WHERE IS MY GENERAL SURGEON?

WHERE IS MY GENERAL SURGEON?

We turn out 1000 general surgeons every year in America.  They each had 4 years of medical school, 5 years of residency, and many have added a year or two of research. They start practice at around age 34 and are at least 250 K in debt  They care for emergencies, traumas, and perform many kinds of operations.  They are probably the most well rounded surgical clinicians. Yet today, 70% of them pursue  specialized training.  That leaves only 300 general surgeons annually to practice general surgery.  The remainder of the  general surgeons average 55 years of age and soon will retire.

Why do these fine doctors want to sub-specialize?  

They want to limit the number and kinds of procedures they perform.  The more refined the expertise the more financial payoff.  They can even charge more for the same procedure they did as a general surgeon.  Graduating doctors today don’t want to work 90 hours a week with little family time.  Hence they join large hospital groups, are on call less, and get paid more.  Very few have the entrepreneurial spirit.   As residents they work 80 hours a week, and when they see a sick patient needing stabilization, they must turn the care to someone else.  Their surgical problems are worse with a growing elderly population, but they work fewer hours.

SO WHAT IS THE PROBLEM?

The public has more inadequate access to health care with the new value systems of young doctors.  The greatest reason for their early retirement and change in careers is their unfavorable work environment.  Managed care constantly changes the rules, reimbursements are uncertain, and professional liability is huge.

 Funds are redistributed, since there  is not enough money to spread around, and the non surgical doctors are paid more.  A surgeon with 30 years experience is paid the same as a young surgeon with 1-year experience.  They can't  charge the patients for any services they render after surgery  for 90 days.  All other doctors can charge for visits. So they send the post op patient to another doctor who will get paid for the office visits.  

Small hospital can’t survive without general surgeons.  They do 40% of all the surgeries.  The sub specialists are no longer secure in their skills in general surgery.  Seventy five percent of hospitals now report an inadequate supply of on call surgeons.

Soon small hospitals may be forced to close their doors when the general surgeon disappears from the scene.  Can this trend be reversed?  

What do you think?