Trouble on the Horizon: An Evaluation of the General Surgeon Shortage in Rural and Frontier Counties

摘要

The number of general surgeons presently practicing in rural communities is critically low. Lynge et al. found that from 1981 to 2005, the rural surgeon to population ratio declined by 21 per cent. There are multiple factors that contribute to the apparent shortage of rural surgeons including declining numbers of medical students entering general surgery (GS) residencies and fewer residents choosing rural surgical practices. This could be due to lack of exposure to rural environments while in training or lack of adequate broad scope of training during residency. In addition, there is an increasing trend in surgical residency graduates to pursue fellowship training, which therefore reduces the number of graduates who will be seeking rural GS positions. The shortage is also only going to get worse based on demographics of rural versus urban surgeons. The rural general surgeon on average is older than their urban counterparts, so as surgeons reach retirement, rural hospitals will feel the impact the soonest. A list of all hospitals in the state of Kansas was generated using a simple internet search of public records. The county for each hospital was categorized based on the population density county peer groups as defined by the Kansas Department of Health and Environment. Only hospitals from nonurban population density county peer group counties (frontier, rural, or densely settled rural) were included. Hospital administrators were contacted by phone. Hospitals were excluded after three failed attempts.