Why American doctors don't want to be surgeons

Rising malpractice awards, strikes by surgeons in several states and the issue of malpractice insurance are some of the reasons why American doctors don't want to be surgeons, says Steven G. Friedman.

According to the U.S. National Resident Matching Programme:

  • The number of American medical students applying to general surgery residency programmes declined by 30 percent from 1992 to 2002.

  • If this trend continues, less than 5 percent of medical school graduates will choose a career in surgery by 2005, and only 75 percent of general surgery residency positions will be filled by graduates of medical schools in the United States.

    Money is also an issue. According to the American Association of Medical Colleges:

  • The debt incurred by most medical graduates has quadrupled to more than $100,000 since 1985.

  • Because residents get menial salaries, longer residencies like general surgery mean greater difficulty repaying student loans.

  • In addition, reimbursement for most surgical procedures has steadily decreased since 1992.

  • The prospect of declining reimbursements has caused residents to drop out of training programs in record numbers.

  • In some programmes the attrition rate is as high as 25 percent; and practising surgeons are retiring earlier than ever or undertaking new careers.

    The trend of doctors refusing to treat Medicare patients is just beginning, says Friedman, as reimbursement rates are squeezed more and more.

    Source: Steven G. Friedman, Anyone in the O.R.? New York Times, June 10, 2003.

    For text http://www.nytimes.com/2003/06/10/opinion/10FRIE.html
    For more on Quality of Care and Patient Protection http://www.ncpa.org/iss/hea/

    FMF Policy Bulletin/17 June 2003
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