Abstract
Background
Too few general surgeons practice in rural American communities, and many hospitals in the smallest rural areas do not have a surgeon. Therefore, it is likely that some small rural hospitals are using alternative arrangements to provide surgical care, including hiring locum tenens surgeons. We describe the degree to which small rural hospitals are using locum tenens surgeons to provide surgical services.
Methods
Administrators at 129 small rural hospitals were surveyed by telephone. The survey instrument was comprised of questions asking whether the hospital provides surgical services, if the hospital has recruited a surgeon, whether the hospital uses locum tenens surgeons and if so for what purposes.
Results
A total of 76% of surveyed rural hospitals have offered surgical services during the past 5 years. In all, 56% of hospitals providing surgical care have recruited a surgeon during the past 5 years. Of those who have been unsuccessful in their search, 30% have considered using a locum tenens surgeon, and 20% have done so.
Conclusions
Given the difficulty of recruiting surgeons to practice in rural America, it is critical to develop strategies to address this problem. Although using locum tenens surgeons may allow rural hospitals to offer surgical services, the quality of surgical care could be compromised. Other means for delivering surgical services at rural hospitals that cannot recruit or retain a surgeon should be explored to ensure that rural residents have access to high quality surgical care.
Similar content being viewed by others
References
Thompson MJ, Lynge DC, Larson EH et al (2005) Characterizing the general surgery workforce in rural America. Arch Surg 140:74–79
Carr KW, Worthington M, Rodney WM et al (1998) Advancing from flexible sigmoidoscopy to colonoscopy in rural family practice. Tenn Med 91:21–26
Finlayson SRG, Birkmeyer JD, Tosteson A et al (1999) Patient preferences for localization of care: implications for regionalization. Med Care 37:204–209
Kwakwa F, Jonasson O (1997) The general surgery workforce. Am J Surg 173:59–62
Jonasson O, Kwakwa F, Sheldon GF (1995) Calculating the workforce in general surgery. JAMA 274:731–734
Shively E, Shively SA (2005) Threats to rural surgery. Am J Surg 190:200–205
Brennan MF, Debas HT (2004) Surgical education in the United States: portents for change. Ann Surg 240:565–572
Heneghan S, Bordley JIV, Dietz P et al (2005) Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements. J Am Coll Surg 201:732–736
Landercasper J, Bintz M, Cogbill TH et al (1997) Spectrum of general surgery in rural America. Arch Surg 132:494–497
Ritchie WP, Rhodes RS, Biester TW (1999) Work loads and practice patterns of general surgeons in the United States, 1995–1997. Ann Surg 230:533–543
Glenn JK, Hicks LL, Daugird AJ et al (1988) Necessary conditions for supporting a general surgeon in rural areas. J Rural Health 4:85–100
Wright GE, Andrilla CH, Hart LG (2001) How many physicians can a rural community support? A practice income potential model for Washington State. WWAMI Rural Health Research Center, University of Washington School of Medicine, Department of Family Medicine. Working Paper #45
Anonymous (2008) WWAMI Rural Health Research Center. RUCA Data: Using RUCA. University of Washington, Seattle, WA. Available at: http://depts.washington.edu/uwruca/RUCACodeDes2.pdf. Accessed on January 25, 2008
Kronhaus AK (1981) An organized locum tenens service and the cost of free time for rural physicians. Med Care 19:1239–1246
Larsen LC, Derksen DJ, Garland JL, et al (1999) Academic models for practice relief, recruitment and retention at the University of New Mexico and East Carolina School of Medicine. Acad Med 74(Suppl):S136–S140
Acknowledgments
Funding for the Mithoefer Center for Rural Surgery and for this project was received from the Robert Keeler Foundation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Doty, B., Andres, M., Zuckerman, R. et al. Use of Locum Tenens Surgeons to Provide Surgical Care in Small Rural Hospitals. World J Surg 33, 228–232 (2009). https://doi.org/10.1007/s00268-008-9820-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-008-9820-5