CHICAGO (March 24, 2009) – New research published in the March issue of the Journal of the American College of Surgeons reveals shortages of qualified surgeons in many regions of Maryland, especially in rural areas. Excessive administrative demands and an aging physician and general population could push these shortages to critical levels over the next 10 years.
Over the past two decades, the American population has grown by approximately 50 million people, yet the number of practicing physicians has remained the same, at about 750,000. Medical education programs, limited by the 1997 Balanced Budget Act, have had their output capped at about 25,000 per year. Additionally, as the general population has aged, so has the physician population, with about one-third of physicians being 55 or older at the present time. The result of the growing physician shortage has been more crowded emergency departments, longer waiting times in doctors’ offices, and increasing difficulty finding physicians who will accept new patients.
In response to the growing concerns of patients, physicians and lawmakers in Maryland, the state’s governor requested that the Maryland Hospital Association and the State Medical Society of Maryland jointly sponsor the first comprehensive evaluation of the Maryland physician workforce. The study examined the demographics and clinical activities of surgeons in seven surgical specialties: general; orthopaedic; otolaryngology (head and neck surgery); vascular; noncardiac thoracic surgeons; neurosurgeons; and urologists.
“The findings of this study are emblematic of a national trend that has seen significant erosion in the number of doctors per capita,” said Scott E. Maizel, MD, FACS, a breast surgeon with the Greater Baltimore Medical Center. “Unless state and federal lawmakers address this issue soon, there will undoubtedly be a crisis in the access to surgical care for the residents of Maryland and beyond long before 2020.”
Clinical activity of surgeons versus their other obligations–administrative, teaching, research, and so on–was determined after interviews with medical directors at all 52 acute care hospitals in Maryland, as well as with some residency program directors and clinical department leaders. Data were stratified by specialty, location of practice and age of surgeon. After adjusting the baseline number of licensed surgeons in these specialties for those no longer practicing, those practicing out of state, or military and other government physicians, the number of licensed practicing surgeons in these specialties was 1,482, or approximately 60 percent of the number recorded by Maryland’s Board of Physicians.
The number of surgeons providing care to patients per 100,000 residents was below reported requirements in general surgery, vascular and non-cardiac specialties. Overall, 40.3 percent of the surgeons were 55 years or older in 2007. Additionally, the study showed that in some rural regions in Maryland, there were few, if any, surgical specialists, and the western region had no thoracic surgeons available and only one vascular surgeon. The greatest number of specialists practiced in major metropolitan areas, but many of these surgeons were the most actively engaged in nonclinical responsibilities, further reducing the number of surgeons available to care for patients.