Nearly 10% of US surgeons left clinical practice within an eight-year period.
This is according to a study by researchers at The Ohio State University and The Ohio State University Wexner Medical Centre published in the Journal of the American College of Surgeons.
They suggest that targeted interventions to help surgeons most likely to leave practice can keep them on the job.
Timothy M Pawlik, a surgical oncologist at The Ohio State University Wexner Medical Centre, is a co-author on the study.
He said: ‘Surgeons deliver a disproportionate amount of high severity, sensitive health care, which is especially critical right now in a country with an ageing population.
‘These findings show that surgical attrition is a real problem, and that we need to address it in a nuanced and tailored way, focusing on certain subspecialties that are highest risk, and focusing on mid-level providers who are most likely to leave surgery.’
In the retrospective study, researchers linked the Medicare Physician & Other Practitioners Public Use Files to the National Plan and Provider Enumeration System (NPPES) using National Provider Identifiers. This created a cohort of 224,629 unique surgeons in 19 specialties between 2013 and 2023. Across the study period, the number of active surgeons ranged from 154,000 to 157,000 annually.
They found an overall cumulative attrition rate of 9.7% over eight years, with attrition rates steady from 2013 to 2018 before rising sharply in 2020, most likely due to higher retirement rates during the COVID-19 pandemic, Pawlik explained.
They also found that surgeons most likely to leave were mid-career surgeons with five to nine years of practice.
When it comes to subspecialties, researchers found the highest five-year accumulative attrition rates in oral and maxillofacial surgery (25.1%), obstetrics and gynaecology (23.2%), and plastic and reconstructive surgery (19.3%).
The lowest annual attrition rates were observed in orthopaedic surgery (0.7%), otolaryngology (0.5%), podiatry/foot and ankle surgery (0.4%), and vascular surgery (0.8%).
Researchers found demographic changes, too. The percentage of female surgeons rose from 21.2% in 2013 to 28.6% in 2023. The percentage of surgeons practising in rural and non-metropolitan areas decreased from 10.5% to 8.5% during the same period.
While the study doesn’t examine why surgeons are leaving, it does show where policy changes and support are most needed, according to the researchers.
Pawlik said: ‘By identifying who is most likely to leave, we can create targeted retention strategies to support surgeons most likely to leave, and close these gaps.’
Recently, the American College of Surgeons released the first-ever national workplace standards framework for surgeons aimed at, among other things, workforce sustainability and improving surgeon wellbeing.
