Severe surgeon shortage on the horizon, study says

In less than two years, there may not be enough surgeons in U.S. hospitals to treat the critically injured or chronically ill.

A new study suggests that the number of available general surgeons, who often perform life-saving operations on patients in emergency rooms, will not keep up with public demand. As the population continues to grow, there will be a shortage of 1,300 general surgeons in 2010. That shortage will worsen each decade, reaching a deficit of 6,000 by 2050.

That means people will have to wait longer for emergency treatment and for elective general surgery, said Thomas E. Williams, co-author of the study and clinical associate professor of surgery at Ohio State University.

The overwhelming costs of obtaining a medical degree are a large deterrent for many young students, despite scholarships and financial aid. The cost of obtaining a medical degree leaves many students with $125,000 to $150,000 in debt after completing medical school.

"People may wait hours in an emergency room if there is a shortage of surgeons. But the problem is that if you're not operated on within a few hours, your disease progresses and that can create more serious problems in other areas of the body. These are problems that you would not have had with prompt surgical attention," said Williams, who is also a retired thoracic and cardiac surgeon.

In emergency rooms, general surgeons are called upon to determine whether or not to operate on a patient. But an increasing number of medical professionals choose to specialize in other fields such as cardiac or orthopedic surgery. So the shortage of general surgeons will directly impact emergency rooms around the country.

The projections were made based on data from the U.S. Census Bureau and The American Board of Surgery.

The shortage was calculated by taking the difference between the number of retiring surgeons and those entering the workforce. This number is then compared to the expected need for general surgeons. Previous research has shown that 7.53 general surgeons are needed for every 100,000 people to keep the current level of care.

There are about 21,500 general surgeons practicing in the United States today. Each surgeon practices for an estimated 30 years and about 705 surgeons die or leave the workforce every year for personal reasons or retirement.

Meanwhile, nearly 1,000 new surgeons enter the workforce each year. But of that number, only 850 will practice general surgery. After accounting for retiring surgeons, that means only 145 new general surgeons will enter the workforce annually, far less than is needed given the continuous rise in the population.

But some authorities have suggested that as many as 600 of these 1000 surgeons are entering other surgical specialties each year, creating an even larger shortage of general surgeons than the current study projects.

"Many doctors today want to specialize in areas such as vascular, colon, or thoracic surgery. They'll train for one or two more years beyond general surgical residency so they have more professional expertise, and probably won't take the general surgery calls in emergency rooms," Williams said.

Williams estimates that it will cost $62.5 million per year ($750 million total) to train the additional 1,875 general surgeons needed by 2020. Despite recent attempts to increase the number of medical students and establish new medical schools, there are several barriers standing in the way.

Attracting students to the medical field is a growing problem, Williams said. The overwhelming costs of obtaining a medical degree are a large deterrent for many young students, despite scholarships and financial aid. The cost of obtaining a medical degree leaves many students with $125,000 to $150,000 in debt after completing medical school.

In addition, students required to train as residents are often underpaid for their work, Williams said. The average resident earns between $40,000 and $45,000 per year for three to seven years before they are board-certified. Compare that to the average salary of a first-year associate at a New York law firm, who will earn $150,000 to $200,000 per year.

"What we need to do is make this profession more attractive through programs to help reduce costs and arranging the 80 hour work weeks to more manageable schedules," Williams said. "Without these changes, we simply won't keep up with the increasing demand."