Original ArticleTrends in the Neurosurgical Workforce and Implications in Providing for an Aging Population
Introduction
The United States is currently facing a physician workforce shortage, with physician supply falling short of increasing healthcare demands from an aging population.1 A recent report by the American Association of Medical Colleges predicted a shortage of 139,000 physicians by 2033.2 Additionally, a large proportion of the current physician workforce is reaching retirement age, and it has been projected that 2 of every 5 physicians will be aged >65 years in the next decade.2 Thus, a clear and present need exists to assess the trends in the physician workforce and identify areas particularly vulnerable to workforce shortages.
Although several studies have investigated trends in workforce shortages in various subspecialties, to the best of our knowledge, no recent study has been conducted in neurosurgery. The goals of the present study were threefold. First, we sought to characterize the scope of the U.S. neurosurgical workforce shortage by quantifying the neurosurgeon per capita ratio (NPCR) from 2014 to 2019 and projecting these numbers to 2030. Second, we characterized the geographic distribution of the neurosurgery workforce across the United States. Finally, we assessed the average years of practice of the neurosurgeons active in 2020.
Section snippets
Data Source
Data on the individual neurosurgeon statistics, including the state of practice from 2014 to 2020, were obtained via the Physician Compare database, provided by the U.S. Centers for Medicare and Medicaid Services. Physicians must bill ≥1 procedure through Medicare within the calendar year to be included in this dataset. Each physician is assigned a unique national provider identifier number. Because this is a publicly available database, no institutional review board approval was required.
Results
From 2014 to 2019, the number of neurosurgeons increased by 588 (13.3%). The total increase in the U.S. population was 9,938,515 people (3.1%), yielding a significant increase in the surgeon per capita rate of 9.4% (range, 1.39%–1.52%; P < 0.00001), encompassing all states. The greatest increase was from 2018 to 2019, by 214 neurosurgeons. If these trends were to continue, by 2030, the United States would be expected to reach a population of 355.1 million, with 5869 neurosurgeons, increasing
Discussion
Physician workforce shortages threaten the stability of the U.S. healthcare systems and could further exacerbate existing socioeconomic disparities. Neurosurgeons will be in increasing demand as the U.S. population ages owing to the greater prevalence of certain neurologic disorders that are more common in the elderly, such as Parkinson disease, brain tumors, and fall-related subdural hematomas. In the present study, we identified trends in the neurosurgical workforce and presented areas that
Conclusions
Our analysis has shown that the current workforce trends, although positive, might not be adequate for future needs of an aging population or entirely reflective of the neurosurgical workforce across the United States. A lack of emergency and trauma neurosurgical care, combined with a recent decrease in NPCR throughout most regions in the United States, suggests that the workforce supply is not increasing uniformly or at a rate that can adequately provide neurosurgical care to the growing U.S.
CRediT authorship contribution statement
Rohin Singh: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – original draft. Parth P. Parikh: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – original draft. Nicole M. De La Peña: Writing – review & editing. Archis R. Bhandarkar: Writing – review & editing. Matthew K. Doan: Software. Naresh P. Patel: Project administration, Resources.
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.