Powell Anathea C, McAneny David, Hirsch Erwin F
Department of Surgery, Boston University School of Medicine, One Boston Medical Center Place, Boston, MA 02118, USA.
Am J Surg. 2004 Jul;188(1):1-8. doi: 10.1016/j.amjsurg.2003.12.054.
During the past 25 years, there has been much debate about general surgical workforce supply and demand. In the late 1970s and early 1980s, concern was raised by the Study on Surgical Services for the United States and the Graduate Medical Education National Advisory Council that there would be a gross oversupply of total physicians and surgeons by the years 1990 and 2000.
In a 1990 report sponsored by the Council on Graduate Medical Education, reevaluation of the workforce data showed no surplus at that time and instead predicted a deficit of surgeons by 2010. Studies by other investigators in the mid-1990s supported these conclusions. Furthermore, a new workforce model published in 2002 predicted a significant overall deficit of physicians by 2020. The discrepancies in the projected and the actual data have been explained by a variety of factors including an aging population with increased surgical needs, an increasing number of outpatient surgical procedures, subspecialization within the field of general surgery, and decreasing interest in the field by United States medical students.
Although it is difficult to compare data among studies, and there are many confounding factors in the data, review of the workforce data does support a future deficit of surgeons, a prediction that warrants further investigation.
在过去25年里，关于普通外科劳动力的供需一直存在诸多争议。在20世纪70年代末和80年代初，美国外科服务研究以及研究生医学教育全国咨询委员会提出担忧，认为到1990年和2000年，内科医生和外科医生的总体供应将严重过剩。
在研究生医学教育委员会1990年赞助的一份报告中，对劳动力数据的重新评估显示当时不存在过剩情况，反而预测到2010年外科医生会短缺。20世纪90年代中期其他研究人员的研究支持了这些结论。此外，2002年发布的一个新的劳动力模型预测到2020年内科医生总体上将严重短缺。预计数据与实际数据之间的差异已由多种因素解释，包括人口老龄化导致手术需求增加、门诊手术数量增多、普通外科领域内的亚专业化以及美国医学生对该领域兴趣降低。
尽管很难在各项研究之间比较数据，而且数据中存在许多混杂因素，但对劳动力数据的审查确实支持未来外科医生短缺这一预测，这一预测值得进一步研究。
