Is There a Shortage of Neurosurgeons in the US, and What is a “Shortage,” Anyway?

William T. Couldwell, MD, PhD1, Steve Slane, PhD1, Aaron Cohen-Gadol, MD1, Michael Vogelbaum, MD, PhD1, Beth Dery1, Judy Rosman1

1Salt Lake City, UT United States

Keywords: surgery, cost, Neurosurgery Services, health care, hospital

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       Manpower needs in medicine are being evaluated continuously.
     (1) Is the 1:100,000 ratio of neurosurgeons to population in the SOSSUS report (1975) still valid, (2) Are there enough neurosurgeons in the US to meet the need, and (3) Is demand driven by patient need.
     We created three data sets: (1) the distribution of 4675 practicing US neurosurgeons was merged with 2009 census data to yield density indices of neurosurgeons by state; (2) a survey assessing practice characteristics was emailed to 4675 practicing neurosurgeons; and (3) a compilation of web and print job ads for U.S. neurosurgeons.
     Multi-variant statistical analyses yielded inconclusive results regarding patient demand because (1) existing datasets are not designed to establish patient demand, and (2) many neurosurgeons today are subspecialized. The data did yield the ratio of neurosurgeons to total U.S. population is 1:69,000. 462 partial and 362 complete surveys were obtained. Neurosurgeon-to-patient ratios varied dramatically by state and were inconsistently correlated to whether neurosurgeons indicated they were overworked or underworked. The 321 job ads may indicate a shortage. 24% of practices that are recruiting indicated that they are definitely recruiting only for ER coverage, and an additional 26% indicated that they are unsure that they would be recruiting if it were not for the need for ER coverage. The remaining 160 positions, which arguably reflect community need, approximately match the number of graduating residents.
     This is a retrospective study.
     Demand ratios should be re-evaluated to consider changes in neurosurgery practice.
     A shortage in the employment market may reflect factors other than patient need.


Project Roles:

W. Couldwell (), S. Slane (), A. Cohen-Gadol (), M. Vogelbaum (), B. Dery (), J. Rosman ()