EM funding

[average]

Someone please tell me how a physician in a small town ED can get paid a regular salary?

The patient load in some of these rural ED's is under 3k per year?

Is there government subsidy or does the hospital just bear the cost?

How does this all work?

 

[ERMudPhud]

Someone please tell me how a physician in a small town ED can get paid a regular salary?

The patient load in some of these rural ED's is under 3k per year?

Is there government subsidy or does the hospital just bear the cost?

How does this all work?

Most of those places are not and never will be staffed by an EP. After all <3k per year means less than 1 patient every three hours(actually 2.9 hours). I've worked in a few towns like that as a med student and generally the ED was staffed by an EMT who would call one of the local FP's if someone presented to the ED. If it was a non-emergent patient presenting M-F 9-5they might be directed straight over to the FP's clinic. If it was after hours the EMT would start treatment and workup based on a verbal discussion with the doc while the doc drove into the hospital.

I am sort of curious what the minimum census is before you start seeing EP's working the ED. In general I think I've noticed in the job notices I get that many places seeing less than 15-20k/year seemed like they didn't require ACEP/EM residency.

 

[OSUdoc08]

Most of those places are not and never will be staffed by an EP. After all <3k per year means less than 1 patient every three hours(actually 2.9 hours). I've worked in a few towns like that as a med student and generally the ED was staffed by an EMT who would call one of the local FP's if someone presented to the ED. If it was a non-emergent patient presenting M-F 9-5they might be directed straight over to the FP's clinic. If it was after hours the EMT would start treatment and workup based on a verbal discussion with the doc while the doc drove into the hospital.

I am sort of curious what the minimum census is before you start seeing EP's working the ED. In general I think I've noticed in the job notices I get that many places seeing less than 15-20k/year seemed like they didn't require ACEP/EM residency.

A mid-level provider (NP, PA) with telemedicine available is what I've commonly seen.

I can understand a paramedic, but an EMT would likely be rare. If so, I'd hate to be living in that town.

 

[ERMudPhud]

A mid-level provider (NP, PA) with telemedicine available is what I've commonly seen.

I can understand a paramedic, but an EMT would likely be rare. If so, I'd hate to be living in that town.

I've seen more than one rural town where the initial contact is by a paramedic/lpn/emt who can initiate basic therapy after a discussion with the on call doc who is on his way to the ED. Its really no different than medical control of a paramedic by a doc in the ED except that in this case the patient is stationary and the doc is in transit.