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Erschienen in: Journal of Gastrointestinal Surgery 12/2014

01.12.2014 | Original Article

Workforce Shortage for General Surgeons: Results from the Society for Surgery of the Alimentary Track (SSAT) Surgeon Shortage Survey

verfasst von: KMarie Reid-Lombardo, Charity Celeste Glass, Stuart G. Marcus, Juliette Liesinger, Daniel B. Jones, the Public Policy and Advocacy Committee of the SSAT

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 12/2014

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Abstract

Background

Population shifts among surgeons and the general populous will contribute to a predicted general surgeon shortage by 2020. The Public Policy and Advocacy Committee of the Society for Surgery of the Alimentary Tract designed and conducted a survey to assess perceptions and possible solutions from important stakeholders: practicing surgeons of the society, general surgery residents, and medical students.

Results

Responses from 1,208 participants: 658 practicing surgeons, 183 general surgery residents, and 367 medical students, were analyzed. There was a strong perception of a current and future surgeon shortage. The majority of surgeons (59.3 %) and residents (64.5 %) perceived a current general surgeon shortage, while 28.6 % of medical students responded the same. When asked of a perceived general surgery shortage in 20 years, 82.4, 81.4, and 51 % said “yes”, respectively. There were generational differences in responses to contributors and solutions for the impending shortage. Surgeons placed a high value on improving reimbursement, tort reform, and surgeon burnout, while residents held a strong interest in a national loan forgiveness program and improving lifestyle barriers.

Conclusion

Our survey offers insight into possible solutions to ward off a surgeon shortage that should be addressed with programmatic changes in residency training and by reform of the national health care system.
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1
SSAT Public Policy Committee, 2011–2012: Daniel B. Jones, M.D., M.S. Chair; KMarie Reid Lombardo, M.D., M.S, Co-Chair; David Bentrem, M.D.; Ross F. Goldberg, M.D.; Peter T. Hallowell, M.D.; Johnathan R. Hiatt, M.D.; Tara S. Kent, M.D., M.S.; Stuart G. Marcus, M.D.; Fabrizio Michelassi, M.D., ex-officio; Marek Rudnicki, M.D.; Shean Satgunam, M.D.; Thomas Schnelldorfer, M.D.; Richard Smith, M.D.
 
