Department of Surgery, The Ohio State University School of Medicine, Columbus, Ohio, USA.
J Thorac Cardiovasc Surg. 2010 Apr;139(4):835-40; discussion 840-1. doi: 10.1016/j.jtcvs.2009.12.004. Epub 2010 Feb 1.
To estimate the cardiovascular workforce needed by 2030 to meet the needs of our population and to quantify its costs. Our field is changing. The volume of surgery and the nature of the surgery are changing. The nation's population grew from 227,000,000 to 282,000,000 between 1980 and 2000, and by 2030 the population is estimated to be 364,000,000. At the same time, the applications for fellowship in our specialty are decreasing at an alarming rate. The American Board of Thoracic Surgery has certified 4500 cardiothoracic surgeons since 1975, but only 1300 in the last 10 years. The US Department of Health and Human Services predicts only 3620 full-time cardiothoracic surgeons in 2020. Will we have enough cardiovascular and thoracic surgeons?
Retrospective examination of the pertinent literature and with a modified Richard Cooper's economic trend analysis, a population algorithm with a ratio of physicians to population of 1.42 per 100,000. Each thoracic surgeon is predicted to practice 30 years from Board certification to retirement. The Balanced Budget Act will not be revised; therefore, we will certify 100 graduates from our programs per year. The assumed salaries will be 50,000 dollars with benefits of 30% and 15,000 dollars of additional Direct Medical Education costs.
The population in 2030 will be 364,000,000 with 5169 cardiothoracic surgeons needed at that time. Unfortunately, there will be approximately only 3200 cardiothoracic surgeons in practice with a shortage of approximately 2000. To maintain our current status per 100,000 population from 2011 to 2030, we will have to train 4000 residents. The total person years would be approximately 28,000. The cost for this is more than 2,000,000,000 dollars. The annual cost for this training prorated over 20 years would be more than 110,000,000 dollars.
We must train approximately 4000 surgeons, an extra 100 per year, in our specialty to meet the needs of the population by 2030. That will cost approximately 2,250,000,000 dollars. To do this, the Balanced Budget Act of 1997 must be revised to permit more residents to be trained in the United States.
估算到 2030 年满足人口需求所需的心血管劳动力数量，并量化其成本。我们的领域正在发生变化。手术量和手术性质正在发生变化。1980 年至 2000 年间，美国人口从 2.27 亿增长到 2.82 亿，到 2030 年，预计人口将达到 3.64 亿。与此同时，我们专业的研究员申请数量正以惊人的速度减少。自 1975 年以来，美国胸外科委员会认证了 4500 名心胸外科医生，但在过去 10 年中只有 1300 名。美国卫生与公众服务部预测，到 2020 年，全职心胸外科医生将只有 3620 名。我们是否会有足够的心血管和胸外科医生？
回顾相关文献，并采用理查德·库珀（Richard Cooper）经济趋势分析的改良方法，使用每 10 万人中有 1.42 名医生的人口算法。每位胸外科医生预计从委员会认证开始行医 30 年，直到退休。《平衡预算法案》（Balanced Budget Act）不会修订；因此，我们每年将从我们的项目中认证 100 名毕业生。假设工资为 50000 美元，福利为 30%，外加 15000 美元的直接医疗教育费用。
到 2030 年，人口将达到 3.64 亿，届时需要 5169 名心胸外科医生。不幸的是，届时实际从事该领域工作的心胸外科医生将只有大约 3200 名，短缺约 2000 名。为了维持我们目前每 10 万人中有 4000 名居民的现状，我们将不得不培训 4000 名住院医师。大约需要 28000 人年。这项培训的费用超过 20 亿美元。这项培训在 20 年内的年费用将超过 1.1 亿美元。
到 2030 年，我们必须在我们的专业领域培训大约 4000 名外科医生，每年增加 100 名，以满足人口需求。这将花费大约 22.5 亿美元。要做到这一点，必须修订 1997 年的《平衡预算法案》，允许在美国培训更多的住院医师。
