The recent evolution of the breadth of practice for pediatric surgeons in the United States, 2005–2014

  • Daniel A. Reich
  • Katherine W. Herbst
  • Brendan T. Campbell
Original Article



Our objective was to determine if there was an association between subspecialist supply and a specific sub-set of procedures performed by pediatric surgeons over a 10-year period.


Data source was the Pediatric Health Information Systems database. Included were patients < 12 years who underwent one of nine outpatient surgical procedures between 1/1/2005 and 12/31/2014. Procedures were grouped into categories: pediatric surgery cases (PS), overlapping otolaryngology cases (OO), and overlapping urology cases (OU). Outcomes were number of cases performed by pediatric surgeons per pediatric surgeon, and proportion of cases performed by pediatric surgeons. Linear regression was used to test for association and temporal trends.


Included were 193,695 procedures, 18.9% PS, 4.8% OO, and 76.3% OU. There was a strong association between specialty supply and number of cases performed by pediatric surgeons. Temporally, there was no change in proportion of pediatric surgeons who performed PS cases (R2 = 0.08, p = 0.08), but a downward trend in proportion of OO (R2 = 0.82, p < 0.001) and OU cases. (R2 = 0.79; p < 0.001.)


We found an association between physician supply and pediatric surgeon case type, and a reduction in OO and OU cases performed by pediatric surgeons. These findings suggest a narrowing of case-mix for pediatric surgeons.


Pediatric surgery Pediatric urology Pediatric otolaryngology Workforce 



This study was not funded.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Daniel A. Reich
    • 1
  • Katherine W. Herbst
    • 2
  • Brendan T. Campbell
    • 1
  1. 1.Department of Pediatric SurgeryConnecticut Children’s Medical CenterHartfordUSA
  2. 2.Department of Pediatric Surgery/Department of ResearchConnecticut Children’s Medical CenterHartfordUSA

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