This is a very serious situation. General surgeons and general surgery are the backbone of all surgical care. This includes trauma, oncology (cancer), burns and a wide array of other “mundane” health conditions which require surgical intervention for cure or treatment. For decades the field as been “nibbled” at from all sides. The expansion of sub-specialty surgery, while not all bad, has proved a more financially lucrative draw to those otherwise inclined to continue on as a general surgeon. Factors cited in the article below, including decreasing pay, long hours and many night calls (and night surgeries) have led to an exodus from this essential field. Remember all the surgeons on MASH were really general surgeons and that almost all sub-specialty surgeons start out as, or spend a good deal of their training in, general surgery. Incentives for training and retention of our general surgeons is critical to the nation’s health . . . jomaxx
More hospitals are hiring surgeons on a temporary basis
When someone doubles over from stomach pain, the general surgeon is the one who performs an appendectomy. Gallstones? The general surgeon removes the gallbladder. Breast and colon tumors and hernias are also matters for the surgeon’s scalpel. Now the economic and cultural forces reshaping U.S. medicine are prompting an exodus from this once venerable field, creating a growing market for temporary surgeons-for-hire.creating a growing market for temporary surgeons-for-hire.” This “shift toward temporary assignments comes as the traditional way of practicing general surgery is fading in many parts of the country. For decades, general surgeons have been the backbone and economic engine of the community hospital.” Yet, “the increasingly grueling schedules, shrinking payments, and the temptation of more profitable surgical niches have made the field less attractive.” Thus, in “the past 25 years, the number of general surgeons per capita has declined 25 percent, according to” some estimates. That is why some hospitals now rely on “temporary physicians to fill the void.” While opponents “of the practice worry that it carries potential safety risks,” some temporary surgeons say that patients actually “fare better” under their care . . .
read more @ http://online.wsj.com/article/SB123179145452274561.html
There are serious problems concerning the Surgeon -Hire that you have mentioned, one important thing being when in an immediate need of a doc there wouldnt be any. Appointments would work this way but emergencies wont.
Every comment above is accurate. The decreasing reimbursement for the general surgeon has pushed many of them into hospital employment. Despite that, the reimbursement is still low compared to those subspecialties that initially follow the general surgical training path. Long nights followed by long days with little to show for it is leading to a dwindling number of GSs.
The other side of the coin is that the hospitals are willing to pay locums companies large amounts for locums surgeons. The surgeons themselves see little of this money. In most cases the hospital can recoup its expenses by receipts from the surgeon’s work. Once again the GS is on the short end.
I do not see an end to this trend in the near future. The market place is not free floating and will not allow the value of the general surgeon to seek its own level under the present environment.