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September 6, 1995, Vol 274, No. 9 >
ARTICLE | September 6, 1995

Calculating the Workforce in General Surgery FREE

Olga Jonasson, MD; Francis Kwakwa, MA; George F. Sheldon, MD
[+] Author Affiliations

Reprint requests to American College of Surgeons, 55 E Erie St, Chicago, IL 60611 (Dr Jonasson).


JAMA. 1995;274(9):731-734. doi:10.1001/jama.1995.03530090063023
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Article
References

Objective.  —To provide a reasonable estimate of the patient care and resident physician workforce practicing general surgery in 1994.

Design.  —Data regarding general surgical residents and practicing general surgeons were obtained from four sources and compared with previously published numbers.

Data Sources.  —Information was derived from the American College of Surgeons' Longitudinal Study of Surgical Residents: 1992-1993; the American Medical Association's Physician Characteristics and Distribution in the United States, 1994 Edition; the American Board of Medical Specialties' database on general surgeons; and the American Board of Surgery recertification data from the files of diplomates since 1968. Each of these sources was analyzed separately to derive a count of graduates from general surgery residency programs and an estimate of fully trained general surgeons engaged in patient care activities.

Results.  —We found that approximately 600 graduates of general surgery residency programs enter the practice of general surgery each year, and we found a close correlation between maximum and minimum estimates of the number of fully trained general surgeons engaged in active patient care, certified general surgeons who are not retired, and currently certified general surgeons. This number (17289 to 23 502) is approximately half that commonly used in calculations of the general surgery workforce (38 239). The larger number includes surgeons with subspecialty training beyond general surgery, surgical residents, and surgeons not engaged in patient care.

Conclusions.  —Estimations of the workforce in general surgery and predictions of future needs for general surgeons must be derived from the appropriate number of general surgery residents and practicing general surgeons.(JAMA. 1995;274:731-734)

