Welcome to the American College of Surgeons Health Policy Research Institute Website
The American College of Surgeons Health Policy Research Institute is an organization which studies and reports on issues related to the state of the surgical profession, the surgical workforce, and surgical utilization in the United States. The Institute provides expert advice, data analysis, and original research for surgical professional associations and boards, policymakers, and the health services research community.
October 2011: Drs. George Sheldon, Anthony Charles, Karyn Stitzenberg and Thomas Ricketts presented on panels at the American College of Surgeons Clinical Congress in San Francisco. Dr. Sheldon moderated a panel on the Patient Protection and Affordable Care Act as well as presenting a paper on GME and health reform. Dr. Ricketts presented on "Secular Trends Trump Health Reform" on the panel that also included Dr. Donald Detmer and Dr. Andrew Warshaw. Drs. Stitzenberg and Charles were part of a panel on Surgery and Inequality, the theme of the overall meeting.
July 2011: Dr. Brad Wright and Dr. John Scarborough published, Characterizing and Fostering Charity Care in the Surgeon Workforce in the July 2011 issue of Annals of Surgery.
May 2011: Dr. Erin Fraher and colleagues published, Shaping Public Policy through Evidence-based Policy Analyses, from the May 2011 Bulletin of the American College of Surgeons. This article is being published jointly in the Bulletin of the American College of Surgeons and the Bulletin of The Royal College of Surgeons of England. With health reform underway in both countries, the issues confronting the surgical workforce in the US are strikingly similar to the challenges facing the surgical workforce in England. This article describes the American College of Surgeons (ACS) Health Policy Research Institute's (HPRI) role in collecting, analyzing and disseminating information about the surgical workforce in the U.S. and suggests that HPRI might serve as a model for the Royal College of Surgeons (RCS) of England to assist the UK government in workforce planning.
April 2011: Dr. Anthony Charles, Dr. George Sheldon, and Dr. Karyn Stitzenberg were three of the seven invited co-authors of the April 2011 edition of Current Problems in Surgery: The Surgery of Poverty. It was edited by Wiliams Schecter, MD, Professor of Clinical Surgery, University of California, San Francisco.
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Burn care: Are there sufficient providers and facilities? Approximately 450,000 burn injuries receive medical treatment each year, and roughly 3,500 people die in fire-related accidents each year. Burn center care, similar to medical services delivered at trauma centers, has been associated with improved survival, decreased hospital costs, and shorter lengths of hospital stay. This article briefly describes the number and distribution of burn centers in the U.S., and provides an explanation of the verification and referral process for burn centers. |
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The Geographic Distribution of General Surgeons: Comparisons across Time and Specialties Policymakers and researchers continue to debate whether there is an overall shortage of surgeons, a maldistribution, or both. The recurring question, "How many surgeons do we need?" has not been definitively answered. There are specific surgeon-to-population ratios that are considered benchmarks for this issue, but they offer little guidance on what constitutes a shortage. In this article, the Gini index—a tool for assessing the overall fairness of the distribution of surgeons—is presented, along with guidance for how it may be useful in monitoring geographic access to surgical services. |
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Developing an Index for Surgical Underservice Findings from this fact sheet highlight areas that may not have the resources to support surgery. Based on existing Hospital Services Areas, the fact sheet proposes a threshold for a critical shortage area for general surgeons (3.0 per 100,000 population) and maps the US Hospital Service Areas (HSAs) that have a critical shortage of general surgeons. The analysis in this fact sheet also shows that the current HSA definitions are not adequate for the development of a surgical Health Professional Shortage Area methodology. The ACS HPRI is redefining HSAs based on similar, but updated, data. |
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Independent Practice Becoming Increasingly Rare among Surgeons Findings presenting in this fact sheet show that the number of surgeons employed in group practice increased by more than 50% between 2001 and 2009. Anticipating the effects of health care reform on the surgical profession is difficult, however language in the Affordable Care Act (ACA) suggests that future payment changes may favor organizational structures resembling accountable care organizations (ACOs). |
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Mapping the Supply of Surgeons in the United States, 2009, is a static collection of national, regional, and state-level maps of the total and general surgeon workforce relative to population density. These maps provide the ratio of providers to population at the county-level for the purpose of assessing the geographic distribution of surgeons in the United States. Access and download individual maps here. |
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The Surgical Workforce in the United States: Profile and Recent Trends: This publication provides detailed descriptive statistics about active physicians and physicians in training in 12 major surgical specialties: colorectal surgery, dermatologic surgery, general surgery,neurosurgery, obstetrical and gynecological surgery, ophthalmologic surgery, orthopedic surgery,otolaryngological surgery, pediatric surgery, plastic surgery, thoracic surgery, urologic surgery. Data include comparisons of a given surgical specialty to other surgical specialties, as well as to all surgeons and all physicians. The purpose of this report is to provide health services researchers, policy makers, and the public with data to better understand surgical workforce trends and dynamics to inform their decision making. This project was developed under subcontract with the Association of American Medical Colleges. |
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Charity Care Among Surgeons Findings presented in this fact sheet show that surgeons provide more hours of charity care than other types of physicians and that some practice characteristics, such as ownership and size of practice, is associated with the provision of more charity care among surgeons. |
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The Aging Surgeon Population Findings presented in this fact sheet highlight the demographic characteristics of the surgical workforce. This fact sheet presents trends by surgical specialty, regions, and rural-urban county status.
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