Policy Priorities to Improve Access, Equity, and Quality in Surgical Care: Advancing Innovative and Sustainable Solutions.

Abstract

Rural Americans face persistent challenges in accessing surgical care, including workforce shortages, infrastructure limitations, and geographic barriers. A 29% decline in the per capita supply of general surgeons from 2001 to 2019 raises concern about growing disparities. This article outlines policy priorities to strengthen rural surgical care through sustainable and practical solutions. Evidence from peer-reviewed studies, policy analyses, and federal initiatives was synthesized to identify actionable recommendations. Legislative proposals and health system strategies were reviewed for feasibility and potential impact on rural access and delivery of surgical care. Priority areas include strengthening the rural surgical workforce, supporting rural-focused medical education and training, sustaining hospital infrastructure, and expanding telehealth and broadband capacity. Policies that address insurance-related barriers, promote flexible care delivery models, and support appropriate use of clinical technologies are also needed. Collectively, these strategies aim to enhance access, improve coordination, and maintain essential surgical services in rural settings. Improving access to surgical care in rural America will require a coordinated set of policies that address workforce development, infrastructure stability, and care delivery innovation. Targeted, sustainable action at both federal and state levels is essential to ensure that rural communities receive consistent and high-quality surgical care.