Predictors of Emergency Physician Productivity in a National Emergency Medicine Group
Jonathan J. Oskvarek, Mark S. Zocchi, Bernard S. Black, Laura G. Burke, Marika Kachman, Andrew Leubitz, Ali Moghtaderi, Dhimitri A. Nikolla, Nishad Rahman, Jesse M. Pines
Annals of Emergency Medicine, March 27, 2025
ā Conclusion:
Physician experience, shift timing, staffing, and ED boarding levels impact productivity. Importantly, higher productivity does not appear to compromise patient care, as evidenced by unchanged admission-level return rates. This supports the idea that experienced, consistently scheduled physicians can safely maintain higher throughput.
š Methods:
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Data Source: 184 EDs in 24 U.S. states
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Time Frame: January 2021 ā December 2022
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Sample: 234,146 shifts worked by 2,099 emergency physicians
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Outcome Measures:
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Patients per hour
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72-hour ED return rate
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72-hour return with admission
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Analysis: Multivariable linear regression
š Key Findings:
|
Predictor |
Effect on Patients/Hour |
|
Younger physician age |
Associated with higher productivity |
|
Longer tenure at site |
Increases productivity even beyond 60 months |
|
Tenure effect at 6 months |
+0.06 patients/hour (95% CI: 0.02 to 0.09) |
|
Tenure effect at 12 months |
+0.11 patients/hour (95% CI: 0.07 to 0.15) |
|
More shifts in prior 3ā30 days |
+0.003 patients/hour per shift (95% CI: 0.002 to 0.004) |
|
Overnight shifts |
Associated with lower productivity |
|
Non-Monday shifts |
Associated with lower productivity |
|
More physicians on shift |
Slight decrease in patients/hour |
|
Longer shift lengths |
Slight decrease in patients/hour |
|
More boarding patients (ED LOS > 6 h) |
Associated with lower productivity |
š Clinical Outcomes:
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Higher patients/hour was associated with:
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Slightly lower 72-hour return rates
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No significant difference in 72-hour returns with admission
Oskvarek, J.J., Zocchi, M.S., Black, B.S., Burke, L.G., Kachman, M., Leubitz, A., Moghtaderi, A., Nikolla, D.A., Rahman, N. and Pines, J.M., 2025. Predictors of Emergency Physician Productivity in a National Emergency Medicine Group. Annals of Emergency Medicine.