Literatur
1.
Zurück zum Zitat Williams, T.E., Jr. and E.C. Ellison, Population analysis predicts a future critical shortage of general surgeons. Surgery, 2008. 144(4): p. 548–54; discussion 554–6.PubMedCrossRef Williams, T.E., Jr. and E.C. Ellison, Population analysis predicts a future critical shortage of general surgeons. Surgery, 2008. 144(4): p. 548–54; discussion 554–6.PubMedCrossRef
2.
Zurück zum Zitat Williams, T.E., Jr., B. Satiani, and E.C. Ellison, A comparison of future recruitment needs in urban and rural hospitals: the rural imperative. Surgery, 2011. 150(4): p. 617–25.PubMedCrossRef Williams, T.E., Jr., B. Satiani, and E.C. Ellison, A comparison of future recruitment needs in urban and rural hospitals: the rural imperative. Surgery, 2011. 150(4): p. 617–25.PubMedCrossRef
3.
Zurück zum Zitat Health Resources and Services Administration, Physician Supply and Demand: Projections to 2020. 2006. Health Resources and Services Administration, Physician Supply and Demand: Projections to 2020. 2006.
4.
Zurück zum Zitat Fischer, J., The impending disappearance of the general surgeon. JAMA, 2007. 298(18): p. 2191–2193.PubMedCrossRef Fischer, J., The impending disappearance of the general surgeon. JAMA, 2007. 298(18): p. 2191–2193.PubMedCrossRef
5.
Zurück zum Zitat Sheldon, G.F., Access to care and the surgeon shortage: American Surgical Association forum. Annals of Surgery, 2010. 252(4): p. 582–90.PubMed Sheldon, G.F., Access to care and the surgeon shortage: American Surgical Association forum. Annals of Surgery, 2010. 252(4): p. 582–90.PubMed
7.
Zurück zum Zitat Executive Office of the President of the United States, The Economic Case for Health Care Reform, Executive Office of the President Council of Economic Advisers, Editor 2009: Washington D.C. Executive Office of the President of the United States, The Economic Case for Health Care Reform, Executive Office of the President Council of Economic Advisers, Editor 2009: Washington D.C.
8.
Zurück zum Zitat United States Senate and House of Representatives. 105th Congress. H.R. 2015; Pages: 111, STAT. 251, Public Law 105-33: An Act to provide for reconciliation pursuant to subsections (b)(1) and (c) of section 105 of the concurrent resolution on the budget for fiscal year 1998. Short title: The Balanced Budget Act of 1997. Washington: Government Printing Office, 1997. http://www.gpo.gov/fdsys/pkg/PLAW-105publ33/html/PLAW-105publ33.htm. Accessed 24 Apr 2014 United States Senate and House of Representatives. 105th Congress. H.R. 2015; Pages: 111, STAT. 251, Public Law 105-33: An Act to provide for reconciliation pursuant to subsections (b)(1) and (c) of section 105 of the concurrent resolution on the budget for fiscal year 1998. Short title: The Balanced Budget Act of 1997. Washington: Government Printing Office, 1997. http://​www.​gpo.​gov/​fdsys/​pkg/​PLAW-105publ33/​html/​PLAW-105publ33.​htm. Accessed 24 Apr 2014
9.
Zurück zum Zitat Program for uninsured cuts ED visits, admissions. Hospital Case Management, 2012. 20(10): p. 154–5. Program for uninsured cuts ED visits, admissions. Hospital Case Management, 2012. 20(10): p. 154–5.
10.
Zurück zum Zitat DeHaven, M., et al., The effects of a community-based partnership, Project Access Dallas (PAD), on emergency department utilization and costs among the uninsured. Journal of Public Health, 2012. 34(4): p. 577–83.PubMedCrossRef DeHaven, M., et al., The effects of a community-based partnership, Project Access Dallas (PAD), on emergency department utilization and costs among the uninsured. Journal of Public Health, 2012. 34(4): p. 577–83.PubMedCrossRef
11.
Zurück zum Zitat Henningsen, J.A., Why the numbers are dropping in general surgery: the answer no one wants to hear–lifestyle! Archives of Surgery, 2002. 137(3): p. 255–6.PubMedCrossRef Henningsen, J.A., Why the numbers are dropping in general surgery: the answer no one wants to hear–lifestyle! Archives of Surgery, 2002. 137(3): p. 255–6.PubMedCrossRef
12.
Zurück zum Zitat Borman, K.R., et al., Changing demographics of residents choosing fellowships: longterm data from the American Board of Surgery. Journal of the American College of Surgeons, 2008. 206(5): p. 782–8; discussion 788–9.PubMedCrossRef Borman, K.R., et al., Changing demographics of residents choosing fellowships: longterm data from the American Board of Surgery. Journal of the American College of Surgeons, 2008. 206(5): p. 782–8; discussion 788–9.PubMedCrossRef
14.