REFERENCES

1 +
National Advisory Commission on Health Manpower. Report of the National Advisory Commission on Health Manpower . Washington, DC: US Government Printing Office; 1967;;1:13.
2 +
Fein R. The Doctor Shortage: An Economic Diagnosis . Washington, DC: Brookings Institute; 1967;.
3 +
Lee RI, Jones LW. The Fundamentals of Good Medical Care . Chicago, Ill: University of Chicago Press; 1933;:114. Publication of the Committee on the Cost of Medical Care, No. 22.
4 +
America's Health Status: Needs and Resources . Washington, DC: President's Commission on Health Needs of the Nation; 1952;:114.
5 +
Bane F. Physicians for a Growing America: Report of the Surgeon General's Consultant Group on Medical Education . Washington, DC: US Government Printing Office; 1959;.
6 +
Ginzberg E.  Do we need more generalists? Acad Med . 1989;;64:495-498.
7 +
Ginzberg E, ed. From Physician Shortage to Patient Shortage: The Uncertain Future of Medical Practice . Boulder, Colo: Westview Press; 1986;.
8 +
Weiner JP.  Forecasting the effects of health reform on US physician workforce requirement: evidence from HMO staffing patterns. JAMA . 1994;; 272:222-230.
9 +
Feil EC, Welch HG, Fisher ES.  Why estimates of physician supply and requirements disagree. JAMA . 1993;;269:2659-2663.
10 +
Rivo ML, Jackson DM, Clare FL.  Comparing physician workforce reform recommendations. JAMA . 1993;;270:1083-1084.
11 +
Mulhausen R, McGee J.  Physician need: an alternative projection from a study of large, prepaid group practices. JAMA . 1989;;261:1930-1934.
12 +
Tarlov AR.  HMO enrollment growth and physicians: the third compartment. Health Aff (Millwood) . 1986;;5:23-35.
13 +
Graduate Medical Education National Advisory Committee. Summary Report to the Secretary, Department of Health and Human Services . Hyattsville, Md: Health Resources Administration; 1980;: 1. Publication HRA 81-651.
14 +
Council on Graduate Medical Education. The First Report of the Council . Rockville, Md: US Dept of Health and Human Services; 1988;:1.
15 +
Council on Graduate Medical Education. Third Report: Improving Access to Health Care Through Physician Workforce Reform: Directions for the 21st Century . Rockville, Md: US Dept of Health and Human Services; 1992;:59.
16 +
Council on Graduate Medical Education. Fourth Report: Recommendations to Improve Access to Health Care Through Physician Workforce Reform . Rockville, Md: US Dept of Health and Human Services; 1994;:21.
17 +
Bureau of Health Professions. Sixth Report to the President and Congress on the State of Health Personnel in the United States . Washington, DC: US Dept of Health and Human Services; 1988;:3-1. Publication HRS-P-OD-88-1.
18 +
Kronick R, Goodman DC, Wennberg J, Wagner E.  The marketplace in health care reform: the demographic limitations of managed competition. N Engl J Med . 1993;;328:148-152.
19 +
Perry HB, Detmer DE, Buchanan-Davidson DJ.  Policy proposal for correcting the imbalance in general surgical manpower. Surgery . 1984;;95:243-248.
20 +
Kindig DA, Libby D.  How will graduate medical education reform affect specialties and geographic areas? JAMA . 1994;;272:37-42.
21 +
Rivo ML, Satcher D.  Improving access to health care through physician workforce reform: directions for the 21st century. JAMA . 1993;;270:1074-1078.
22 +
Cohen JJ.  Transforming the size and composition of the physician work force to meet the demands of health care reform. N Engl J Med . 1993;; 329:1810-1812.
23 +
Iglehart JK.  Health care reform and graduate medical education. N Engl J Med . 1994;;330:1167-1171.
24 +
Cooper RA.  Seeking a balanced physician workforce for the 21st century. JAMA . 1994;;272:680-687.
25 +
Kindig DA, Cultice JM, Mullan F.  The elusive generalist physician: can we reach a 50% goal? JAMA . 1993;;270:1069-1073.
26 +
Mullan F, Politzer RM, Gamliel S, Rivo ML.  Balance and limits: modeling graduate medical education and reform based on recommendations of the Council on Graduate Medical Education. Milbank Q . 1994;;72:385-398.
27 +
Abt Associates. Reexamination of the Adequacy of Physician Supply Made in 1980 by the Graduate Medical Education National Advisory Committee for Selected Specialties: Final Report . Springfield, Va: National Technical Information Service, US Dept of Commerce; 1991;. Publication HSRA 240-89-0041.
28 +
Longitudinal Study of Surgical Residents: 1992-1993 . Chicago, Ill: Education and Surgical Services Dept, American College of Surgeons; 1994;.
29 +
Physician Characteristics and Distribution in the United States, 1994 Edition . Chicago, Ill: American Medical Association; 1994;.
30 +
Approved Training Programs in Surgical Oncology, 1995 . Arlington Heights, Ill: Society of Surgical Oncology; 1995;.
31 +
Aging America: Trends and Projections (Annotated): An Information Paper to the Special Committee on Aging, United States Senate [101st Congress, 2nd Session] . Washington, DC: US Government Printing Office; 1990;.
32 +
National Health Policy Reform: The Rural Perspective . Kansas City, Mo: National Rural Health Association; 1992;:4, 9.
33 +
Health Care in Rural America . Washington, DC: Office of Technology Assessment; 1990;:43. Publication OTA-H-434.
34 +
Sheldon GF.  Graduate medical education: issues for the 21st century. Am J Surg . 1991;;161: 294-299.
35 +
Jacobsen SJ, Rimm AA.  The projected physician surplus reevaluated. Health Aff (Millwood) . 1987;;6:48-55.
36 +
Harris JS.  How many doctors are enough? Health Aff (Millwood) . 1986;;5:73-83.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
