McCarthy E G, Finkel M L
Med Care. 1980 Sep;18(9):883-92. doi: 10.1097/00005650-198009000-00002.
Data complied by The National Center for Health Statistics show that surgical utilization has increased dramatically, particularly during 1971-1977 (+34 per cent). Increases were greater among females than males, primarily because of an increase in gynecologic surgery. The 15-year-and-younger cohort was the only age group that did not show an increase, while surgical patients per 1,000 increased consistently with advancing age. Many factors probably have contributed to the increase in surgical utilization, yet the one factor which as been suggested more frequently than any other is surgical manpower (there may be too many doctors performing surgery for the needs of the population and this situation may lead to excessive surgery). This issue of how many physicians there should be in surgical training is widely disputed and politically volatile, however. The problems inherent in estimating future manpower requirements are many, making it hard to derive "optimal" distribution patterns.
美国国家卫生统计中心汇编的数据显示，手术利用率大幅上升，尤其是在1971年至1977年期间（增长了34%）。女性的增幅大于男性，主要原因是妇科手术的增加。15岁及以下的人群是唯一没有增长的年龄组，而每1000人中的手术患者数量随着年龄的增长持续增加。许多因素可能导致了手术利用率的上升，但被提及频率最高的一个因素是外科人力（可能从事手术的医生数量超过了人口需求，这种情况可能导致过度手术）。然而，关于外科培训中应该有多少医生的问题存在广泛争议，并且在政治上很敏感。估计未来人力需求存在许多固有问题，因此很难得出“最佳”的分配模式。
