Midwest and Northeast May Face Surgeon Shortage

Specialists are concentrating in areas with high doctor/patient ratios, experts say

THURSDAY, March 26, 2009 (HealthDay News) -- Certain rural and urban areas of the United States may soon face shortages of access to surgical care, especially for underserved and aging populations, a new study warns.

Researchers found that surgeons are moving to areas with already established medical communities, a trend that could lead to shortages in some local areas, particularly in the Northeast and Midwest. Though the federal government offers incentives to persuade primary care doctors to practice in underserved areas, no such program exists for general surgeons.

"Our data shows that, over the past decade, surgeons moved more frequently than all other physicians and tended to relocate to areas with higher concentrations of established physicians," Thomas C. Ricketts, co-director of the Health Policy Institute of the American College of Surgeons and a University of North Carolina professor, said in a news release from the surgeons' group. "This is the opposite of that seen for physicians in general, who were more likely to move to areas with less competition. If this trend continues, the need for surgeons in rural and urban underserved areas, especially in the Northeast and Midwest, may increase significantly."

An analysis of data gathered in prior studies revealed that more than 32 percent of the 94,630 physicians who were established surgeons in clinical practice between 1996 and 2006 moved to another county during that time period. Other data showed that about 27 percent of all physicians moved in a 10-year period.

The average distance of surgeons' moves was 593 miles. Interstate moves were largely from the Northeast and parts of the Midwest to the South and West. Surgeons tended to move to counties with a slightly higher ratio of total physicians to population, counties that are slightly less densely populated, counties that are three times more likely to be more rural than the county they left, and counties with lower income levels, a lower proportion of Hispanic residents, a lower unemployment rate and lower poverty than the county they left.

The likelihood of moving varied by surgical subspecialty. More than half of surgical critical care practitioners moved. Thoracic and neurological surgeons were more likely to move (41 percent and 38 percent) than urologists and ophthalmologists (27 percent and 26 percent). The study also found that older surgeons moved farther. For each additional year of age, the distance increased by eight miles.

The findings were shared during a March 24 panel discussion organized by Operation Patient Access, a campaign formed by surgical groups and others involved in health care.

More information

The American College of Surgeons explains how to find a qualified surgeon.

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