In 2022, at least 7.4% of emergency departments across the U.S. did not have an attending physician on-site 24/7, a recent PubMed Central study found.
Published in February, the study drew data from 4,621 EDs surveyed in the National ED Inventory-USA survey. The 2023 survey was administered to all EDs open during 2022 and asked, "Is at least one attending physician (not resident) on duty in the ED 24 [hours per day]?"
Here are six things to know:
1. Three hundred and forty-four EDs reported they did not have 24/7 attending physician coverage.
The study is the first of its kind so there isn't proof that such staffing arrangements are increasing, Carlos Camargo, MD, the lead author and a professor of emergency medicine at Harvard Medical School, told KFF Health News.
2. The states with the highest percentage of EDs that lacked 24/7 coverage were North Dakota with 58%, South Dakota with 56%, and Montana with 46%.
3. Among the 344 EDs, 92% had annual visit volumes under 10,000.
4. Of EDs without 24/7 physician coverage, 89% were a critical access hospital, 72% were rural and 2% were freestanding.
5. Allowing EDs to operate without a physician is a controversial practice. Associations like the American Medical Association and American College of Emergency Physicians support laws or regulations that would require EDs to staff a physician 24/7. However, others say that advanced practice providers with the right experience and support are capable of overseeing the ED.
6. Dr. Camargo told KFF some physicians say that lawmakers need to pay hospitals more if they are going to require 24/7 on-site physician coverage in EDs.