Maryland short on surgeons

Study finds that the number of surgeons in the state is overcounted because many spend time on tasks outside clinical care.

By Kevin B. O’Reilly — Posted April 23, 2009

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There are critical shortages of surgeons in urban and rural Maryland, and an aging surgical work force will exacerbate the problem, according to a study in the March Journal of the American College of Surgeons.

The study's author, Scott E. Maizel, MD, analyzed data from a comprehensive evaluation of the state's physician work force prepared by the Maryland Hospital Assn. and the Maryland State Medical Society. The evaluation involved interviews with each of the medical directors at the state's 52 acute care hospitals and provided data on how much time surgeons spent in clinical practice and how much time they spent on administrative, teaching and other duties.

Dr. Maizel, a Baltimore-area breast surgeon, used these data to estimate the full-time equivalent number of surgeons available to care for the state's patients. On average, surgeons spent about 70% of their time caring for patients. Because of this, the study concluded, widely referenced work force figures underestimate the physician shortage.

According to this analysis, of all surgical specialties, only otolaryngologists' rate of 2.24 surgeons per 100,000 residents exceeded state work force benchmarks. General surgeons, orthopedic surgeons, thoracic surgeons and other surgical subspecialties all showed shortages, according to the study (link).

"The findings of this study are emblematic of a national trend that has seen significant erosion in the number of doctors per capita," Dr. Maizel said in a statement. "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."

About 40% of Maryland surgeons were 55 years or older in 2007, the time of the study. The aging surgical work force "represents the most immediate concern to hospitals, patients and health care planners," the study said.

Last year, work force studies in Connecticut, Massachusetts and Wisconsin showed a need for more doctors, particularly primary care physicians. In November 2008, national reports from The Physicians' Foundation and the American College of Physicians projected escalating primary care physician shortages.

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