Secondary Logo

Journal Logo

Letter to the Editor

The Winners in a Saturated Market are Corporations

doi: 10.1097/01.EEM.0000616516.76098.24
Letter to the Editor
Back to Top | Article Outline

Letters to the Editor

Emergency Medicine News welcomes letters to the editor about any subject related to emergency medicine. Please limit your letter to 250 words, and include your full name, credentials, and city and state of residence or practice.

Letters may be edited for content, length, and grammar. Submission of a letter constitutes the author's permission to publish on all media, including print, online, and social media, but does not guarantee publication. Letters express the views of the authors and do not necessarily reflect those of Emergency Medicine News and Wolters Kluwer.

Letters to the editor may be sent to


I want to praise Thomas Cook, MD, for calling attention to what appears to be an underreported phenomenon of our profession. (“Are There Too Many Emergency Physicians?” EMN. 2019;41[8]:8,; “The Unchecked Growth of EM Programs [and No Signs of Stopping],” EMN. 2019;41[9]:6,

As he pointed out, the abrupt rise in AGCME-approved residencies is due primarily to the merger of AOA-accredited residencies with allopathic ones. Here in my home state of Florida, HCA-initiated residency programs appear to be another factor.

Over the past eight years, five additional HCA residency programs have begun, and more are in the application process. We now have 16 residency programs! When I moved here in 1993, there were three.

This number of graduates will saturate the local market and drive down salaries. There appears to be no oversight, and Dr. Cook's articles help begin the discussion of whether there should be some regulation over the numbers. If the free-trade argument is applied, the consequence will be an abundance of EPs with a limited job market and lower pay. Perhaps this will benefit patients, but the winners will more likely be the for-profit CMGs and hospitals.

Leo Alonso, DO

Jacksonville, FL

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.