The demand for surgical procedures will outgrow the number of available surgeons, according to a new study released by UCLA researchers.
The study, featured in he August issue of the Annals of Surgery, predicts a shortages in most surgical specialties.
In an interview with the Nursing Times, UCLA lead author Dr. David A. Etzioni said his study shows that almost 60 percent of the surgical procedures analyzed were more commonly performed on adults aged 65 and up compared to other groups. This is alarming because by the year 2020 the largest population surge will be in the age group of people 65 and older - a 53 percent increase.
Will the country’s surgeons be able to keep up? Not likely, Etzioni says.
"The biggest problem will be access to care," Etzioni told the Nursing Times. Currently, the U.S. healthcare system is accustomed to the routine presence of highly qualified healthcare professionals of all types. A shortage of surgeons means less availability for urgencies/emergencies, and it may be become more difficult to find surgical care in rural areas."
Jan Sosias, director of human resources for Kaiser Permanente Medical Group in Colorado, says her organization is aware of the upcoming shortage and plans are in place to combat that.
"I think certainly we have individuals in our organization who are trying to anticipate what demographics are going to look like for the people we serve," Sosias said.
That includes the number of physicians that will be needed, Sosias said.
"Our organization has been in a position of forward thinking for some time now," she said.
That includes identifying and trying to pre-hire in speciality areas, primary care and surgical areas.
Researchers found that surgeries performed predominantly on older adults, such as cataract and heart surgery, will have the highest increase in demand by 2020. Ophthamlology will have the biggest increase with a 47 percent increase in demand, fllowed by cardiothoracic surgery with a 42 percent increase.
Nearly 70 percent of the workload in cardiothoracic is for patients age 65 and over.
Historically, primary care providers have been in demand.
But in recent years, Etzioni said that trend may change to more specialties.
Putting an even greater strain on the existing surgeons is the fact there already isn’t enough time to train new surgeons to avoid the shortage since it takes 14 years to train surgeons.
"Invevitably, in the near future, we will have to start training more surgeons," Etzioni said.
"This is a long-term solution, however, as it takes almost a decade to train a surgeon from scratch (before medical school) surgical practices will need to become more efficient, and possibly even more sub-specialized than they are already. Non-physician clinicians including advance practice nurses, physician assistants, etc. will be called on to assist."
UCLA researchers developed a model using national surveys of medical and surgical services to establish a profile of age-specific rates of surgical use. Data was taken from thew 1996 National Survey of Ambulatory Surgery and the National Hospital Discharge Survey. Census forecasts were taken from the Census Bureau.
General surgery, which included vascular, abdominal, gastrointestinal, hernia, breast and pediatric surgery, was forecast to increase by 13 percent by the year 2010, rising to a 31 percent increase in 2020. Urology surgeries, including kidney, prostate and bladder surgeries, will increase 35 percent by 2020.
Orthopedics will also see a marked rise in demand. Those surgeries, which include knee surgeries, shoulder and other joints, will increase 28 percent by 2020.
Neurosurgery is expected to jump 28 percent by 2020.
The smallest increase will be in otolaryngology, which involves, ear, nose and throat surgery. Many of the patients needing these surgeries are under the age of 15, a population which is expected to show little growth in the coming years.
Etzioni also pointed out that with improved techology - which includes surgeries that are minimally invasive - procedures are becoming easier and more appealing to more patients, also increasing surgical demand.
Sosias said so far Kaiser Permanente is in good shape when it comes to surgeons.
"I have not yet encountered a recruitment situation where we have not been able to come up with a solution," Sosias said.