Zurück zum Zitat American Association of Colleges of Osteopathic Medicine, 2011–2012 Osteopathic Medical College Total Enrollment, by State of Legal Residence, American Association of Colleges of Osteopathic Medicine, Editor 2012: Chevy Chase, MD. American Association of Colleges of Osteopathic Medicine, 2011–2012 Osteopathic Medical College Total Enrollment, by State of Legal Residence, American Association of Colleges of Osteopathic Medicine, Editor 2012: Chevy Chase, MD.
15.
Zurück zum Zitat Charles, A.G., et al., Increasing the number of trainees in general surgery residencies: is there capacity? Academic Medicine, 2011. 86(5): p. 599–604.PubMedCrossRef Charles, A.G., et al., Increasing the number of trainees in general surgery residencies: is there capacity? Academic Medicine, 2011. 86(5): p. 599–604.PubMedCrossRef
16.
Zurück zum Zitat Youngclaus, J. and J. Fresne, Physician Education Debt and the Cost to Attend Medical School, 2013, Association of American Medical Colleges. Youngclaus, J. and J. Fresne, Physician Education Debt and the Cost to Attend Medical School, 2013, Association of American Medical Colleges.
17.
Zurück zum Zitat Work, S.C.S.f.S. National Health Service Corporation—State Loan Repayment Program. 2014. Work, S.C.S.f.S. National Health Service Corporation—State Loan Repayment Program. 2014.
18.
Zurück zum Zitat Akl, E.A., et al., The United States physician workforce and international medical graduates: trends and characteristics. Journal of General Internal Medicine, 2007. 22(2): p. 264–8.PubMedCentralPubMedCrossRef Akl, E.A., et al., The United States physician workforce and international medical graduates: trends and characteristics. Journal of General Internal Medicine, 2007. 22(2): p. 264–8.PubMedCentralPubMedCrossRef
19.
Zurück zum Zitat Council on Graduate Medical Education, Summary of Third Report: Improving Access to Health Care Through Physician Workforce Reform: Directions for the 21st Century Council on Graduate Medical Education 1992, U.S. Department of Health and Human Services: Washington DC Council on Graduate Medical Education, Summary of Third Report: Improving Access to Health Care Through Physician Workforce Reform: Directions for the 21st Century Council on Graduate Medical Education 1992, U.S. Department of Health and Human Services: Washington DC
20.
Zurück zum Zitat Mitchell, D. and S. Lassiter, Addressing health care disparities and increasing workforce diversity: the next step for dental, medical, and public health professions. American Journal of Public Health, 2006. 96(12): p. 2093–2097.PubMedCentralPubMedCrossRef Mitchell, D. and S. Lassiter, Addressing health care disparities and increasing workforce diversity: the next step for dental, medical, and public health professions. American Journal of Public Health, 2006. 96(12): p. 2093–2097.PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Armstrong, K., et al., Prior experiences of racial discrimination and racial differences in health care system distrust. Med Care, 2013. 51(2): p. 144–150.PubMedCentralPubMedCrossRef Armstrong, K., et al., Prior experiences of racial discrimination and racial differences in health care system distrust. Med Care, 2013. 51(2): p. 144–150.PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Norris, K., et al., Historically black medical schools: addressing the minority health professional pipeline and the public mission of care for vulnerable populations. Journal of the National Medical Association, 2009. 101(9): p. 864–872.PubMedCentralPubMed Norris, K., et al., Historically black medical schools: addressing the minority health professional pipeline and the public mission of care for vulnerable populations. Journal of the National Medical Association, 2009. 101(9): p. 864–872.PubMedCentralPubMed
23.
Zurück zum Zitat Stewart, R.M., et al., Tort reform is associated with more medical board complaints and disciplinary actions. Journal of the American College of Surgeons, 2012. 214(4): p. 567–71; discussion 572–3.PubMedCrossRef Stewart, R.M., et al., Tort reform is associated with more medical board complaints and disciplinary actions. Journal of the American College of Surgeons, 2012. 214(4): p. 567–71; discussion 572–3.PubMedCrossRef
24.
Zurück zum Zitat Stewart, R.M., et al., Malpractice Risk and Cost Are Significantly Reduced after Tort Reform. Journal of the American College of Surgeons, 2011. 212(4): p. 463–467.e42.PubMedCrossRef Stewart, R.M., et al., Malpractice Risk and Cost Are Significantly Reduced after Tort Reform. Journal of the American College of Surgeons, 2011. 212(4): p. 463–467.e42.PubMedCrossRef
