Shortage of general surgeons is straining some facilities

The effects of this decline are most evident at trauma centers, urban emergency departments and rural hospitals.

By Myrle Croasdale, AMNews staff. June 2, 2008.

The number of general surgeons per 100,000 people fell 26% during the past 25 years, according to an April Archives of Surgery study.

Some hospitals are finding it difficult to locate general surgeons to repair hernias or abdominal traumas on an emergency basis, said Dana Christian Lynge, MD, lead study author.

"We know the system is somewhat strained in areas like urban emergency call and in some rural areas," said Dr. Lynge, associate professor of surgery at the University of Washington School of Medicine in Seattle.

One or two general surgeons can make or break a rural hospital, he said, because it relies on revenue from routine and emergency surgical procedures. Mortality and morbidity from trauma increases if there isn't a general surgeon available, he added.

Dr. Lynge and his co-authors found that the number of general surgeons dropped in both rural and urban areas. Overall, the number of general surgeons per 100,000 people fell to 5.69 in 2005 from 7.68 per 100,000 in 1981 in the U.S. The urban ratio of general surgeons per 100,000 fell to 5.85 from 8.04 during the same time, and the rural ratio sank to 5.02 from 6.36.

One reason for the decline is that many general surgical trainees choose to subspecialize, he said, referring to recent research that found 70% of general surgery residents pursued fellowships.

And while the U.S. population has grown, the amount of general surgical residency positions has stayed nearly unchanged, according to the study.