Analysis of Demand for General Surgeons in Northern New England
Robin Cotter*, Matthew Carroll, Brent White, Sean Bears, Kari Rosenkranz
General Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH
Objective: Characterize the workforce needs and scope of practice required of general surgeons practicing in northern New England.
Design: Multi-institutional needs assessment survey.
Setting: Tertiary, community, and critical access hospitals with surgery programs in Vermont, New Hampshire, and Maine.
Participants: Hospital chief medical officers (CMOs).
Interventions: N/A.
Main Outcome Measures: Current general surgeons' scope of practice, predicted future need for coverage, fellowship requirements for employment, and skill sets desired of future general surgeons.
Results: A total of 37 surveys were completed by New Hampshire CMOs (n=17), Vermont CMOs (n=10) and Maine CMOs (n=8) with an overall response rate of 57%. The majority (n=19, 51.3%) of hospitals responding were designated critical access hospitals. Hospitals in this region are most frequently staffed by 1-2 general surgeons. Over half (n=45, 55%) of surgeons currently practicing in the region are >50 years old. Many hospitals expect their surgical practice to grow and most hospitals responding anticipate the need to hire a general surgeon in the next five years (n=20, 64.5%). While none require fellowship training, many indicate that minimally invasive experience and endoscopic skills are in high demand. All respondents report the surgical program to be important for the financial stability of the hospital.
Conclusions: These results highlight the importance of general surgery coverage and surgery programs in northern New England. The increasing age of current general surgeons in the region is concerning when coupled with the anticipated increased need for surgical care. It is crucial to develop recruitment strategies for general surgeons which may include a rural residency training track in the region, affiliation with larger systems, or collaboration between smaller hospitals.
Figure 1. Current scope of practice of general surgeons in this region.
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