*RosmanSearch, Inc, Cleveland, Ohio; ‡Psychology Department, Cleveland State University, Cleveland, Ohio; §Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio; ¶Department of Neurosurgery, Goodman Campbell Brain and Spine & Indiana University, Indianapolis, Indiana; ‖Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.
Neurosurgery. 2013 Aug;73(2):354-5; discussion 365-6. doi: 10.1227/01.neu.0000430762.08458.49.
Neurosurgical workforce decision-making is typically driven by the 1 neurosurgeon per 100,000 population ratio proposed in 1977 in the Study on Surgical Services for the United States report. The actual ratio has always been higher than suggested.
We evaluated whether the 1:100,000 ratio from the Study on Surgical Services for the United States report is still valid, whether there are enough neurosurgeons in the United States to meet patient needs, and whether demand is driven by patient need.
For our analysis, the distribution of practicing US neurosurgeons was merged with census data to yield density indices of neurosurgeons by state; a survey assessing practice characteristics was e-mailed to practicing neurosurgeons; and a compilation of job advertisements for US neurosurgeons was evaluated.
Multivariant statistical analyses yielded inconclusive results regarding patient demand because existing data sets are not designed to establish patient demand and many neurosurgeons are subspecialized. The data indicated that the ratio of neurosurgeons to total US population is 1:65,580. In the survey responses, neurosurgeon-to-patient ratios varied dramatically by state and were inconsistently correlated with whether neurosurgeons indicated they were overworked or underworked. The 305 job advertisements may indicate a shortage. Twenty-four percent of advertising practices indicated that they are recruiting only for emergency department coverage, and an additional 26% indicated that they might not be recruiting if not for the need for emergency coverage.
Demand ratios should be reevaluated by region and subspecialty to consider changes in neurosurgery practice. A "shortage" in the employment market may reflect factors other than patient need.
神经外科学术劳动力决策通常由 1977 年《美国手术服务研究报告》中提出的每 10 万人口 1 名神经外科医生的比例驱动。实际比例一直高于建议比例。
我们评估《美国手术服务研究报告》中的 1:10 万比例是否仍然有效，美国是否有足够的神经外科医生来满足患者的需求，以及需求是否由患者的需求驱动。
在我们的分析中，将执业美国神经外科医生的分布与人口普查数据合并，得出各州神经外科医生的密度指数；向执业神经外科医生发送了一份评估实践特征的调查；并评估了美国神经外科医生的招聘广告汇编。
多元统计分析结果对患者需求没有得出明确的结论，因为现有的数据集不是为了确定患者需求而设计的，而且许多神经外科医生都有亚专业。数据表明，神经外科医生与美国总人口的比例为 1:65580。在调查回复中，神经外科医生与患者的比例因州而异，与神经外科医生表示工作过度或工作不足的情况不一致。305 个招聘广告可能表明存在短缺。24%的广告实践表示，他们只招聘急诊部门的医生，另外 26%的广告实践表示，如果不是因为需要急诊医生，他们可能不会招聘。
应根据地区和亚专业重新评估需求比例，以考虑神经外科学术实践的变化。就业市场的“短缺”可能反映了除患者需求以外的其他因素。
