The Evolving Surgeon Shortage in the Health Reform Era

Original Article


The evolving surgeon shortage is occurring at a time of societal change. For one of the first times in history, a scientific revolution is occurring while the organization of health care is also changing. With a demand for a more quality health care and a population that has both aged significantly and grown by ten million citizens each decade, the shortage of health care providers is problematic. For surgery, the shortage is particularly challenging. In 1981, 1047 surgeons were certified by the American Board of Surgery; in 2008, that number had dropped to just 909.


Surgeon shortage Health care Change 


  1. 1.
    Becker G. Longer life was the century’s greatest gift. Business Week. January 31, 2000;32.Google Scholar
  2. 2.
    Steinbrook R. Health care reform in Massachusetts—expanding coverage, escalating costs. N Engl J Med 2008;358:2757–2760.PubMedCrossRefGoogle Scholar
  3. 3.
    Cutler DM, Rosen AB, Vijan S. The value of medical spending in the United States, 1960–2000. N Engl J Med 2006;355:920–927.PubMedCrossRefGoogle Scholar
  4. 4.
    Center for Health Workforce Studies. University of Albany, March 2004., accessed May 13, 2009.
  5. 5.
    Jolly P. Characteristics of applicants who matched to their preferred specialty in the 2005 NRMP main residency match, July 2006. Available at Accessed May 13, 2009.
  6. 6.
    Report of the graduate medical education national advisory committee to the secretary of the department of the health and human services. Vol 1. GMENAC summary report. Washington DC: Government Printing Office, 1981.Google Scholar
  7. 7.
    Sheldon GF. Surgical workforce since the 1975 study of surgical services in the United States. Ann Surg 2007; 246:541–545.PubMedCrossRefGoogle Scholar
  8. 8.
    Donaldson M, Yordy K, Vanselow N, eds. Defining primary care: an interim report. Washington DC: National Academy Press, 1992.Google Scholar
  9. 9.
    Schoen C, Osborn R, Huynh PT, Doty M, Peugh J, Zapert K. On the front lines of care: primary care doctors’ office systems, experiences, and views in seven countries. Health Aff (Millwood) 2006;25:w555–571.CrossRefGoogle Scholar
  10. 10.
    Croasdale M. Advanced-practice nurses seek wider scope in 24 states (American College of Physicians Annual Meeting). AMA News. April 21, 2008;1–2.Google Scholar
  11. 11.
    Landers SJ. Consolidating Care. AMA News. June 16, 2008, vol 51, no 23, p 19–20.Google Scholar
  12. 12.
    Holmes GM, Slifkin RT, Randolph RK, Poley S. Underserved populations: the effect of rural hospital closures on community economic health. Health Serv Res 2006; 41:467–485.PubMedCrossRefGoogle Scholar
  13. 13.
    Leading causes of death. National Center for Health Statistics. December 2009.Google Scholar
  14. 14.
    Lynge DC, Larson EH, Thompson MJ, Rosenblatt RA, Hart LG. A longitudinal analysis of the general surgery work force in the United States, 1981–2005. Arch Surg 2008; 143:345–350.PubMedCrossRefGoogle Scholar
  15. 15.
    Fischer JE, The impending disappearance of the general surgeon. JAMA 2007;298:2191–2193.PubMedCrossRefGoogle Scholar
  16. 16.
    Mullan F. N Engl J Med 2005;353:1810–1818.PubMedCrossRefGoogle Scholar
  17. 17.
    American Hospital Association. Special Workforce Survey, 2001. Accessed May 13, 2009 at
  18. 18.
    World Health Organization. Accessed May 13, 2009 at
  19. 19.
    Longitudinal trends in the U.S. surgical workforce 1981–2006 L overall growth has stalled; general surgery supply contracting. May 2009, Issue 1. (data from the American College of Surgeons Health Policy Research Institute and the Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina).Google Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  1. 1.Department of Surgery and Social MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.American College of Surgeons Health Policy Research Institute, Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA

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