The developing crisis in the National General Surgery Workforce
The developing crisis in the National General Surgery Workforce
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DOI：
10.1016/j.jamcollsurg.2007.12.017
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发表时间：
2008-05-01
影响因子：
5.2
通讯作者：
Burns, R. Phillip
中科院分区：
文献类型：
--
作者：
Cofer, Joseph B.;Burns, R. Phillip
背景：愿意以传统形式进行普通外科手术的外科医生数量正在下降。作为一名住院医师项目主任，鉴于对新普通外科医生（GS）的要求很多，人们会敏锐地意识到这种短缺。 研究设计：从2007年2月7日到2007年4月30日，以及从2007年5月23日到2007年8月10日，一位项目主任收集了所有发给他的新普通外科医生的招标和空缺广告。这些通信内容多种多样，从电子邮件提交到正式信件。为了评估 GS 对医院的经济影响，我们从现有的招聘行业调查、一家大型内城区教学医院的首席财务官以及一名乡村外科医生中收集了数据。 结果：在最初的研究期间，全国有 140 个 GS 职位空缺。在第二个研究期间，共有 40 个州的 149 个职位。一名 GS 的年经济价值估计在 105 万至 240 万美元之间。结论：目前，普外科领域存在供需不平衡的情况。如果GS退休或离开小医院且无法替代，这些医院将面临关闭的威胁。这将使大型安全网医院承受更大的压力。解决方案应包括进行全国劳动力调查，允许医院补充外科医生的收入，外科住院医师审查委员会应考虑立即将普通外科的名额数量增加20%，并重点招聘其他国家的医学毕业生。
BACKGROUND: The number of surgeons willing to practice general surgery in its traditional form is in decline. One becomes acutely aware of this shortage, as a residency program director, given the many requests for new general surgeons (GS).STUDY DESIGN: From the 7th of February 2007 through the 30th of April 2007, and from May 23, 2007 through August 10, 2007, one program director collected all solicitations and advertised openings sent to him for a new GS. These communications varied from email submissions to formal letters. To assess the economic impact of a GS on a hospital, data were collected from existing recruiting industry surveys, the chief financial officer of a large inner-city teaching hospital, and an individual rural surgeon.RESULTS: There were 140 openings nationally for GSs during the initial study period. During the second study period, there were 149 positions in 40 states. The annual economic worth of a GS was estimated to be between $1.05 million and $2.4 million.CONCLUSIONS: Currently, there is an imbalance in supply and demand for the field of general surgery. If GSs retire or leave small hospitals and cannot be replaced, those hospitals will be threatened with closing. This will strain the large, safety-net hospitals even more. Solutions should include a national workforce survey, allowing hospitals to supplement a surgeon's income, the Residency Review Committee for Surgery should consider an immediate 20% increase in the number of categorical spots in general surgery, and focused recruitment of medical graduates from other countries.