Study objective: To obtain current demographic data and information regarding the opinion of a stratified random sample of emergency physicians about the greatest current challenges facing emergency medicine.
Methods: An annual survey was conducted by the American Board of Emergency Medicine (ABEM) using a stratified random sample of 1,004 emergency physicians selected from four cohorts, 1979, 1984, 1988, and 1993. These samples were further divided between diplomates who had completed emergency medicine residency training and those who had not. The 1993 non-residency-trained panel was replaced by a random sample of American College of Emergency Physicians members who were full-time emergency physicians, were not ABEM diplomates, and had not completed a residency in emergency medicine. The interim survey instrument is a one-page collection of relevant demographic items selected from the comprehensive 5-year questionnaire with the addition of the open-ended question, "What are the greatest challenges facing emergency medicine today?"
Results: Of the interim surveys distributed, 95% (n = 956) were returned. Because the 1995 interim survey was the first distributed after the initial 1994 comprehensive survey, the demographic data had changed little. Such data will become increasingly important and useful as changes are reported over subsequent years. The main challenge identified by participants was the impact of managed care (31%), followed by economic and financial issues (23%). Personal impact issues, such as individual stress and malpractice, accounted for a smaller number of responses (18%).
Conclusion: Overall, the ABEM Longitudinal Study participant responses to the 1995 interim survey describe a committed group of emergency physicians who are struggling and coping with the needs of a maturing specialty and with the crosscurrents and changes in American medicine.