A two-part Special Article in the New England Journal of Medicine (295:921-926, 982-989, 1976) and a companion SPECIAL COMMUNICATION in The Journal (236:1864-1871, 1976) critically contrast the operative workloads of surgical specialists and of nonspecialist physicians performing surgical operations. Concern with the growing shortage of family physicians, amidst indications of a tilt towards specialization in surgical fields, provided the impetus. (Some 25% of beginning physicians enter surgical training programs.)
The study encompassed all in-hospital operations during 1970 for the entire population of four comparable medical service areas in the Northeast, Southeast, and Northwest. A total of 2,700 practitioners together performed 256,500 operative procedures. For an additional 28,500 procedures, the responsible physician was in training or could not be identified or both.
Slightly more than half of the 2,700 physicians performed one operation or less per week; just 1% of the physician total accounted for ten or more operations per week.
de Jong RH. Too Many Surgeons?. JAMA. 1977;237(3):267–268. doi:10.1001/jama.1977.03270300071013
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