25.
Zurück zum Zitat Glass, C., et al., American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment. American Journal of Surgery, 2014. 207(2): p. 165–169.PubMedCrossRef Glass, C., et al., American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment. American Journal of Surgery, 2014. 207(2): p. 165–169.PubMedCrossRef
27.
Zurück zum Zitat Deslich, S. and A. Coustasse, Expanding technology in the ICU: the case for the utilization of telemedicine. Telemed J E Health, 2014. 20(5): p. 485–92PubMedCrossRef Deslich, S. and A. Coustasse, Expanding technology in the ICU: the case for the utilization of telemedicine. Telemed J E Health, 2014. 20(5): p. 485–92PubMedCrossRef
28.
Zurück zum Zitat Reynolds, E., et al., Utilization of robotic “remote presence” technology within North American intensive care units. Telemed J E Health, 2012. 18(7): p. 507–515.PubMedCrossRef Reynolds, E., et al., Utilization of robotic “remote presence” technology within North American intensive care units. Telemed J E Health, 2012. 18(7): p. 507–515.PubMedCrossRef
29.
Zurück zum Zitat Marcin, J., et al., Use of telemedicine to provide pediatric critical care inpatient consultations to underserved rural Northern California. J Pediatr, 2004. 144(3): p. 375–380.PubMedCrossRef Marcin, J., et al., Use of telemedicine to provide pediatric critical care inpatient consultations to underserved rural Northern California. J Pediatr, 2004. 144(3): p. 375–380.PubMedCrossRef
30.
Zurück zum Zitat Davis, L., et al., Teleneurology: Successful delivery of chronic neurologic care to 354 patients living remotely in a rural state. Telemed J E Health, 2014. 20(5): p.473–7. Davis, L., et al., Teleneurology: Successful delivery of chronic neurologic care to 354 patients living remotely in a rural state. Telemed J E Health, 2014. 20(5): p.473–7.
31.
Zurück zum Zitat Goldberg, R., et al., Will there be a good general surgeon when you need one? J Gastrointest Surg, 2013. 18(5): p. 1032–9.PubMedCrossRef Goldberg, R., et al., Will there be a good general surgeon when you need one? J Gastrointest Surg, 2013. 18(5): p. 1032–9.PubMedCrossRef
34.
Zurück zum Zitat United States Senate and House of Representatives. 110th Congress. S. 2499; Pages: 121, STAT. 2942, Public Law 110-173: An act to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. Short title: Medicare, Medicaid, and SCHIP Extension Act of 2007. Washington: Government Printing Office, 2007. http://www.gpo.gov/fdsys/pkg/PLAW-110publ173/html/PLAW-110publ173.htm. Accessed 24 Apr 2014 United States Senate and House of Representatives. 110th Congress. S. 2499; Pages: 121, STAT. 2942, Public Law 110-173: An act to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. Short title: Medicare, Medicaid, and SCHIP Extension Act of 2007. Washington: Government Printing Office, 2007. http://​www.​gpo.​gov/​fdsys/​pkg/​PLAW-110publ173/​html/​PLAW-110publ173.​htm. Accessed 24 Apr 2014
35.
Zurück zum Zitat United States Senate and House of Representatives. 110th Congress. H.R. 6331; Pages: 122, STAT. 2494, Public Law 110-275: An Act to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. Short title: Medicare Improvements for Patients and Providers Act of 2008. Washington: Government Printing Office, 2008. http://www.gpo.gov/fdsys/pkg/PLAW-110publ275/pdf/PLAW-110publ275.pdf. Accessed 24 Apr 2014 United States Senate and House of Representatives. 110th Congress. H.R. 6331; Pages: 122, STAT. 2494, Public Law 110-275: An Act to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. Short title: Medicare Improvements for Patients and Providers Act of 2008. Washington: Government Printing Office, 2008. http://​www.​gpo.​gov/​fdsys/​pkg/​PLAW-110publ275/​pdf/​PLAW-110publ275.​pdf. Accessed 24 Apr 2014
36.
Zurück zum Zitat United States Senate and House of Representatives. 111th Congress. H.R. 4691; Pages: 124, STAT. 42, Public Law 111-144: An Act to provide a temporary extension of certain programs, and for other purposes. Short title: Public Law 111-144: An Act to provide a temporary extension of certain programs, and for other purposes. Washington: Government Printing Office, 2010. http://www.copyright.gov/legislation/pl111-144.pdf. Accessed 24 Apr 2014 United States Senate and House of Representatives. 111th Congress. H.R. 4691; Pages: 124, STAT. 42, Public Law 111-144: An Act to provide a temporary extension of certain programs, and for other purposes. Short title: Public Law 111-144: An Act to provide a temporary extension of certain programs, and for other purposes. Washington: Government Printing Office, 2010. http://​www.​copyright.​gov/​legislation/​pl111-144.​pdf. Accessed 24 Apr 2014
