On the heels of my recent post, Free Medical School Tuition Could Solve Physician Shortage, comes a new article about the shortage of general surgeons.
Friday, Reuters Health reported about a new study in the US that projected that the shortage of general surgeons in the US will get worse as the number of doctors entering the workforce fails to keep pace with population growth.
The study’s researchers predicted shortages based on their estimates of population growth by 2050, and by the number of medical schools and hospital-sponsored general surgery trainee positions.
- By 2050, there will be a deficit of 7,047 general surgeons nationwide
- That is higher than the shortage of 6,000 they predicted a decade ago based on the pace of population growth and new surgeons entering the job market at that time.
The lead study author, Dr. E. Christopher Ellison of Ohio State University, was quoted as saying, “Leaders in surgery have predicted a pending shortage in the general surgery workforce for more than 10 years.”
Dr. Ellison also said that, “the impact of the general surgeon shortages on patients is measured in the timeliness of care and the consequences of delays in care.”
The study was published in the journal Surgery, and the researchers noted that there should be about 7.5 general surgeons for every 100,000 people, to maintain acceptable access to surgical care.
According to the study, the number of general surgery resident positions and the number of residents completing their training has been rising in the US, but these increases have been insufficient to maintain the ideal number of surgeons for the population.
The authors stated, that if anything, the projected shortage is an underestimate.
Dr. Ellison: “We have not considered the impact of the aging population on the surgeon’s workload…Patients 65 years and older are more likely to need general surgery services, and as that segment of the population increases, there will be a corresponding increase in the demands for general surgeons.”
Ellison also added, that because most general surgeons practice in metropolitan areas, the impact of the shortage will be more keenly felt by rural communities.
The researchers assumed, in calculating the projected shortage, that some young trainees would choose subspecialties like vascular or transplant surgery, instead of general surgery. They assumed, also, that general surgeons would work for 30 years before retiring.
Two possibilities can be reached from the findings of the study: one, it is possible that the researchers have over- or under-estimated how many general surgeons will enter the profession each year and how many years they will remain on the job; and two, it is also possible that population growth estimates might change again, altering the shortage projections.
Dr. Anupam Jena, a Harvard Medical School researcher and a physician at Massachusetts General Hospital said the following: “Because there are fixed high costs to developing a general surgical practice in a more remotely populated area, we observe fewer practices in these areas. I wouldn’t call this a shortage per se, but I do think it’s a problem that as a society we need to figure out solutions to.”
Dr. Jena was not part of the study. Two solutions offered by Dr. Jena, however, were identifying ways for rural patients who need surgical care to be promptly evaluated and treated at medical centers several hours away, or it might involve encouraging graduates of both American and foreign medical training programs to work in remote parts of the country.
I’ve discussed the projected shortage of physicians in the past, but this is the first time, a specific specialty of physicians has been studied for a projected shortage specifically. And as in the past, I have suggested that medical travel could alleviate the shortage, especially in workers’ compensation.
Either we follow the suggestions of Dr. Jena and others, or we consider looking abroad for the solution to a growing problem — a shortage of general surgeons.