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Fewer general surgeons in U.S. - researchers

21 Apr 2008 20:00:29 GMT
Source: Reuters

CHICAGO, April 21 (Reuters) - The United States may be facing a shortage of general surgeons, even as a growing and aging population creates a rising need for their broad capabilities, researchers said on Monday.

There was a 26 percent decline in the number of practicing general surgeons per 100,000 Americans between 1981 and 2005, according to an analysis of data from the American Medical Association.

General surgeons can operate on any part of the body and are especially useful in emergencies involving multiple injuries.

"There is some question as to whether there will be an adequate number of general surgeons to care for an increasingly elderly population, with its attendant increased demand for surgical care," Dr. Dana Lynge of the University of Washington in Seattle, wrote in the Archives of Surgery.

The trend could cause a crisis in some rural areas where finding any type of surgeon can be difficult, Lynge wrote.

Fewer than one in five general surgeons practice in rural areas of the United States, and Lynge said they are aging faster than their urban counterparts and hospitals are having trouble finding replacements for them.

She said there is an understandable reluctance to face the pressures of being one of few doctors serving a wide area.

"The issue remains, however, of who will take general surgical call, particularly at night, for abdominal emergencies and trauma because some surgical subspecialists (though qualified as general surgeons) seek to avoid this burden, which is bound to increase as the population ages," she wrote.

The number of general surgeons dropped 4 percent during the study period to a 25-year low of 16,662 in 2005. Meanwhile, the U.S. population grew by 29 percent to 292 million. The researchers cited several possible factors for the trend.

There has been no increase since 1980 in the roughly 1,000 general surgeons trained to enter the profession each year and that number should be increased, Lynge wrote.

Of those trained to be surgeons, more than 70 percent later opt for lucrative surgical specialties that can be less demanding of their time. Also, health maintenance organizations that insure millions of Americans tend to employ fewer surgeons to cover more patients.

The number of active general surgeons fluctuated from 17,394 in 1981 to a peak of 17,922 in 2001. The proportion of women in the profession grew to 13 percent in 2005 from 1 percent in 1981.

In a sign the trend could worsen, only one in six general surgeons were younger than 40 in 2005, compared to one in four in 1981. (Reporting by Andrew Stern; editing by Maggie Fox and Todd Eastham)

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