Rural surgery: framing the issues.

Many rural residents have limited access to surgical care. Although this problem has been ongoing for the past few decades, several factors threaten to exacerbate the situation. The narrowing of general surgery practice, workforce shortages and inappropriate distribution of surgeons, changes in how surgeons are trained, and increasing health care costs contribute to the problem. Creative approaches to address these issues are needed to provide high-quality surgical services to the approximately 50 million Americans living in rural communities.