title: Maintaining a surgery service for local hospitals under the situation of a decreasing number of surgeons in a region of Japan.
abstract: BACKGROUND
  The number of surgeons is decreasing in Japan, leading to the problem of how to maintain a surgery service in local hospitals. We introduce our strategy for supporting ongoing surgical services in regional hospitals by dispatching surgeons temporarily to assist in operations.
  
  
  METHODS
  We conducted a questionnaire-based survey at three local hospitals in Tottori and a neighboring prefecture to which surgeons from our department were temporarily dispatched over 5 years from January 2008 to March 2013.
  
  
  RESULTS
  We supported 686 operations at three hospitals over 5 years. The average age of the patients was 72.4 years. Of the diseases treated, 45.1 % were malignant, and 54.9 % were benign. The emergency operation rate was 17.3 %.
  
  
  CONCLUSIONS
  Our strategy has produced a continuous surgical service at local hospitals in the face of diminishing numbers of surgeons. We recommend that such a strategy be adopted in other regions in which there are a decreasing number of surgeons and where it is not easy to move patients elsewhere for care.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan, watanabe.j@med.tottori-u.ac.jp.
authors.forename: Joji
authors.initials: J
authors.lastname: Watanabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Saito
authors.forename: Shinji
authors.initials: S
authors.lastname: Otani
authors.forename: Masahide
authors.initials: M
authors.lastname: Ikeguchi
mesh_terms: D000368:Aged; D003695:Delivery of Health Care / Q000458:organization & administration*; D004630:Emergencies; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D009369:Neoplasms / Q000601:surgery*; D066231:Surgeons / Q000600:supply & distribution*; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D000078329:Workforce