The Employed Surgeon A Changing Professional Paradigm
The Employed Surgeon A Changing Professional Paradigm
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DOI：
10.1001/jamasurg.2013.1013
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发表时间：
2013-04-01
期刊：
影响因子：
16.9
通讯作者：
Sheldon, George F.
中科院分区：
文献类型：
--
作者：
Charles, Anthony G.;Ortiz-Pujols, Shiara;Sheldon, George F.
目的：了解美国外科医生就业的趋势和特点。外科医生越来越多地选择医院或大型群体就业作为他们的执业环境。设计：分析了2001-2009年美国医学会医师主档案数据。设置：美国医学会主档案中确定的外科医生。参与者：外科医生是根据美国医学协会专业数据和美国医学专业委员会认证数据中的定义定义的，包括80岁以下的在职、非联邦和非常驻医生。主要观察指标：就业状况和趋势。结果：2001-2009年间，报告自己创业的外科医生数量从48%下降到33%，这一下降与受雇外科医生数量的增加相对应。在美国，68%的外科医生现在自认为他们的执业环境是有工作的。2006至2011年间，全职医院聘用外科医生的人数增加了32%。年轻的外科医生和女性外科医生越来越倾向于在大型团体诊所工作。结论：普通外科医生和外科专科医生更倾向于在医院工作，而不是独立执业。这一趋势在年轻外科医生和女性外科医生中尤为明显。这一趋势表明，职业范式发生了重大转变。
Objective: To identify trends and characteristics of surgeon employment in the United States. Surgeons are increasingly choosing hospital or large group employment as their practice environment.Design: American Medical Association Physician Masterfile data were analyzed for the years 2001 to 2009.Setting: Surgeons identified within the American Medical Association Masterfile.Participants: Surgeons were defined using definitions from the American Medical Association specialty data and the American Board of Medical Specialties certification data and included active, nonfederal, and nonresident physicians younger than 80 years of age.Main Outcome Measures: Employment status and trends.Results: The number of surgeons who reported having their own self-employed practice decreased from 48% to 33% between 2001 and 2009, and this decrease corresponded with an increase in the number of employed surgeons. Sixty-eight percent of surgeons in the United States now self-identify their practice environment as employed. Between 2006 and 2011, there was a 32% increase in the number of surgeon in a full-time hospital employment arrangement. Younger surgeons and female surgeons increasingly favor employment in large group practices. Employment trends were similar for both urban and rural practices.Conclusions: General surgeons and surgical subspecialists are choosing hospital employment instead of independent practice. The trend is especially notable among younger surgeons and among female surgeons. The trend denotes a professional paradigm shift of major importance.