A study of the workforce in Emergency Medicine in Israel: 2003.

Emergency Medicine (EM) was officially recognized as a specialty in Israel in 1999. In 2003 the first nine Israeli trained emergency physicians (EPs) were certified. This survey was undertaken to assess current staffing of Emergency Departments (ED) in Israel and to attempt to estimate future staffing needs for EPs. A survey was sent to all ED directors at general hospitals in Israel. We asked questions relating to staffing by number of physicians, type and level of training, and differential staffing by time of the day and week. In addition, we inquired as to the census, structure, hospital resources available, and size of the ED. Twenty-four of 25 (96%) EDs responded. There were 59 EM specialists registered in Israel; there were 37 EM residents. EDs reported a total of 1,872,500 visits annually. Emergency care is otherwise given by specialists and residents in other fields, and non-specialist physicians. At large hospitals there is an average of 2.5 EM specialists during daytime hours, and another four specialists of other types on duty. During the night in large hospitals, there is an average of <1 specialist of any kind (typically not EM) on duty. In most EDs, care is turned over to non-specialists (residents and others) during evenings and nights. The recognition of the need for Emergency Medicine as a specialty in Israel has not as yet translated into care of emergencies by EPs for most patients. To adequately staff EDs with physicians trained in EM, an emphasis needs to be placed on increasing EM staff and resident positions. The need seems most acute in medium-sized hospitals and during off hours and weekends.