National Advisory Commission on Health Manpower. Report of the National Advisory Commission on Health Manpower . Washington, DC: US Government Printing Office; 1967;;1:13.
2 +
Fein R. The Doctor Shortage: An Economic Diagnosis . Washington, DC: Brookings Institute; 1967;.
3 +
Lee RI, Jones LW. The Fundamentals of Good Medical Care . Chicago, Ill: University of Chicago Press; 1933;:114. Publication of the Committee on the Cost of Medical Care, No. 22.
4 +
America's Health Status: Needs and Resources . Washington, DC: President's Commission on Health Needs of the Nation; 1952;:114.
5 +
Bane F. Physicians for a Growing America: Report of the Surgeon General's Consultant Group on Medical Education . Washington, DC: US Government Printing Office; 1959;.
6 +
Ginzberg E.  Do we need more generalists? Acad Med . 1989;;64:495-498.
7 +
Ginzberg E, ed. From Physician Shortage to Patient Shortage: The Uncertain Future of Medical Practice . Boulder, Colo: Westview Press; 1986;.
8 +
Weiner JP.  Forecasting the effects of health reform on US physician workforce requirement: evidence from HMO staffing patterns. JAMA . 1994;; 272:222-230.
9 +
Feil EC, Welch HG, Fisher ES.  Why estimates of physician supply and requirements disagree. JAMA . 1993;;269:2659-2663.
10 +
Rivo ML, Jackson DM, Clare FL.  Comparing physician workforce reform recommendations. JAMA . 1993;;270:1083-1084.
11 +
Mulhausen R, McGee J.  Physician need: an alternative projection from a study of large, prepaid group practices. JAMA . 1989;;261:1930-1934.
12 +
Tarlov AR.  HMO enrollment growth and physicians: the third compartment. Health Aff (Millwood) . 1986;;5:23-35.
13 +
Graduate Medical Education National Advisory Committee. Summary Report to the Secretary, Department of Health and Human Services . Hyattsville, Md: Health Resources Administration; 1980;: 1. Publication HRA 81-651.
14 +
Council on Graduate Medical Education. The First Report of the Council . Rockville, Md: US Dept of Health and Human Services; 1988;:1.
15 +
Council on Graduate Medical Education. Third Report: Improving Access to Health Care Through Physician Workforce Reform: Directions for the 21st Century . Rockville, Md: US Dept of Health and Human Services; 1992;:59.
16 +
Council on Graduate Medical Education. Fourth Report: Recommendations to Improve Access to Health Care Through Physician Workforce Reform . Rockville, Md: US Dept of Health and Human Services; 1994;:21.
17 +
Bureau of Health Professions. Sixth Report to the President and Congress on the State of Health Personnel in the United States . Washington, DC: US Dept of Health and Human Services; 1988;:3-1. Publication HRS-P-OD-88-1.
18 +
Kronick R, Goodman DC, Wennberg J, Wagner E.  The marketplace in health care reform: the demographic limitations of managed competition. N Engl J Med . 1993;;328:148-152.
19 +
Perry HB, Detmer DE, Buchanan-Davidson DJ.  Policy proposal for correcting the imbalance in general surgical manpower. Surgery . 1984;;95:243-248.
20 +
Kindig DA, Libby D.  How will graduate medical education reform affect specialties and geographic areas? JAMA . 1994;;272:37-42.
21 +
Rivo ML, Satcher D.  Improving access to health care through physician workforce reform: directions for the 21st century. JAMA . 1993;;270:1074-1078.
22 +
Cohen JJ.  Transforming the size and composition of the physician work force to meet the demands of health care reform. N Engl J Med . 1993;; 329:1810-1812.
23 +
Iglehart JK.  Health care reform and graduate medical education. N Engl J Med . 1994;;330:1167-1171.
24 +
Cooper RA.  Seeking a balanced physician workforce for the 21st century. JAMA . 1994;;272:680-687.
25 +
Kindig DA, Cultice JM, Mullan F.  The elusive generalist physician: can we reach a 50% goal? JAMA . 1993;;270:1069-1073.
26 +
Mullan F, Politzer RM, Gamliel S, Rivo ML.  Balance and limits: modeling graduate medical education and reform based on recommendations of the Council on Graduate Medical Education. Milbank Q . 1994;;72:385-398.
27 +
Abt Associates. Reexamination of the Adequacy of Physician Supply Made in 1980 by the Graduate Medical Education National Advisory Committee for Selected Specialties: Final Report . Springfield, Va: National Technical Information Service, US Dept of Commerce; 1991;. Publication HSRA 240-89-0041.
28 +
Longitudinal Study of Surgical Residents: 1992-1993 . Chicago, Ill: Education and Surgical Services Dept, American College of Surgeons; 1994;.
29 +
Physician Characteristics and Distribution in the United States, 1994 Edition . Chicago, Ill: American Medical Association; 1994;.
30 +
Approved Training Programs in Surgical Oncology, 1995 . Arlington Heights, Ill: Society of Surgical Oncology; 1995;.
31 +
Aging America: Trends and Projections (Annotated): An Information Paper to the Special Committee on Aging, United States Senate [101st Congress, 2nd Session] . Washington, DC: US Government Printing Office; 1990;.
32 +
National Health Policy Reform: The Rural Perspective . Kansas City, Mo: National Rural Health Association; 1992;:4, 9.
33 +
Health Care in Rural America . Washington, DC: Office of Technology Assessment; 1990;:43. Publication OTA-H-434.
34 +
Sheldon GF.  Graduate medical education: issues for the 21st century. Am J Surg . 1991;;161: 294-299.
35 +
Jacobsen SJ, Rimm AA.  The projected physician surplus reevaluated. Health Aff (Millwood) . 1987;;6:48-55.
36 +
Harris JS.  How many doctors are enough? Health Aff (Millwood) . 1986;;5:73-83.

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