Abstract

ABSTRACT Background.We surveyed emergency medicine, practice systems in Louisiana. Methods.We surveyed 105 emergency department (ED) directors in Louisiana requesting annual ED volume, hospital type, physician coverage scheduled, type of documentation used, use of physician extenders, use of minor care or observation areas, and employment status of emergency physicians. Results.Directors of 71 EDs responded. Eighty-six percent of emergency physicians were employed as independent contractors. Public and teaching EDs accounted for 51% and 23%, respectively. Mode of documentation was handwritten in 56% and dictated in 21%; 23% used a combination. Physician extenders were used in 7%, with 4% using physician assistants and nurse practitioners. Minor care areas were used in 17%, observation areas in 25%. Nonteaching EDs had a significantly less mean annual volume and physician hours scheduled; they also treated significantly fewer patients per hour. Emergency departments using dictation, physician extenders, or accessory care areas had significantly greater mean annual patient volumes. Conclusions.Emergency departments in teaching hospitals, using dictation, physician extenders, and accessory care areas, have significantly greater system productivity than nonteaching hospitals.