How many orthopaedic surgeons in us

The demand for orthopedic surgical services will likely further intensify as more of the U. Bert: Is there any data to support the contention that there will continue to be a shortage of specialists in coming years? Alex Jahangir, MD: While I understand your observation that there seems to be a recent increase in the number of orthopedic surgeons treating relatively smaller populations of people, I would propose that this phenomenon is temporary as it is possible that many older surgeons have delayed retirement and will begin to retire once the economy improves and retirement becomes more financially stable.

This will once again open positions in the potentially more desirable urban setting for new surgeons finishing training. Furthermore as more surgeons retire, the potential shortage of orthopedic surgeons to treat the increasing number of older Americans, projected to be more than 71 million, will indeed become a real problem.

I make this statement with the caveat and assumption that there will be no change to the American health care delivery system in the future, which may decrease the current demand patterns for orthopedic services. Nicholas A. Sgaglione, MD: Observations remain consistent in the New York City metropolitan region where increasing trends have been noted toward hospital-based employment of orthopedic surgeons.

In contrast, a reduction in private practice-based positions has been observed. Many factors may be responsible, including geographic phenomenon, economic uncertainty, health care reform and changing practice paradigms. Bert: Have you noticed a shortage or overabundance of orthopedic surgeons in your respective areas? Jacobs: I practice in a large urban center. I am not aware of either a shortage or overabundance. Graduates of our residency and fellowship programs seem to be able to obtain a position in the geography of their choosing, although the main growth of new orthopedic surgeon jobs seems to be in suburban and exurban areas.

Jahangir: As I look at the southeastern United States, my home for most of my life, the shortage of orthopedic surgeons is real. According to the April AAOS report on the state-level changes in AAOS orthopedic fellows, three of the eight states with a relative low number of orthopedic surgeons per population were southern states: Arkansas, Florida and Louisiana. More concerning is that Arkansas and Florida were the only states in the country identified as having a relative low number of orthopedic surgeons with a trend of fewer surgeons entering the market resulting in a potential future shortage of orthopedic surgeons in these states.

Interestingly according to the AAOS report, Tennessee, my home state, has a relative high number of surgeons per population. However, similar to most states, many surgeons practice in larger cities leaving many rural areas without orthopedic care. According to a recent report on the impact of health reform in Tennessee and the implications on health care manpower, it was estimated that of the , Tennessee residents who are currently uninsured, , will receive coverage under the PPACA, reducing the uninsured from Finally, this report projects that there will be an annual increase of , visits to surgical specialist in the state of Tennessee as a result of the PPACA.

With this potential increase of people requiring surgical specialists and the fact that many of the rural areas have no access to musculoskeletal care, the predicated future shortage of orthopedic surgeons is a potential problem in the Southeast again assuming that there is no change in the American health care delivery system. Bert: Is it possible to develop an accurate methodology in to determine if an orthopedic surgeon shortage exists in a specific area of the United States that can benefit graduating fellows in the future?

If so, how could it be accomplished? Jacobs: The determination of the supply side of the workforce equation is relatively straightforward. However, the determination of the demand side of the equation is fraught with difficulty, particularly in the era of health care reform.

Jahangir: The question of whether there will be a surplus or shortage of orthopedic surgeons in the future is a question of what will the demand for orthopedic services be in the future.

As I noted previously, there will indeed be an increase in the number of older Americans who, under our current health care delivery system, will result in an increased demand for orthopedic services such as arthroplasty. However, as the American health care system continues to evolve, one potential result may be that more of the financial burden for health care services will be shifted to individual patients rather than third-party payers. I believe that if this shift of financial responsibility were to occur, then the demand for orthopedic services will decrease compared to today as a person who might have received an arthroplasty if it was paid for by Medicare may forego this procedure if he or she had to pay thousands of dollars out of pocket.

This change in the health care delivery system that would place more of the financial burden of health care on a patient would result in a decrease in the number of needed orthopedic surgeons as a percentage of the population of a community compared to the situation today.

Orthopedic surgery is the top-paying medical specialty. Orthopedic practice administrator salaries vary widely but are similar to the salaries of administrators of other types of physician practices. Administers earn more as their experience and practice size grows. Based on comparisons of Health Care Group and MGMA data, salaries of orthopedic administrators appear to be in line with what administrators in other specialties earn.

A shortage of orthopedic surgeons performing joint replacement is expected in the next several years. According to two new studies presented at the AAOS Annual Meeting, the number of patients requiring hip or knee replacement surgery is expected to soon outpace the number of surgeons available to perform such procedures. If the number of orthopedic surgeons trained in total joint replacements continues at its current rate, in , there will not be enough physicians to complete 46 percent of needed hip replacements and 72 percent of needed knee replacements.

According to the authors of both studies, this shortage could be halted by improving reimbursement rates for total joint replacement, which has consistently decreased over the last several years. Medicare professional fees for orthopedic procedures are, on average, more than 40 percent less than the average commercial payments. Medicare pays physicians significantly less than commercial payors for performing orthopedic procedures, but the differences between the two payors vary by procedure.

Spine in the most highly reimbursed subspecialty within orthopedics. Because of the increased difficulty of spine cases and the time needed to complete them, spine procedures receive, on average, the highest reimbursements of all subspecialties of orthopedics. All rights reserved. AAOS Now. Published September 1, December Rechtoris M.

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