Surgeons discuss health care shortages and disparities


Janis M. Orlowski, MD, MACP
Janis M. Orlowski, MD, MACP

“Based on current trends, the supply of surgeons is not projected to change substantially over the next 15 years and might decline as future attrition offsets or exceeds the number of newly trained surgeons,” said Janis M. Orlowski, MD, MACP, in her opening remarks for an October 25 session at Clinical Congress, Optimizing the National Surgical Workforce.

In her presentation, The Future of the U.S. Surgical Workforce, she said there continues to be a physician shortage across the U.S., and “the south and the west are the two areas where we need to have an increase in the number of surgeons.”

Dr. Orlowski, chief health care officer, Association of American Medical Colleges, offered five ways to increase the surgical workforce: diversify the workforce, increase graduate medical education (GME) slots, prevent burnout, improve the use of technology, and maximize team-based care delivery. “When we take a look at technology, it’s not just telehealth, but how do we use electronic consultation? How do we use hospitals at home? And how do we use artificial intelligence?” she said.

Paris D. Butler, MD, FACS
Paris D. Butler, MD, FACS

Paris D. Butler, MD, FACS, assistant professor, division of plastic surgery, and director of underrepresented in medicine affairs, GME office, University of Pennsylvania Health System, Philadelphia, focused his presentation, Ensuring a Diverse Workforce, on health care disparities in the U.S. “It is a growing consensus that in order to alleviate health care disparities in this country, it is going to require a multifaceted approach,” he said, noting that “every specialty under the surgical/medical umbrella has documented evidence of racial/ethnic disparities.”

Dr. Butler said he believes patients need to see providers of medical care who reflect their demographics, as it makes the patients much more comfortable. “I believe that we need to move health care disparities research to what I call ‘2.0,’ which is proposing interventions, not just describing that the disparities exist,” he said.

To help alleviate these disparities, he suggested the following changes: show a predilection to care for the uninsured and underinsured; increase minority-specific research efforts; serve as role models and mentors to aid in the pipeline efforts; and improve patient perceptions of their care.

When asked about the role that the American College Surgeons plays when it comes to mentorship, Dr. Butler said, “Our leadership is paying attention. They are putting their money where their mouth is.”

Amy B. Reed, MD
Amy B. Reed, MD

Amy B. Reed, MD, secretary, Society for Vascular Surgery; director of vascular services, M Health; professor and chief, vascular surgery, University of Minnesota, Minneapolis, said it was time for surgeons to think about new, innovative ways to care for patients. In her presentation, The Future of U.S. Vascular Surgery—A Case Study, Dr. Reed discussed ways to increase the vascular surgery workforce. “One of the ways to increase our workforce is to increase the numbers of diverse trainees going into our specialty. This starts early and involves reaching out—far out, back into high school even—to encourage the best and the brightest to consider medicine and surgery for their life’s passion.”

Figuring out what future surgeons want after they finish training is important, too. “With more and more graduates of training programs entering vascular surgery in the United States, we know that new graduates want to be in larger groups. Larger groups are what make up health systems in many parts of the United States. Larger groups are often able to support better lifestyles that we’re all desiring in surgical practice overall,” Dr. Reed said.

In the end, health systems need to provide the resources and tools in an innovative and efficient way to work, she said, noting, “This paradigm change will only come about with us as surgeons pushing this agenda.”

This and other Clinical Congress 2021 sessions are available to registered attendees for on-demand viewing for a full year following Congress on the virtual meeting platform.