37.
Zurück zum Zitat United States Senate and House of Representatives. 111th Congress, 2D Session. H.R. 4851 Amendment; Pages: 124, STAT. 1116, Public Law 111-157: An Act to suspend the Rules and Pass the Bill, H.R. 4851 “To provide a temporary extension of certain programs, and for other purposes”, with An Amendment. Short title: Continuing Extensions Act of 2010. Washington: Government Printing Office, 2010. http://npl.ly.gov.tw/pdf/7208.pdf. Accessed 24 Apr 2014 United States Senate and House of Representatives. 111th Congress, 2D Session. H.R. 4851 Amendment; Pages: 124, STAT. 1116, Public Law 111-157: An Act to suspend the Rules and Pass the Bill, H.R. 4851 “To provide a temporary extension of certain programs, and for other purposes”, with An Amendment. Short title: Continuing Extensions Act of 2010. Washington: Government Printing Office, 2010. http://​npl.​ly.​gov.​tw/​pdf/​7208.​pdf. Accessed 24 Apr 2014
38.
Zurück zum Zitat United States Senate and House of Representatives. 111th Congress. H.R. 3962; Pages: 124, STAT. 1280, Public Law 111-192: An act to provide a physician payment update, to provide pension funding relief, and for other purposes. Short title: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010. Washington: Government Printing Office, 2010. http://www.gpo.gov/fdsys/pkg/PLAW-111publ192/html/PLAW-111publ192.htm. Accessed 24 Apr 2014 United States Senate and House of Representatives. 111th Congress. H.R. 3962; Pages: 124, STAT. 1280, Public Law 111-192: An act to provide a physician payment update, to provide pension funding relief, and for other purposes. Short title: Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010. Washington: Government Printing Office, 2010. http://​www.​gpo.​gov/​fdsys/​pkg/​PLAW-111publ192/​html/​PLAW-111publ192.​htm. Accessed 24 Apr 2014
41.
Zurück zum Zitat United States Senate and House of Representatives. 112th Congress. H.R. 8; Pages: 126, STAT. 2313, Public Law 112-240: An Act to extend certain tax relief provisions enacted in 2001 and 2003, and to provide for expedited consideration of a bill providing for comprehensive tax reform, and for other purposes. Short title: American Taxpayer Relief Act of 2012. Washington: Government Printing Office, 2013. http://www.gpo.gov/fdsys/pkg/BILLS-112hr8eas/pdf/BILLS-112hr8eas.pdf. Accessed 24 Apr 2014 United States Senate and House of Representatives. 112th Congress. H.R. 8; Pages: 126, STAT. 2313, Public Law 112-240: An Act to extend certain tax relief provisions enacted in 2001 and 2003, and to provide for expedited consideration of a bill providing for comprehensive tax reform, and for other purposes. Short title: American Taxpayer Relief Act of 2012. Washington: Government Printing Office, 2013. http://​www.​gpo.​gov/​fdsys/​pkg/​BILLS-112hr8eas/​pdf/​BILLS-112hr8eas.​pdf. Accessed 24 Apr 2014
42.
Zurück zum Zitat United States Senate and House of Representatives. 113th Congress. H.R. 4302; Pages: Public Law 113-93: An Act to amend the Social Security Act to extend Medicare payments to physicians and other provisions of the Medicare and Medicaid programs, and for other purposes. Short title: Protecting Access to Medicare Act of 2014. Washington: Government Printing Office, 2014. http://beta.congress.gov//bill/113th-congress/house-bill/4302/text. Accessed 24 Apr 2014 United States Senate and House of Representatives. 113th Congress. H.R. 4302; Pages: Public Law 113-93: An Act to amend the Social Security Act to extend Medicare payments to physicians and other provisions of the Medicare and Medicaid programs, and for other purposes. Short title: Protecting Access to Medicare Act of 2014. Washington: Government Printing Office, 2014. http://​beta.​congress.​gov/​/​bill/​113th-congress/​house-bill/​4302/​text. Accessed 24 Apr 2014
Metadaten
Titel
Workforce Shortage for General Surgeons: Results from the Society for Surgery of the Alimentary Track (SSAT) Surgeon Shortage Survey
verfasst von
KMarie Reid-Lombardo
Charity Celeste Glass
Stuart G. Marcus
Juliette Liesinger
Daniel B. Jones
the Public Policy and Advocacy Committee of the SSAT
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 12/2014
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-014-2636-8

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