The movement to abolish MOC is gaining momentum across specialties, so we expected the number of EPs seeking board certification to drop. But that was just not the case in the latest EMN salary survey: The percentage of EPs who were board-certified rose to 85.2 percent in 2017 from 81.2 percent in 2015, and the percentage of EPs who did not have board certification fell to 14.8 percent from 18.8 percent two years ago.
That wasn't the only surprise. More EPs, board-certified and non-board-certified, worked in remote areas in 2017, increasing to 1.3 percent from 0.6 percent in 2015 and to 2.2 percent from 0.4 percent, respectively. Non-board-certified EPs still mostly resided in urban areas in 2017 at 35 percent v. 37 percent in 2015, but board-certified EPs transitioned away from those areas, with 36.6 percent saying they lived in an urban locale compared with 42.4 percent two years ago. Most board-certified doctors still lived in suburbia, with that percentage inching up further to 47.8 percent in 2017 from 45.1 percent in 2015. More of those with board certification also said they lived in rural areas at 14.3 percent in 2017 compared with 11.9 percent before.
EPs have gone through not only a change in locale but also a change of pace in the ED over the past two years. Most emergency physicians, regardless of board certification, still worked in high-volume EDs with more than 30,000 annual visits but at slightly lower percentages compared with 2015—74 percent in 2017 v. 76.5 percent in 2015 for board-certified doctors and 45.8 percent v. 50 percent for their non-board-certified colleagues. Some EPs from both groups migrated to EDs that saw fewer patients but more so for those without board certification. The percentage of non-board-certified EPs who worked in EDs with 1,001-5,000 visits per year grew to five percent from three percent in 2015, and that rose in EDs with 15,001-20,000 annual visits to 11 percent from nine percent two years ago.
This trend is also evident in the number of ED beds. Fewer EPs, with or without board certification, worked in EDs with more than 50 beds, the highest bed count in our survey in 2017, but that decline was more pronounced among non-board-certified doctors. More than 16 percent of board-certified EPs said their EDs had more than 50 beds, down from 17.8 percent in 2015, while only 7.9 percent of their non-board-certified peers said the same, compared with 11.3 percent in our previous survey. Board-certified EPs still mostly fell in the 31-40- and 41-50-bed groups, with percentages in those categories increasing to 18.6 percent from 18 percent and to 15.1 percent from 14.5 percent, respectively. It's the reverse, however, for their non-board-certified counterparts: Most of them were concentrated in the lower end of the spectrum, with the percentage of EPs without board certification who reported working in EDs with fewer than 10 beds hiking up to 20.9 percent in 2017 from 14.6 percent in 2015 and that in EDs with 21-30 beds rising to 23.3 percent from 18.2 percent before.
The distributions of board-certified and non-board-certified EPs were more similar in our hospital bed data. Both groups were more likely to be in smaller hospitals, but the number of non-board-certified EPs working in hospitals with fewer than 100 inpatient beds increased more substantially: 42.1 percent in 2017 v. 33 percent in 2015. The percentage of board-certified EPs working in hospitals with fewer than 100 beds also went up slightly to 17.5 percent from 21.4 percent. The majority of board-certified doctors were still found at hospitals with 101-300 beds in 2017 at 37 percent, the same as in 2015.
More EPs, board-certified or not, planned to make a move, but more doctors without board certification reported that—81.1 percent of board-certified EPs (80.4% in 2015) v. 84.6 percent of non-board-certified EPs (78.1% in 2015). A similar number of board-certified EPs (about 10%) said they were not planning to move in 2015 and 2017. Fewer non-board-certified EPs said they had no intention to move, however, at 7.1 percent, dropping from 10 percent two years ago.
Not surprisingly, given how many more non-board-certified doctors said they worked in lower-volume EDs and smaller hospitals compared with our last survey, 11.1 percent of them cited wanting to move to larger hospitals as the reason to move while none of them reported that as a motivating factor in 2015. This contrasts starkly with board-certified EPs, only four percent of whom said they wanted to move to a bigger hospital. Overall, money was the most cited reason for wanting to move, with 50.8 percent of board-certified doctors (20.9% in 2015) and 38.9 percent of non-board-certified EPs (13.3% in 2015) reporting that they wanted to move to get a better salary. Back in 2015, the main motivator for a move was better location for both groups—21.7 percent of board-certified doctors (40.5% in 2017) and 20 percent of non-board-certified ones (27.8% in 2015).
Next month: Then and Now: Plans to Move. We'll cross-reference plans to move with gender, career satisfaction, salary, age, and more in next month's salary survey article. We'll also publish that article ahead of print in our enews. Sign up for the enews (free!) at http://bit.ly/EMNenews. You can also find past salary survey articles with additional tables in the Emergency Medicine News Salary Survey blog at http://bit.ly/EMNSalarySurvey.