Supply, Distribution, and Aging of the General Surgeon Workforce by Rurality and Over Time: A National Observational Study.

Abstract

The purpose of this study is to estimate differences in the supply of general surgeons by age group and rurality and model potential impending shortages, with an emphasis on surgeons reaching and above the traditional retirement age. The healthcare workforce at large is experiencing shortages and impending retirements, which are especially prominent in rural communities and have implications for access to care. General surgeons play a vital role in a robust health care system, yet there is limited updated evidence on their supply, distribution, and aging across the U.S. This repeated, cross-sectional study uses county-level data to describe the supply of general surgeons by metropolitan status from 2010 to 2020. Analyses include descriptive and bivariate comparisons of general surgeon staffing levels by county metropolitan status. In aggregate, 16.5% of all general surgeons are ages 65 and above. At the county-level, a significantly greater portion of general surgeons in nonmetropolitan counties are older, with 28.1% of surgeons ages 65 and over compared to 20.2% in metropolitan areas. In contrast, a significantly greater proportion of surgeons in metropolitan counties are younger compared to nonmetropolitan counties. A significantly greater share of rural general surgeons is above the traditional age of retirement, and there is an insufficient amount of younger surgeons to replace them. These findings may inform potential future shortage areas, with 60% of practicing general surgeons in nonmetropolitan areas to reach or exceed retirement age within the next decade. Findings from this study may better inform efforts to train, recruit, and retain surgeons in rural areas.