Regional Population-Based Workforce Shortages in General Surgery by Practicing Surgeon and Resident Trainee

Abstract

Background The physician shortage in the United States (US) continues to become more apparent. We aimed to evaluate the relationship between the US physician distribution from 2012-2019 by specialty at the state/regional level relative to the corresponding population growth. Methods US matched residents and practicing physicians from 2012-2019 were extracted from the National Resident Matching Program and Association of American Medical College databases, respectively. Residents and practicing physicians were divided by geographic regions (West, Midwest, South, Northeast), states, and specialties (anesthesiology, emergency medicine, family medicine, general surgery (GS), internal medicine, obstetrics/gynecology and pediatrics). Results Entering residents and physicians increased across 7 specialties from 2012-2019 with the exception of GS, which showed .2% decrease in practicing physicians. GS experienced decreases in entering residents in all US regions except the South. All specialties showed a decrease in the people-per-physician (PPP) except GS and pediatrics, which had a 4.1% and 71.3% increase, respectively. EM showed the largest growth overall, both in entering residents and overall workforce. Conclusion GS experienced slow growth of residents, decreases in practicing physicians and workforce overall, and an increase in PPP from 2012-2019. Our findings suggest that current population growth rate is exceeding the rate of physicians entering the field of GS and highlights the need for interventions to promote the recruitment of GS residents and retainment of attending physicians, particularly for rural areas. Future research to measure surgeon distribution in relation to patient outcomes and the efficacy of recent policy to address shortages can help define additional interventions to address physician shortages moving forward.

Regional Differences in Primary Total Knee Arthroplasty Utilization, Physician Reimbursement, and Patient Characteristics

“…However, even between 2013 and 2019, TKA utilization increased at the slowest rate in the West. Previous studies have identified the West to have the greatest physician shortage which may be manifesting as an inability to keep up with TKA demand [ 24 , 25 ]. This hypothesis is supported by the fact that despite a decrease in TKA utilization, the number of TKAs per surgeon increased by over 10% in the West, which was a greater rate of increase than the Midwest and South.…”

Comparison of active versus passive robotic-endoscope-holder-assisted unisurgeon uniportal thoracoscopic surgery in terms of surgical efficacy and patient safety

“…Staff requirements may be more flexible for a simple procedure than for a relatively complex procedure. In Taiwan and some other area, increasing concerns have been reported regarding the regulation of residents’ work hours ( 19 ); the decline in the number of residency applications to surgical departments has resulted in a shortage of efficient staff ( 20 - 22 ). Hence, the introduction of robotic arms to replace manpower is a direction worth considering.…”