A longitudinal analysis of the general surgery workforce in the United States, 1981-2005.
OBJECTIVE
The overall supply of general surgeons per 100 000 population has declined in the past 2 decades, and small and isolated rural areas of the United States continue to have relatively fewer general surgeons per 100 000 population than urban areas.


METHODS
Retrospective longitudinal analysis.


METHODS
Clinically active general surgeons in the United States.


METHODS
The American Medical Association's Physician Masterfiles from 1981, 1991, 2001, and 2005 were used to identify all clinically active general surgeons in the United States.


METHODS
Number of general surgeons per 100 000 population and the age, sex, and locale of these surgeons.


RESULTS
General surgeon to population ratios declined steadily across the study period, from 7.68 per 100 000 in 1981 to 5.69 per 100 000 in 2005. The overall urban ratio dropped from 8.04 to 5.85 (-27.24%) across the study period, and the overall rural ratio dropped from 6.36 to 5.02 (-21.07%). The average age of rural surgeons increased compared with their urban counterparts, and women were disproportionately concentrated in urban areas.


CONCLUSIONS
The overall number of general surgeons per 100 000 population has declined by 25.91% during the past 25 years. The decline has been most marked in urban areas. However, more remote rural areas continue to have significantly fewer general surgeons per 100 000 population. These findings have implications for training, recruiting, and retaining general surgeons.
Lynge
Dana Christian
DC
Department of Surgery, University of Washington, Seattle, USA. dlynge@u.washington.edu
Larson
Eric H
EH
Thompson
Matthew J
MJ
Rosenblatt
Roger A
RA
Hart
L Gary
LG
D000328:Adult; D005260:Female; D013502:General Surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000600:supply & distribution*; D012189:Retrospective Studies; D014481:United States; D000078329:Workforce