors (40 %). The main countermeasures were given as assuming costs for education and training of prospective emergency physicians and higher salaries.
  
  
  CONCLUSIONS
  The described problems are complex. Besides financial incentives, they necessitate greater general appreciation of the preclinical work of emergency physicians. Further studies including the emergency physicians concerned are necessary. The low percentage of female emergency physicians requires special consideration.
authors.affiliation: Deutsches Zentrum für Notfallmedizin und Informationstechnologie - DENIT, Fraunhofer IESE, Fraunhofer-Platz 1, 67663, Kaiserslautern, Deutschland, thomas.luiz@iese.fraunhofer.de.
authors.forename: T
authors.initials: T
authors.lastname: Luiz
authors.forename: J
authors.initials: J
authors.lastname: Jung
authors.forename: S
authors.initials: S
authors.lastname: Flick
mesh_terms: D000328:Adult; D017677:Age Distribution; D004632:Emergency Medical Services / Q000191:economics; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000191:economics / Q000706:statistics & numerical data* / Q000600:supply & distribution*; D010822:Physicians, Women / Q000706:statistics & numerical data; D012456:Salaries and Fringe Benefits; D000078329:Workforce