High Attrition Among Non-Physician Practitioners in EDs

TOPLINE:

A study reveals high attrition rates among non-physician practitioners (NPPs) in emergency departments (ED), with particularly high rates among women and rural nurse practitioners (NPs).

METHODOLOGY:

• Researchers conducted a repeated cross-sectional analysis of 31,679 emergency medicine NPPs (64.6% women) using Medicare Data from 2014 to 2021.
• The analysis included 19,846 physician assistants (PAs) and 11,833 NPs.
• The primary outcome was the annual attrition rate of emergency medicine NPPs, assessed from 2014 to 2019 with rates stratified on the basis of sex, clinician type, and practice location.

TAKEAWAY:

• The annual attrition rate was 13.8%, with women exhibiting higher attrition rates (14.7%) than men (11.8%).
• The attrition rate was 15.9% among NPs and 12.6% among PAs.
• Rural NPPs had higher attrition rates (15.1%) than urban NPPs (13.1%).
• The median age of NPPs at attrition was 40.2 years for women and 45.9 years for men, with PAs leaving at younger ages than NPs.

IN PRACTICE:

“This study reveals key findings about the emergency medicine non-physician practitioner workforce from 2014 to 2021, including an increase in non-physician practitioners and notably higher attrition rates among women and rural non-physician practitioners,” the authors wrote. “By directly addressing identified disparities, health care policymakers and organizations can strengthen the stability and effectiveness of the emergency medicine workforce to meet future health care demands,” they added.

SOURCE:

The study was led by Cameron J. Gettel, MD, MHS, Yale School of Medicine, New Haven, Connecticut, and was published online on January 17, 2025, in the Annals of Emergency Medicine.

LIMITATIONS:

The findings cannot be generalized to NPPs working in settings with lower Medicare patient volumes. Potential workforce changes due to the COVID-19 pandemic were not considered. 

DISCLOSURES:

Funding information for the study was not provided. One author received support from the National Institute on Aging of the National Institutes of Health and the National Academy of Medicine of the National Academy of Sciences.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.