Number of general surgeons in U.S. declined by 26% since 1981

The ratio of practicing general surgeons to patients in the U.S. declined by 26% between 1981 and 2005, according to an analysis published Monday in the Archives of Surgery, Reuters reports.

For the analysis, Dana Lynge, a general surgeon at the University of Washington in Seattle, and a team of researchers examined data from the American Medical Association. Researchers found that the number of general surgeons declined by 4% overall, while the U.S. population increased by 29% to 292 million from 1981 to 2005. The analysis also found that the number of general surgeons who enter the field each year -- about 1,000 -- remained steady during that time period (Stern, Reuters, 4/21). According to the analysis, there were 17,394 general surgeons in the U.S. in 1981, or 7.68 per 100,000 patients, compared with 16,662 general surgeons in 2005, or 5.69 per 100,000 patients (Shelton, Orlando Sentinel, 4/22).

The analysis also found that in 2005, one of every six general surgeons was age 40 or younger, compared with one of every four in 1981, which is a "sign that the trend could worsen," according to Reuters (Reuters, 4/21).

The Sentinel reports that the trend is part of an overarching shift in medicine from general to specialty fields. According to Lynge, younger doctors place more value on their personal lives, making fields that require frequent and less-predictable duties -- like general surgery -- less attractive. In addition, many medical students finish school with a "mountain of debt," and by necessity they search for higher-paying fields, Lynge said.

"If you're a plastic surgeon, there aren't a lot of emergencies and you're paid up front," Lynge said, adding, "You're not likely to be up all night working. It's very different from a rural general surgeon who might be on call 24/7 or every other night" (Orlando Sentinel, 4/22).

An abstract of the analysis is available online.

CABG Surgery Study

The Archives of Surgery this month also published a study that found the rate of in-hospital deaths after coronary artery bypass graft surgery has declined since 1997, and the proportion of the procedures performed at low-volume centers increased, Reuters Health reports. For the study, Rocco Ricciardi of the Lahey Clinic in Burlington, Mass., and colleagues analyzed a random sample of discharge records for patients at U.S. hospitals. The analysis found that overall mortality rates for the procedure declined from 5.4% to 3.3% from 1997 to 2003. Hospitals performing the lowest volume of CABG surgeries had the greatest improvements in survival, according to the analysis. The analysis found that the number of high-volume centers decreased in recent years, while the number of low-volume centers increased.

Pervious studies had shown that CABG surgery outcomes are better when performed in hospitals that perform a high volume of the procedure, but the new research "should dampen enthusiasm for regionalization of CABG care based solely on volume," Ricciardi said (Reuters Health, 4/21).

An abstract of the study is available online.